It’s been more than 30 years since the Americans with Disabilities Act (ADA) became law, but even with equal protections legally guaranteed, progress for disabled Texans has been mixed.
On the one hand, employment for disabled adults in the U.S. fell over the past three decades, leaving many at heightened risk of poverty. On the other, a program new in 1997, now known as Medicare Advantage, has helped expand their health care access.
The public generally associates Medicare with senior citizens, but the program also funds health care for over nine million disabled adults under age 65. Like other Medicare beneficiaries, disabled individuals who rely on Medicare can choose between traditional coverage and Medicare Advantage.
Medicare Advantage is attractive because it provides a comprehensive health plan, which pays for everything from doctors’ appointments and prescription drugs to emergency care and hospital stays. A variety of plans are available, including many that charge no monthly premium. In fact, 96 percent of Medicare Advantage members have access to a premium-free plan in their area.
Cost is an important factor, as the median income for Americans with disabilities barely reaches above $20,000 per year. Confronting both tight budgets and often complex health care needs is challenging.
Medicare Advantage helps by driving costs down. Most care is available for a small co-pay, health screenings and other preventive services carry no costs for members, and an annual out-of-pocket cap ensures enrollees are never forced to overspend. Removing financial deterrents to care helps increase patients’ utilization so they stay well.
In some cases, disabling conditions can also complicate efforts to obtain care. Developmental disabilities, mental illness, or vision impairment, for example, can make it more difficult to research providers, deal with coverage issues, or access transportation.
Medicare Advantage once again responds effectively. For example, patients have just one health care card. Whether they’re visiting a primary care physician or taking part in a free online fitness program, a single card opens the door. There’s no need to juggle confusing supplemental insurance or fill out extra forms.
Care coordination is another asset. Medicare Advantage plans employ specialists who can help patients schedule appointments and ensure that all aspects of a treatment regimen work in concert.
Moreover, Medicare Advantage plans cover an array of services traditional Medicare doesn’t, such as home modifications, home-delivered meals and some in-home caregiver support. The plans provide transportation to and from medical appointments and home delivery of essential supplies, including prescription drugs and groceries. Telehealth empowers members to consult with doctors by phone or videoconference, a feature that helps disabled people receive timely care regardless of reduced mobility or other barriers.
There are many factors that promote an inclusive society for people of varying abilities. Quality health care is an essential foundation, and our elected leaders should protect the programs delivering exceptional care to millions of older and disabled people. That means rejecting any proposals that would raise costs.
It also means advancing legislation aimed at enhancing equity. S. 150, the Ensuring Parity in MA for Audio-Only Telehealth Act, is a prime example. Many Medicare Advantage members—particularly rural and low-income Texans—lack high-speed internet access to support videoconferencing with their doctors. S. 150 would bring them further into the fold for convenient remote care.
With concerted effort by all members of our congressional delegation, Texans with disabilities can continue to enjoy affordable, accessible health care through Medicare Advantage. With that benefit solidified, leaders can then consider how best to increase employment for people with disabilities and invite disabled Americans to take greater part in all aspects of our communities.
Editor’s Note: The above guest column was penned by Dennis Borel, executive director of the Coalition of Texans with Disabilities. The column appears in The Rio Grande Guardian with the author’s permission. Borel can be reached at: [email protected].
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