Laura Katz Olson

Aging is a woman's problem: Issues faced by the female elderly population

Abstract Demographic trends indicate that the number and percentage of single, older females have been increasing dramatically each year, particularly in the upper age groups. Consequently, there is a growing economically and socially deprived older population. Women, who have greater health care problems, face government cost containment measures that have both undermined access to quality medical care and engendered greater home care needs. At the same time, the paucity of appropriate home health services, along with public programs that encourage institutional care, force many single, elderly women into nursing homes. While costs and profits of such institutions have increased significantly, fraud and patient abuse continue unabated. It is evident that aging is a womens problem and that its sources are the social systemic problems of deprived, or soon to be deprived, younger women.

Handbook of long-term care administration and policy

SETTING THE STAGE History, Concepts and Overview, C.M. Mara Public Perceptions of Long-Term Care, L.K. Olson Looking for Care in All the Wrong Places: A Narrative Approach to Understanding System Failure, D. Stone Medicalization of Long-Term Care: Weighing the Risks, C.M. Grogan PROVIDING AND RECEIVING CARE Older Long-Term Care Recipients, M.E. McCutcheon and W.J. McAuley Younger Individuals with Disabilities: Compatibility of Long-Term Care and Independent Living, A.W. Blaser Informal Caregivers and Caregiving: Living at Home with Personal Care, S.M. Keigher Trends and Challenges in Building a 21st Century Long-Term Care Workforce, E.A. Miller and V. Mor The Role and Responsibilities of the Medical Director and Attending Physician in Long-Term Care Facilities, D. Swagerty FOCUSING ON SERVICES Long-Term Care Services, Care Coordination and the Continuum of Care, M.E. McCutcheon and W.J. McAuley Legal Issues Related to Long-Term Care: Elder Law, Estate Planning and Asset Protection, J.L. Brown Long-Term Care Housing Trends Past and Present, S.M. Chance ADMINISTERING CARE Long-Term Care Governance and Administration, S.E. Proctor Improving the Quality of Long-Term Care with Better Information, V. Mor Long-Term Care Housing Types and Design, S.M. Chance POLICYMAKING AND FINANCING The Politics of Long-Term Care, W. Weissert Geriatric Mental Health Policy: Impact on Service Delivery and Directions for Effecting Change, B.E. Karlin and M. Duffy Private Financing for Long-Term Care, G.H. Smith and W.P. Brandon Public Financing for Long-Term Care, S.A. Stemkowski and W.P. Brandon LOOKING AHEAD Focal Points of Change, C.M. Mara

The ACA Medicaid Expansion Waiver in the Keystone State: Do the Medically Uninsured “Got a Friend in Pennsylvania”?

Medicaid is fundamental to near universal health insurance coverage under the 2010 Affordable Care Act (ACA). Its goal of broadening the program to all households with income at or below 138 percent of the federal poverty level was thwarted in 2012 by a Supreme Court decision that allowed the states to choose whether or not they would join. This essay seeks to assess the status of Pennsylvania with regard to the Medicaid expansion controversy. It briefly describes the Keystone States existing Medicaid program and the potential impact of the ACA on its growth. It then discusses Governor Tom Corbetts market-based alternative and what he achieved in his deliberations with the Obama administration. The article also discusses some of the financial considerations facing Pennsylvania policy makers in the expansion decision, the role of three of the more influential lobby groups, and the problematic situation of the medically uninsured population.

Medicaid, the States and Health Care Reform

Health care reform in the US is relying extensively on Medicaid for achieving universal health coverage. This article addresses the question of whether Medicaid is an appropriate foundation for reducing the ranks of the uninsured, given its dependence on economic conditions and the vulnerability of state budgets, along with the ever-changing preferences of governors and legislators. This article assesses the effects of the ebb and flow of Medicaid policy-making on at‐risk populations and what this implies for the Affordable Care Act. By establishing a nationwide income floor at 133% of the Federal Poverty Level, the legislation eliminates eligibility inequities across the states. However, it is argued that when state budgets are strained, as they undoubtedly will be when the reform bill is fully implemented, local officials will downsize benefit packages, raise co-payments, mandate more managed care, and reduce provider payments, negatively affecting the availability, scope, and quality of services.

The Affordable Care Act and the Politics of the Medicaid Expansion

The Patient Protection and Affordable Care Act (ACA) seeks near-universal health insurance coverage in the USA. Medicaid is central to this expansion: half of the newly enrolled population was initially scheduled to participate in the program by extending eligibility to all households with income at or below 138 percent of the Federal Poverty Level. However, in 2012 the Supreme Court ruled that states had a choice of whether to adopt the expansion. Currently, 23 states have opted out, undermining the ACA significantly. This article assesses how partisanship, in the overall context of the neoliberal agenda, has affected US state governments in making the decision as to whether they will participate in this key component of President Obamas reform bill. It contends that Democrats and Republicans have separate but interrelated visions for the neoliberal state. The article also discusses how a number of reluctant states are attempting to take advantage of federal expansion money by proposing market-based alternatives. Finally, it addresses the various vested interests affected by the Medicaid expansion decision.

TennCare, One State's Experiment with Medicaid Expansion

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