Is Health Care Reform Really That Important to Occupational Therapy?
Yes! Health care reform is working on a fast track through Congress. Changes happen every day with new bills, new ways to finance, and new ideas to save money. But every part of health care reform will affect you as an occupational therapy practitioner! And AOTA is your voice and guide in this battle.
What could it mean? Every area of practice could be affected. No one is immune from potential consequences and benefits.
Although AOTA has not taken a position on any of the bills or proposals currently under discussion, your Association and you working together can prevent any negative changes and promote positive changes which benefit occupational therapy and consumers in health care reform.
For example, AOTA is working to prevent significant cuts to Medicare and Medicaid, to assure coverage of occupational therapy in any new plans and promote better uses of occupational therapy to achieve health for the American public.
Here are some examples of how YOU could be affected in your practice area:
Productive Aging: Cuts are being proposed to “bend the curve” of Medicare spending downward to save money to put toward health care for the uninsured. This could mean significant cuts to nursing home and rehabilitation. But Congress is also discussing expansions for Medicare, including the allowance for occupational therapy to be the first service in certain home health cases.
Children and Youth: Whatever happens to Medicaid will affect school-based practice and early intervention. Children on Medicaid now are eligible for their school-based services and early intervention services, like occupational therapy, to be reimbursed. This is a boon to school districts and a right of the children on Medicaid. Discussions have also concerned what to do with the Children’s Health Insurance Program, which also has good coverage generally for occupational therapy. Changes could really harm the availability of services in schools and elsewhere.
Mental Health: While mental health parity passed last year provided a significant boost to availability of mental health services under health insurance, the bills under discussion generally specify and reinforce that mental health services must be included in any new health care reform system. Non-discrimination against individuals with conditions, including mental health and substance abuse problems, is outlawed in many proposals.
Health and Wellness: Services to promote healthy living, to promote better management of chronic diseases, and generally to prevent the need for expensive care creates opportunities for occupational therapy practitioners to contribute, particularly in participation in care coordination for those with common. A recent House bill included a specific category of benefits for prevention if they are recommended by the U.S. Task Force on Preventive Benefits.
Work and Industry: Tied with wellness, there is a move in the Senate to include a provision that would allow employers to get tax credits for certain workplace activities that promote wellness. This might open opportunities for ergonomic and other programs. None of the current bills make changes to workers’ compensation, which is a state program, but spending on this is part of the overall growth that is of concern.
Rehabilitation, Disability and Participation: While most of the bills do not specify what services will be covered and what limits might be placed on coverage, several bills do require that any insurance products include rehabilitation and sometimes habilitation services. Also covered are professional services. One bill on the Senate side also includes a new program for paying for and funding community services for people with disabilities. Of course any cuts to Medicaid would have a negative effect on community supports, including occupational therapy that is provided to elderly individuals and people with disabilities.
Overall, no part of the profession is immune from health care reform. Research funding will follow the direction of health care reform. Community services in many cases will be affected by changes in Medicaid or other cuts. Private insurance coverage may be restructured if only a certain amount of insurance coverage will be tax-free. (Some proposals say that high-cost, Cadillac health care plans provided by insurers should be taxed if they go beyond a certain average amount.) School-based services will be impacted by Medicaid and other changes.