Biden Says ‘Long COVID’ Could Qualify As A Disability Under Federal Law

U.S. President Joe Biden signs a proclamation on the anniversary of the Americans with Disabilities Act (ADA), as (L-R) artist Tyree Brown, Sen. Pat Leahy (D-VT), former Rep. Tony Coelho (D-CA), House Majority Leader Steny Hoyer (D-MD), U.S. Vice Presiden

Source: NBC News, by Lauren Egan

President Joe Biden announced Monday that serious long-term Covid-19 cases could qualify as a disability, making federal protections and resources available to those suffering from the disease.

Speaking at an event at the White House celebrating the 31st anniversary of the Americans with Disabilities Act, he said that lingering Covid symptoms, such as fatigue or brain fog, “can sometimes rise to the level of a disability.”

“We’re bringing agencies together to make sure Americans with long Covid who have a disability have access to the rights and resources that are due under the disability law, which includes accommodations and services in the workplace and school, and our health care system so they can live their lives in dignity,” Biden said.

The departments of Health and Human Services, Justice, Education and Labor released guidelines to help individuals experiencing effects of long-term Covid navigate federal benefits.

The guidance makes clear, however, that the so-called long Covid does not automatically qualify as a disability. The HHS guidance says that an “individualized assessment is necessary to determine whether a person’s long Covid condition or any of its symptoms substantially limits a major life activity.”

The guidance says people with long Covid could qualify for “reasonable modifications” at work or in schools, as well as community-based resources that help with medical care and housing.

While most people who have been infected with Covid recover within weeks, some suffer from lingering symptoms. The long-term effects are wide-ranging, including such problems as joint pain, fevers, fatigue, double vision and even hair loss.

Little medical treatment exists for long-haul Covid patients. The World Health Organization and the Centers for Disease Control and Prevention have said they are working to better understand the recovery phase of the illness.

Harris Unveils Disability Plan Focusing On Education and Employment Opportunities

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Source: CNN

Presidential candidate Sen. Kamala Harris unveiled her plan for Americans with disabilities on Thursday, with a focus on employment through access to education and social programs.

“As President, Harris will expand access to health care, fight for integrated employment opportunities and fair wages, ensure our emergency preparedness and disaster programs are fully inclusive, fight to adequately fund classrooms to ensure equal access, build a diverse federal workforce that includes people with disabilities and fight for the civil rights of people with disabilities across the country,” Harris campaign wrote in a press release.

The plan comes on the heels of a drop in the polls for Harris, with CNN’s latest national poll showing her tied for fourth at 5% — after clocking in at second place with 17% in a June CNN survey. The proposal highlights different laws and agency programs seeking to expand access and employment opportunities, making Harris the only candidate with a plan focused exclusively on people with disabilities, according to her campaign.

On the legislative side, Harris ensured the passage of the Transformation to Competitive Employment Act, which creates a state grant program incentivizing ways for businesses to hire and integrate more employees with disabilities. Citing statistics that people with disabilities are more likely to earn low and less-than-minimum wages, she also promised to pass a bill raising the minimum wage to $15 an hour.

At the Department of Education, Harris would increase funding for and expand the agency’s vocational rehabilitation system to cover more people and services in accessing workplace accommodations and adaptive technology.

At the Department of Transportation and Department of Housing and Urban Development, the California Democrat would expand accessible transportation and housing projects and require plans demonstrating full accessibility for projects seeking federal funding, pointing to projects seemingly compliant with the Americans with Disabilities Act that failed to address accessibility during early planning.

In the White House, Harris promised to establish senior positions to include the perspectives of people with disabilities in policy decisions, specifically domestic and economic initiatives.

She would also implement government-wide accessibility initiatives. Citing former President Barack Obama’s efforts to make the federal government an inclusive employer, Harris promised efforts across all agencies to prioritize disability-inclusive recruitment strategies, diverse leadership, full accessibility requirements for new federal technology and timelines for updating existing technologies.

The plan included a variety of other targeted initiatives, ranging from ratifying US participation in the United Nations’ Convention on the Rights of Persons with Disabilities to backing the IDEA Full Funding Act, which ensures education funding for students with disabilities. She would also ensure disaster services and protections so that people with disabilities affected by disasters can return to normal life at the same time as everyone else.

Harris’ plan also referenced general policies that she said would help people with disabilities, such as making the Child Tax Credit fully refundable and passing her “Medicare for All” plan, which would cover screenings and treatments for children with disabilities.

Why Proposition 8 Is One of the Most Contentious, and Confusing, Ballot Measures in Play

Rich Pedroncelli / AP Photo

Source: Capital Public Radio

Roughly 140,000 Californians spend the equivalent of a part-time job — 12 to 20 hours a week — in a dialysis clinic, where a machine functioning as a kidney filters waste out of their blood.

It’s a tricky procedure — and right now it’s at the center of a heated political battle between labor unions and dialysis companies.

Californians will vote in November on Proposition 8, which would regulate dialysis clinic spending. It’s a move that could either improve patient conditions or degrade them, depending on who you ask.

So far, it’s the most expensive proposition on the ballot, with supporters putting in $20 million and opponents fighting back with $99 million as of October 11.

The measure would cap what clinics can spend on overhead and administrative costs, versus actual care.

One of the largest health care labor groups on the West Coast — Service Employees International Union – United Healthcare Workers West — put it on the ballot. Their members say clinic owners are overcharging for low-quality care, and that Prop. 8 will force dialysis companies to spend more on patients, including hiring additional staff.

The opposition campaign, backed by two of the state’s largest dialysis companies, argues that spending limitations could make it harder for clinics to stay afloat.

Los Angeles resident Tangi Foster, who’s working with the “Yes on 8” campaign, said she’s visited multiple dialysis clinics over the last decade and that employees seem overwhelmed and exhausted. She says this makes her feel unsafe.

“These people have to save our lives,” she said. “ I don’t think it’s fair to them, nor is it fair to us as patients, for them to carry this kind of workload.”

Opponents of the measure argue it is a power-play by labor groups trying to unionize dialysis workers.

They also worry that, if the measure passes, funding for certain positions would be in jeopardy. That’s because it would create two categories for dialysis company spending: “allowable” and “other” costs. Anything that goes over the limit in the other category would have to be paid back to insurance companies.

“These things are going to result in the closure of clinics, and they are going to result in less access for patients,” said Dr. Luis Alvarez, a practicing physician and board member for a dialysis clinic group called Satellite Healthcare. “To me, that is really a terrible, terrible thing.”

The allowable category would include “non-managerial” staff that provide direct care to dialysis patients. Opponents say jobs that are key to delivering patient care, such as medical director or nurse manager, could be excluded and face a funding cut.

Prop. 8 would also require clinic operators to report spending to the state, and forbid them from turning away patients based on their insurance payer.

The California Department of Public Health received 577 complaints about dialysis clinics and found 370 deficiencies during a two-and-a-half-year period between 2014 and 2017 — roughly 18 complaints and 12 deficiencies per month, according to an analysis by nonprofit journalism site CalMatters.

Those included complaints that patients’ vital signs weren’t checked by staff every 30 minutes, as required by law, and that translation services were not provided to non-English-speaking patients.

One grievance accused staff members of failing to check the connection between a patient and machine, even though blood was inappropriately oozing from the patient’s medical port, according to the CalMatters story.

DaVita, one of two major dialysis companies in California, has faced multiple lawsuits in recent years from the families of patients who died at their clinics.

If the measure passes, the decision on how clinics can spend their budgets will fall to the state and to the courts. The nonpartisan Legislative Analyst’s Office said in its assessment that the measure’s vague language makes its fiscal impact difficult to determine.

“If the measure is ultimately interpreted to have a narrower, more restrictive definition of allowable costs, the amount of rebates chronic dialysis clinic owners and operators are required to pay would be greater,” the office wrote in the California voter guide.

The office said clinic groups might need to “scale back operations in the state.”

Ken Jacobs at the UC Berkeley Center for Labor Research and Education pointed out that just two dialysis companies control 70 percent of all clinics in California. And because very few laws require them to be transparent about their costs, prices will just continue to climb.

“I think we’re going to see a lot more attention on these issues in the future,” he said. “The ballot initiative specifically addresses [market consolidation] in a particularly profitable industry in terms of the dialysis centers. But the issues its raising are issues that go well beyond this particular case.”

Opponents feel the measure is too drastic and doesn’t belong on the ballot. Supporters have tried legislation before — bills to require staffing ratios in dialysis clinics and impose a revenue cap on clinic operators failed in prior legislative sessions.

Still, much of the Prop. 8 debate brings into question whether the voters should be the ones to decide how to fix these problems.

Court Rejects Regulation on Dialysis

Advocates for dialysis patients, including Dialysis Patient Citizens, are welcoming a federal court ruling in Texas that granted a preliminary injunction preventing the U.S. Department of Health and Human Services from implementing a regulation that could force patients off their current health insurance and jeopardize their access to care.

In enjoining the regulation’s enforcement, the U.S. District Court for the Eastern District of Texas held that the rule was first procedurally defective because HHS adopted it without first giving the public notice of it and seeking comment on it, and second “arbitrary and capricious” because HHS failed to consider the benefits of private coverage and ignored the disadvantages of adopting the rule.

The court concluded that the regulation cannot be implemented because HHS “failed to consider the benefits of private qualified health plans and ignored the disadvantages of the Rule,” including that “the rule would leave thousands of Medicare-ineligible dialysis patients without health insurance.”

The court went beyond invalidating the rule on procedural grounds and questioned the policy itself.

“Congress has long recognized the importance of dialysis treatment for end-stage renal disease patients and has afforded patients the opportunity to elect coverage that best serves their needs,” the opinion stated. The court added that, “For decades, dialysis patients have had the choice of selecting private insurance options over Medicare if those options better served their treatment needs. Private insurance is particularly attractive to dialysis patients with families because Medicare does not provide coverage for spouses and dependents.”

AHIP-commissioned study: Half of us will need LTC

People have a 50% chance of needing long-term care at some point, yet many underestimate the likelihood of needing such care, according to a new LifePlans study commissioned by AHIP, but insurance can provide protection. The study also found that of those who do need LTC, 30% will need the care for five years or more, and 3 in 5 people surveyed underestimate how much care in a skilled nursing facility costs in their community. AHIP blog (1/10)

California Has the Most LTCi Policyholders

In California, more than 600,000 are covered under a traditional long-term care insurance policy, according to the American Association for Long-Term Care Insurance. “This is certainly due to the size of California as well as the fact that the state has been very active in making residents aware of the importance of planning. While the California Partnership program has little relevance to consumers today, in former years it was valuable protection that I strongly advocated and which was actively marketed by insurance professionals,”   explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance (AALTCI). Roughly seven million Americans have traditional long-term care insurance protection and another million have coverage under a linked-benefit or alternative product.

“A significant number of the inbound phone calls we handle and the online request for information come from Californians. Admittedly, there are fewer specialists today than there were a few short years ago, but there are still good avenues available for those who want to get information and compare their choices and options,” he said. For more information, visit or call 818-597-3227.

Integrated Health Care Is the Best Approach to Fighting Diabetes

by Collette Manning
A growing trend in population health management aims to address treating a patient’s whole body, rather than individual parts. Integrated health care connects dental, vision, and disability data through a patient’s insurance carrier, which promotes early detection and improved management of chronic conditions. Integrated health care programs help improve patients’ health by coordinating medical and specialty care, making every patient-provider interaction more meaningful with richer information.

These programs not only help improve patient outcomes but can also reduce medical costs. For example, retinal scans can often lead to early diagnosis of diabetes since eye care providers can detect early signs of the disease in the eye. With an integrated health plan, vision patients, who are showing signs of early diabetes, trigger a referral to the care management team that helps them get the best care possible.

This approach can also help people with diabetes manage their condition through regular checkups and reminders. Regular vision check-ups are critical since diabetes is the leading cause of adult-onset blindness. With this approach, there is a free flow of data between a patient’s diabetes care provider and their vision specialist, so the specialist can monitor the patient’s eyesight even more closely for signs of deterioration.

Integrated care helps manage diabetes by managing disease in other areas of the body. Diabetics face an increased risk of periodontal disease. Inflammation in the mouth can make it harder to manage blood sugar, leading to a cycle of patient health concerns and potential escalating cost. According to the CDC, diabetics who treat their periodontal disease through increased care have 39% fewer hospital admissions and 40% lower medical costs. With an Integrated health care program, patients with diabetes who have medical and dental coverage get enrolled automatically into a care-management program with enhanced dental services. They are notified of coverage for an added cleaning—three, instead of the usual two per year.

Diabetes cases are expected to increase. Prevention, early detection, and management of the disease will be essential to ensuring the best outcomes for patients while mitigating the cost burden. Integrated health care programs, are the future of better care and can achieve this goal. Diabetes cannot be treated in a vacuum, and health care plans should seek to mimic the body’s inter-connectivity.

Collette Manning, RN, CCM, ONC is the Clinical Integration Strategy and Planning Director for Specialty Businesses at Anthem Blue Cross where she works with a team to identify and implement opportunities designed to deliver a fully integrated healthcare experience among health, vision, dental, disability, life and voluntary products for Anthem Blue Cross members. Collette has more than 30 years of Care Management experience in the provider and insurance setting. Anthem’s integrated care program is called the “Anthem Whole Health Connection.”

Consumers Face Steep Rate Increases for federal LTC Policies

Many federal employees face rate increases of up to 126% under the federal long-term care insurance program. Rate increases take effect November 1st. Despite premium increases, enrollment continues to grow. The Office of Personnel Management blames the rate increases on longer life expectancies, higher-than-anticipated claims, and the lower returns on the trust fund’s investments.

Jesse Slome, director of the American Association for Long-Term Care Insurance recommends investigating private market options before the September 30 deadline to make a change. “Options are available to help reduce the impact of the premium increase, but one shouldn’t wait until the last minute to explore alternatives. If you are switching, make sure you’ve been approved before dropping any existing coverage.” George Mellendorf, president of LTC Solutions said that some private options offer excellent coverage — some with no risk of future rate increases. Not all enrollees in the federal long-term care insurance plan face rate increases. Rates are increasing for long-term care insurance purchased by federal and Postal Service employees as well as active and retired members of the military and qualified families. For more information, visit

Not all enrollees in the federal long-term care insurance plan face rate increases. Rates are increasing for long-term care insurance purchased by federal and Postal Service employees as well as active and retired members of the military and qualified families. For more information, visit

Obesity Is Driving Disability Claims

Disability claims have increased significantly over the past 10 years for joint disorders and musculoskeletal issues in the U.S., according to data from Unum. Greg Breter, senior vice president of benefits at Unum noted that aging Baby Boomers are staying in the workforce longer, and more than a third of U.S. adults are classified as overweight or obese. “Almost everyone over 55 begins to feel the twinges in joints and backs. But research is showing that obesity is contributing to a dramatic increase in knee replacement surgery and exacerbates other conditions like arthritis, back injuries and joint pain. We also see obesity contributing to other issues, like heart disease, stroke, type 2 diabetes, sleep apnea and respiratory problems, and certain types of cancer.” Aging and obesity tip scales in Unum’s 10-year review of disability claims. For musculoskeletal issues, there has been a 33% increase in long term disability claims and a 14% increase in short term disability claims. There has been a 22% increase in long term disability claims and 26% increase in short term disability claims for joint disorders. While Unum has seen an increase in joint and musculoskeletal issues, cancer has stayed the number one reason for long term disability claims over the past decade, and pregnancy continues to top the list of reasons for short-term disability.

Here are the top long-term disability causes for 2015:

  • Cancer 16.5%
  • Back disorders 13.9%
  • Injury 10.4%
  • Cardiovascular 9.6%
  • Joint disorders 9.2%

Here are the top short-term disability causes:

  • Pregnancy 27.4%
  • Injury (excluding the back) 11.3%
  • Joint disorders 2%
  • Back disorders 7%
  • Digestive system 6.6%

Americans Greatly Underestimate the Cost of Homecare

The average American underestimates the cost of in-home care by almost 50%, according to a Genworth study. Thirty percent say that home care costs less than $417 a month when the national median rate is $3,861 a month for an in-home aide or $3,813 a month for homemaker care. Homemaker costs are up 2.6% from 2015, marking the highest year-over-year increase across all care categories. In comparison, home care aide services rose modestly at 1.25% since 2015. Over the past five years, home maker costs have risen 11% and 6.6% for health aides.

Interestingly, people who stand to be affected most by long term care events are more likely to underestimate the cost of care. This includes women (who are more likely to enter caregiving roles), single adults (who may not have a partner to rely on for caregiving needs), and younger adults (aged 25 to 45), who are more likely to deal with the reality of a parent needing care).

The national median cost of care rose across all care settings, except adult day care, which decreased slightly. The monthly cost of a private nursing home room is $7,698, up 1.24% from 2015. The cost of a semi-private room is up 2.27% to $6,844 a month. Assisted living communities saw a slight increase in costs of .8% to $3,628 a month. Adult day care costs fell 1.25%.

Last Updated 12/01/2021

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