NAHC: Healthcare Reform Needs a Larger Focus on Long-Term Care

The United States’ healthcare system needs fixing, which is exactly what the Affordable Care Act seeks to do, but the reform itself needs improvement and a larger focus on long-term care, says the National Association of Home & Hospice Care (NAHC). 

“There were a lot of provisions thrown in, in an effort to get something passed,” says Val Halamandaris, president of the NAHC. “It’s light on the subject of long-term care. How can you ignore this with 78 million baby boomers getting ready for retirement years?” 

What’s needed is more help and assistance for people to remain independent, he says. Right now, there’s somewhat of a dichotomy in terms of what the government will pay for through Medicare and Medicaid: home health care, or institutional care.


“If we try to pay for it all, we cannot physically afford it,” Halamandaris says. 

To him, the most important part of the Supreme Court ruling on the constitutionality of the Affordable Care Act was that the Medicaid provisions were sustained, because “they do [go] a little bit in the direction of beginning to shift the basis from institutional care to home- and community-based care.” 

That’s the only way he knows of to meet the needs that people are going to have, he says, adding that there must be increased access to home care services. 


“That was pretty well neglected and needs to be addressed,” says Halamandaris regarding the healthcare reform law. “We think the states are going to need more time [to implement the new rules and provisions]. 2014 is a date many are not able to meet, [as] many have been waiting to see [what the Supreme Court ruling would be].” 

But if there continues to be cuts to the Medicare program, that might not happen. “People are always looking to make additional cuts to Medicare,” he says. “Home health care [funding] was cut disproportionately.” 

The administration should wait for a couple years, he thinks, which would “save a lot of money instead of another rush to cut Medicare and Medicaid.”

Written by Alyssa Gerace