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Medicare & Medicaid News

Senior Citizens on Medicare Greatly Affected by Obamacare but Not the Insurance Coverage

Answer to question by Social Security representative not exactly accurate saying people in Medicare ‘not affected by Affordable Care Act’

By Tucker Sutherland, editor,

Jan. 6, 2014 – In this week’s Social Security Q&A by Oscar Garcia, Public Affairs Specialist with the Social Security Administration may leave the wrong impression about the Affordable Care Act (Obamacare) and its impact on seniors and others covered by Medicare. He states, “People who have Medicare coverage are not affected by the Affordable Care Act.” He probably meant to explain they do not get health insurance through the program’s Health Insurance Market Place. This is true but many provisions of the health care program do greatly affect senior citizens in Medicare.

But to the question, “What is Medicare and is it changing because of the Affordable Care Act,” Garcia wrote the following first paragraph to this answer:

“It is important to note that people who have Medicare coverage are not affected by the Affordable Care Act. Medicare is not a part of the Affordable Care Act’s Health Insurance Marketplace. If you are a Medicare beneficiary, your Medicare benefits are not changing. You do not need to replace your Medicare coverage with Marketplace coverage.”

Garcia is correct that people covered by Medicare do not need to replace Medicare coverage with plans offered in Market place coverage. But he is badly mistaken to say people with Medicare are “not affected by the Affordable Care Act.

Clarification: Senior Citizens Greatly Affected by Affordable Care Act

Last month the Centers for Medicare & Medicaid Services announced that more than 25.4 million senior citizens and others covered by Original Medicare received at least one preventive service at no cost to them during the first eleven months of 2013, because of the Affordable Care Act.


Related Archive Stories


Are Seniors on Medicare Effected by Obamacare? Answer by Social Security May Be Misleading

This week’s Social Security Q&A gives good synopsis of Medicare health coverage but not of impact on senior citizens by Affordable Care Act - Jan. 6, 2014

Medicare, Other Health Care Spending Slowing but Cost Controls Must Be Implemented

New England Journal of Medicine study finds health spending rose just 0.8% per person in 2012, Affordable Care Act measures to control costs may be contributing to biggest slowdown in decades

Dec. 26, 2013

Medicare’s Accountable Care Organizations Continue Growth as Health Care Spending Slows

123 new ACOs join program; Congressional Budget Office estimates Medicare spending per beneficiary will grow at approximately the rate of growth of the economy for the next decade

Dec. 23, 2013

Free Preventive Services Draws Over 25 Million Seniors, Others in Original Medicare

CMS credits Affordable Care Act for accomplishment in first 11 months of 2013; 3.5 million received free Annual Wellness Visit

Dec. 17, 2013

What Senior Citizens Need to Know About Medicare in 2014

Families USA presents a Q&A on information seniors need to know about Medicare in 2014

Dec. 16, 2013


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Also, in the first eleven months of 2013, more than 3.5 million seniors and other beneficiaries with Original Medicare took advantage of the Annual Wellness Visit established by the health care law (Affordable Care Act, sometimes known as Obamacare).

Before the Affordable Care Act, Medicare recipients had to pay part of the cost for many preventive health services. These out-of-pocket costs made it difficult for many seniors to get the important preventive care they needed. Before the Affordable Care Act, a senior with Medicare could pay as much as $160 in cost-sharing for a colorectal cancer screening.

Today, this important screening and many others are covered at no cost to beneficiaries (with no deductible or co-pay). Obamacare helps tear down a significant barrier for some seniors to staying healthy and helps their care providers prevent, identify and treat problems early.

Obamacare Improving Financial Viability of Medicare

The growth of health care cost is slowing and at least a portion is due to actions stemming from Obamacare, according to an analysis, published last month in the New England Journal of Medicine. It also found that a broad, bipartisan consensus about strategies that will be effective in controlling costs has emerged.

There is no doubt that the Affordable Care Act provisions have had a substantial effect on reducing the growth rate of Medicare spending, according Health and Human Services. Growth in Medicare spending per beneficiary hit historic lows during the 2010-2012 period, and this trend has continued into 2013.

Projections by both the Office of the Actuary at CMS and the Congressional Budget Office estimate that Medicare spending per beneficiary will grow at approximately the rate of growth of the economy for the next decade, breaking a decades-old pattern of spending growth that outstripped U.S. economic growth.

Actions that preserve the future of Medicare to serve the needs of senior citizens certainly have a major effect on seniors today and in the future, and many of the provisions of the Affordable Care Act are aimed at achieving this goal.

One of the most effective has been the Accountable Care Organizations established by Obamacare.

Doctors, hospitals and health care providers establish ACOs to work together to provide better health care through closely coordinated services to their patients, while working to slow the growth of health care cost.

There are now more than 360 ACOs working with Medicare to provide higher-quality coordinated care to 5.3 million seniors and other beneficiaries, while reducing the cost of health care, according to an announcement in December by HHS.

Big Savings in Prescription Drug Coverage

The health care law also saved seniors $8.9 billion on their prescription drugs since the law’s enactment, according to a report by CMS in November.

Seniors with Medicare Part D (prescription drug coverage) will see a $15 drop in their deductible, from $325 in 2013 to $310 in 2014. And the “doughnut hole” (coverage gap for seniors with large prescription drug needs), which has been getting smaller each year since 2011 due to provisions in Obamacare, will continue to get smaller too. In 2014, the doughnut hole will be $158.75 smaller than it was in 2013, another step closer to the plan to eliminate this coverage gap by 2020.

And, these are just some of the provisions of the Affordable Care Act that are proving to be highly beneficial to the health care of senior citizens and the future of the Medicare program that were created by the health care law.


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