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, SeniorJournal.com
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
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.
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
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
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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