Nov. 14, 2014 – Editor’s Note: Unfortunately, the
“open enrollment” period for Obamacare – the Affordable Care Act,
national health insurance program for most of those not eligible for
Medicare – has been scheduled by Health and Human Services to overlap
the Medicare open enrollment.
Changes to Medicare advantage and the so-called Medicare prescription
drug “doughnut hole” are taking center stage for senior citizens. Kaiser
Health News’ Mary Agnes Carey and Julie Rovner discuss key points in
this video, with the text below.
MARY AGNES CAREY: Welcome
to Enrollment Encore. What you need to know before open enrollment and
the health law’s marketplaces begins again on November 15. I’m Mary
Agnes Carey. Kaiser Health News senior correspondent Julie Rovner now
joins me to talk about the health law and Medicare. Julie, what are the
key issues for Medicare beneficiaries when it comes to the Affordable
JULIE ROVNER: Well,
there are not really very many issues from the ACA that directly affect
people on Medicare. In fact, people on Medicare are not allowed to be in
the exchanges. It’s just sort of a coincidence that the Medicare open
enrollment period is going to coincide at least partly with the ACA open
enrollment period. Medicare open enrollment started in the middle of
October and ends December 7.
MARY AGNES CAREY: And
we’ve heard a lot about changes in payments to these private health
insurance plans and Medicare and now there’s Medicare Advantage. What
has been the impact of those changes in the number of plans offered and
also for beneficiaries?
JULIE ROVNER: That’s
right. One of the ways the Affordable Care Act is paid for is by cutting
some of the payments to the Medicare Advantage plans because they were
being overpaid by about 14 percent. Now the last time Congress tried to
cut payments to Medicare Advantage plans in the late 1990s, a lot of the
plans left the market, a lot of seniors were left without any options.
That’s not been the case this time. The cuts are being phased in more
slowly. There are slightly fewer plans, but not that many fewer, and
actually enrollment is way up in Medicare Advantage plans. It’s up 41
percent since the ACA passed in 2010.
MARY AGNES CAREY: There
is also some changes in what they call the donut hole, this gap in
coverage. That’s shrinking and also some higher income beneficiaries and
may pay more for their coverage. Can you tell me about that?
JULIE ROVNER: That’s
rights. Some of the smaller changes the ACA made to Medicare: There are
new preventative benefits for seniors. As you mentioned, the donut hole,
which was a big issue, this is when seniors are still paying for their
Medicare Part D coverage, their prescription drug coverage, and not
getting any benefit from it. That’s no longer the case.
That donut hole is slowly being closed. By 2020 it will be basically all
the way gone. And of course, for higher income Medicare beneficiaries,
those who make more than $85,000 as a single or couples that make more
than $170,000, they do pay a couple of additional taxes. Really, they
are supplemental premiums they were already paying for Part B and now
they’re going to pay them for Part D, for their prescription drug
coverage as well.
MARY AGNES CAREY: Thank
you Julie Rovner with Kaiser Health News.
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