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Get the Facts: Health Reform and Medicare
February 25, 2010 • Volume 10, Issue 8
President Obama’s health reform plan builds on the health care bill passed in the Senate late last year (The Patient Protection and Affordable Care Act). This issue describes how the Obama plan, and the provisions of the Senate bill it incorporates, would impact people with Medicare.
Health Reform Improves Medicare Drug Coverage
The Obama plan will eliminate the coverage gap or “doughnut hole” in prescription drug coverage by phasing it out by 2020. This will reduce the number of older adults and people with disabilities who skip doses or split pills while they are in the doughnut hole and must pay the full price of drugs. The bill provides immediate assistance by providing a 50 percent discount on drugs purchased during the coverage gap. Each year the share of costs paid by consumers in the coverage gap will decrease until it reaches 25 percent—the share people pay before they hit the gap—in 2020.
Health Reform Strengthens Medicare’s Financial Outlook
The Obama plan adds nine years to the life of Medicare’s Hospital Insurance Trust Fund, which is now predicted to run short of money to pay claims in 2017. The bill strengthens Medicare’s finances, primarily by reducing the annual increases in payments to hospitals, nursing homes and home health agencies, and by bringing subsidies to Medicare private health plans in line with costs under Original Medicare. These payment reforms are based on recommendations from the nonpartisan Medicare Payment Advisory Commission. The bill helps shore up the trust fund by increasing the Medicare pay roll tax for upper-income Americans.
There are no cuts to Medicare benefits in the Obama plan. The government will not come between you and your doctor as you make health care decisions together, and nothing in the Obama plan rations care or prevents Medicare from covering treatment for a terminal illness.
Health Reform Makes Medicare More Affordable
The Obama plan eliminates copays and deductibles for preventive services and provides 100 percent Medicare coverage for an annual check-up..
The Obama plan prohibits Medicare private health plans from charging more than Original Medicare for services, like chemotherapy, that people with serious illnesses need.
Health Reform Improves Quality of Care in Medicare
The Obama plan will reduce the number of patients who return to the hospital because the facility did not provide an appropriate plan of care before discharge. The bill makes hospitals financially responsible for ensuring people with Medicare receive appropriate care after discharge.
The Obama plan provides Medicare bonuses to primary care doctors and additional payments to doctors who join Accountable Care Organizations that will coordinate care by different specialists and improve the health of their patients.
“The White House proposal . . . maps a way to passage and enactment of comprehensive health reform legislation that will improve coverage for people with Medicare. . . . The proposal would fully close the coverage gap in the Medicare drug benefit by 2020. [It] also incorporates Medicare improvements in the Senate-passed health bill that would provide Medicare coverage for an annual check-up, eliminate copayments for valuable preventive services, and improve access to primary care doctors and coordination of care received from specialists.” (Statement by Medicare Rights Center President Joe Baker, February 2010)
Learn More About Health Reform and Medicare
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Medicare Part D Appeals Help for Advocates Is Here!
Medicare Rights Center’s new Medicare Part D Appeals: An advocate’s manual to navigating the Medicare private drug plan appeals process offers an easy-to-understand, comprehensive overview of the entire appeals process, including real-life case examples, a glossary of important appeals terms, a sample protocol for advocates, and links to important resources.
Register for a FREE copy of this great resource.
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Medicare Part D Monitoring Project
would like to hear about your experience, or that of someone you know, enrolled in a private drug plan. With information about what the issues are with Medicare Part D, we will be able to demand that those problems be fixed. Medicare Rights Center
Submit your story at http://www.medicarerights.org/issues-actions/tell-your-story.php.
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The Louder Our Voice, the Stronger Our Message
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Asclepios—named for the Greek and Roman god of medicine who, acclaimed for his healing abilities, was at one point the most worshipped god in Greece—is a weekly e-newsletter designed to keep you up-to-date with Medicare program and policy issues, and advance advocacy strategies to address them. Please help build awareness of key Medicare consumer issues by forwarding this action alert to your friends and encouraging them to subscribe today.
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The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs and public policy initiatives.
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