Understanding the ACA and What People with Medicare Will Lose If the ACA Is Repealed
In a symbolic gesture, the House of Representatives voted on Wednesday to repeal the Affordable Care Act (ACA) in its entirety. This includes provisions that would close the doughnut hole in the Medicare prescription drug benefit, prevent insurance companies from discriminating against individuals with pre-existing conditions, and cover as many as 32 million uninsured Americans.
The Senate will not take up the repeal bill, but efforts to dismantle health reform continue.
Other benefits that people with Medicare stand to lose if the law is undermined by its opponents—by cutting off funding for implementation, for example—include free preventive services for Medicare consumers and initiatives to improve the quality and coordination of care that Medicare consumers receive. The ACA also extends the life of the Medicare trust fund for 12 years, in part by eliminating waste and creating greater efficiency in the delivery of care to people with Medicare. The law emphasizes primary care and encourages Medicare physicians and other providers to communicate with each other across settings and specialties to improve outcomes. It also aims to lower hospital readmission rates by lowering payments to facilities with high rates of rehospitalizations.
Read Medicare Rights Center’s press release on repeal of the ACA.
Take action and tell members of Congress not to undermine improvements to Medicare included in the ACA.
Some improvements to Medicare that are included in the ACA took effect on January 1, 2011, and people with Medicare are already benefiting from the law. This year, people in the doughnut hole will receive a 50 percent discount (paid by drug manufacturers) on brand-name drugs and a 7 percent discount on generic drugs. While the 7 percent discount will not count toward the catastrophic limit, both the consumer’s share and the manufacturer’s share of costs for brand-name drugs will count toward getting out of the doughnut hole. For people with Medicare who have high drug expenses, this means they will be spending thousands of dollars less out of pocket this year as compared to years past.
In addition, people with Original Medicare can now receive the preventive services that are recommended by the U.S. Preventive Services Taskforce with no out-of-pocket cost-sharing. Such services include mammograms, colon cancer screenings and smoking cessation counseling. Also, for the first time, people with Medicare can receive an annual wellness exam at no charge in addition to their one-time Welcome to Medicare physical exam. At the annual wellness exam, physicians will take a person’s medical and family history, monitor weight and height, conduct screenings for cognitive impairments, and develop and update care plans.
Read more about the discounts during the coverage gap.
Read more about free preventive services available to consumers with Original Medicare.
Read Medicare’s brochure about free preventive services for consumers with Original Medicare.
Read a timeline of implementation of the ACA, and learn more about when provisions of the law take effect.