Medicare Watch

Your Weekly Medicare Consumer Advocacy Update

The Real Deal with the Affordable Care Act and Medicare

September 19, 2013

The Facts about the Affordable Care Act and Medicare


This week, US News & World Report published an article on the myths and facts of how the Affordable Care Act (ACA) affects Medicare beneficiaries. According to the article, older adults are often confused about how Medicare works and ACA changes are compounding some of that confusion.

The article summarizes five myths about the ACA and Medicare and provides the facts on how the ACA impacts Medicare beneficiaries, both now and going forward.

Medicare is ending.

False. The ACA is not replacing Medicare, and Medicare has grown stronger as a result of the ACA. In fact, the ACA adds eight years to the solvency of Medicare’s Part A Trust Fund, increasing the years of the program’s guaranteed benefits to 2026, 10 years longer than before the ACA.

Seniors on Medicare must buy more health insurance to comply with the ACA.

False. Seniors and people with disabilities will not be required to purchase more health insurance coverage to comply with the ACA. Further, Medicare beneficiaries will not need to purchase health insurance in the new marketplaces.

Medicare beneficiaries will pay more for their medications under [the ACA]. 

False. While the Part D premium will increase slightly for Medicare beneficiaries with higher incomes (individuals with annual incomes over $85,000 or couples with annual incomes over $170,000), the majority of Medicare beneficiaries have already started paying less for their prescriptions. Over time, the ACA closes the prescription drug coverage gap, or doughnut hole, and according to a recent CMS press release, more than 6 million seniors had saved over $7 billion on prescription drugs at the end of June 2013.

Medicare beneficiaries won’t be able to see their current doctors.

False. Nothing in the ACA expressly changes the doctors that Medicare beneficiaries can see.

Medicare premiums are rising.

False. The ACA has not attributed to the rise in Medicare premiums. In fact, Medicare costs are rising more slowly as a result of provisions in the ACA. Also, according to the most recent Medicare Trustees’ Report, the Medicare Part B premium will remain relatively unchanged between 2013 and 2014, and Medicare Advantage plan premiums as well as Part D premiums are also stable year-to-year generally.

Read the U.S. News & World Report article.
Read the CMS press release.
Read Medicare Rights Center President Joe Baker’s statement on the Medicare plan landscape.
Read the Trustees’ Report.

Long-Term Care Commission Provides Its Recommendation to Congress

The Federal Long-Term Care Commission, created by Congress after the repeal of the Community Living Assistance Services and Supports Act (CLASS), released a summary of its recommendations to Congress. The Commission was tasked with addressing the country’s need for long-term services and supports.

According to an article published by Kaiser Health News (KHN), the Commission’s recommendations received bipartisan support from nine of the 15 Commissioners and called for supporting criminal background checks for long-term care workers, ensuring that family caregivers are included in care planning, and improving working conditions and opportunities for long-term care workers.

Noticeably missing from the Commission’s recommendations were options for financing long-term care services. Currently, Medicare does not pay for long-term services and supports, and Medicaid only covers those services for people with low incomes or those who have sufficiently spent down their assets in order to qualify. The Commission did not provide any recommendations on how to pay for long-term services and supports, but did recommend that Congress advocate for new models of public payment on the basis of the service, rather than the setting.

Read the summary of recommendations.
Read the KHN article.

Volume 4, Issue 37

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Medicare Reminder

Sometime in the fall, certain people with Medicare may receive grey Extra Help notices from the Social Security Administration (SSA). This grey notice informs people that they will no longer automatically qualify for Extra Help, beginning the first of the following year. Extra Help is the federal assistance program that helps pay the cost of prescription drugs for those with limited finances.

Generally, people who receive this grey Extra Help notice automatically qualified for the program in the past by having Medicaid, a Medicare Savings Program or by receiving Supplementary Security Income. The grey notice is sent to individuals who will no longer qualify for Extra Help in the upcoming year, because they no longer qualify for Medicaid, have a Medicare Savings Program or no longer receive Supplementary Security Income.

People with limited income and resources may still qualify for Extra Help. However, they must apply directly to Social Security to continue receiving the benefit. They can do so by filling out the application attached to the grey notice or by visiting

Learn more about Extra Help at




Take action to protect your Medicare benefits!

Sign our new online petition to enact responsible solutions to strengthen Medicare’s long-term fiscal outlook and to oppose plans that would shift added costs to people with Medicare.

Medicare has ensured access to guaranteed health care benefits for older adults and people with disabilities since 1965. Today, 50 million Americans rely on Medicare for basic economic and health security. Still, some members of Congress argue that Medicare must be cut now to save the program for the future. Proposals to shift added costs to people with Medicare by increasing premiums, deductibles, copayments and coinsurance and scaling back supplemental insurance are gaining support in Congress. Tell your member of Congress to oppose proposals to shift costs to people with Medicare and to instead advance solutions to eliminate wasteful spending.

Tell Congress to stand up for responsible solutions to strengthen Medicare.


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