One of the most talked-about topics of the 2012 U.S. presidential campaign was the Patient Protection and Affordable Care Act (PPACA), also known as â€œObamacare.â€ Nearly $53 million was spent on health care-related TV advertising during the campaign, according to Statista.com, indicating just how momentous this issue is to Americans.
The statute represents a significant overhaul to the U.S. health care system, and senior citizens across the nation are worrying how the reform will impact their lives. For seniors who are accustomed to meeting their health insurance needs through Medicare and Medicaid, the future may seem uncertain.
Overview of the Reform
It’s important to note that the act does not offer new insurance; it’s a reform of the existing U.S. health care system. A significant part of PPACA amends language found in the Public Health Service Act (PHSA) of 1944. The PHSA created such agencies as the Department of Health and Human Services, the Food and Drug Administration, the Centers for Disease Control and Prevention and the National Institute of Health.
It’s also important to realize that the Affordable Care Act does not take money away from the Medicare Trust Fund. SeniorCorps.gov reports that the savings will primarily come from eliminating fraud and changing the pay schedule for Medicare Advantage.
Will Premiums Rise for Seniors?
Seniors on fixed incomes are especially worried about this. One email making the rounds reported that seniors would pay $247 more a month for their insurance. AARP, the national organization for seniors that offers AARP insurance, reported the email was fraudulent. It was part of a scheme designed to scare America’s seniors.
However, you should expect a slight increase beyond the norm. Every year, seniors see a 6 to 9 percent increase in their premiums as a result of the rising costs of health care, according to FactCheck.org; with the Affordable Care Act in effect, the organization estimated there will be a 1 to 3 percent increase on top of that.
Highlights From the Affordable Care Act
Here are some of the main features of the PPACA, from healthcare.gov:
Benefits: There will be no reduction or elimination of seniors’ existing, guaranteed Medicare-covered benefits. Seniors can still choose their own doctors and continue to take part in normal health checks through regular Medicare channels.
Prescription Drugs: During the law’s first year, millions of seniors on Medicare received cost relief in the form of a one-time, tax-free $250 rebate to help pay for prescriptions.
Discounts: Seniors will get a 50 percent discount on covered, brand-name drugs while in the Medicare coverage gap (also known as the “donut holeâ€). From now until 2020, seniors will get continuous Medicare coverage for prescription drugs. The coverage gap will be closed by 2020.
Preventive Care: Medicare will cover certain preventive services (including a free annual wellness exam) without a separate charge for Part B co-insurance or deductible.
Cost Savings: Seniors are promised future cost savings on premiums and co-insurance, as a result of reducing Medicare waste, fraud and abuse.
Caring for Alzheimer’s Patients: Many seniors are worried about how the Affordable Care Act affects Alzheimer’s patients. Hope can be found in the Independence At Home program, a pilot program included in the act that enables 10,000 people with a chronic disease such as Alzheimer’s to be treated in their own homes by a team of doctors, nurse practitioners, geriatric pharmacists and other health care workers.
Reforming Medicare Advantage
Approximately a quarter of all Medicare recipients use a Medicare Advantage plan, which lets commercial insurance companies provide seniors with both Part A and Part B benefits. Senior who are enrolled in a Medicare Advantage plan will still have coverage under the PPACA, including prescription drug coverage, and can still choose in-network HMOs or PPOs.
Let’s look at three hypothetical seniors who go to a doctorâ€™s office. This doctor takes Medicaid, Medicare and Medicare Advantage. Each of these programs will pay at different rates, even though the patients will receive identical treatment. Under the PPACA, the rates are recalculated and the funds are shifted from Medicare Advantage to regular Medicare and Medicaid. The actual effect of this change on seniors has yet to be fully seen.
Beware of Scams
The PPACA has proved to be great fodder for email scams and false political rhetoric. Like the $247 premium scam, seniors are being bombarded with false information designed to scare them, defraud them or influence their political leanings.
Snopes.com is devoted to identifying fraudulent and false email and Internet communication. They have an extensive list of rumors and frauds related to the Affordable Care Act, including claims that Medicare physicians must ask patients about their gun ownership to a range of alleged price hikes. Snopes.com reported on several emails regarding Obamacare, supposedly from famous or influential people such as John Roberts, Judge David Kithil and Donald Trump. All of them have proven to be false.
Another rumor that may have caught seniors’ attention claims that ethics panels will limit the services that a senior can get under the Affordable Care Act. The act does not have provisions for panels that govern medical services.