How Will the Affordable Care Act Affect Medicare?

The Patient Protection and Affordable Care Act, also known as Obamacare, is set to take full effect next year. The legislation is set to cut $716 billion from Medicare and will bring some significant changes to the program. The Affordable Care Act has already expanded Medicare coverage to include preventive care, and it’s slowly closing the coverage gap in Medicare Part D. 

The Affordable Care Act aims to improve the quality of hospital care for seniors by rewarding hospitals that provide quality care with increased funding, and penalizing those who provide poorer care with decreased funding. Although the legislation does cut some Medicare programs, these cuts aren’t intended to affect benefits; instead, they’re meant to increase Medicare’s cost-effectiveness by moving the money to areas of the program where it can be put to better use.

How Are Medicare Benefits Changing?

The Affordable Care Act broadens existing Medicare benefits, making it possible for seniors on Medicare to receive preventive care with no out-of-pocket costs. Seniors can now get check-ups, cancer screenings, vaccines and other forms of preventive care for free. These changes have been in effect since 2011.

Another important change in Medicare benefits under the Affordable Care Act concerns the so-called “donut hole,” or the coverage gap in Medicare Part D. Under Medicare Part D, many seniors must pay for their own prescription drug costs. As of 2012, seniors receiving Medicare became eligible for discounts on brand-name and generic prescription drugs. These discounts will grow each year until 2020, when the coverage gap should close completely, and Medicare recipients will only need to pay co-pays for their prescription drugs.

The Affordable Care Act also aims to reduce federal spending on Medicare Advantage, a form of supplemental Medicare insurance administered by private insurance companies. Medicare Advantage, which was originally intended to reduce federal spending on Medicare, has turned out to cost the government 14 percent more per patient than traditional Medicare. It is hoped that cutting federal spending on Medicare Advantage will lower overall Medicare costs.

What Is the Value-Based Payment Provision?

Under the Affordable Care Act, providers who offer high-quality care to Medicare patients stand to receive a one percent increase in Medicare payments in 2014, and a two percent increase in Medicare payments in 2015. Conversely, those who provide a lower standard of care — as measured by high re-admittance rates and patient dissatisfaction — stand to lose up to two percent of their payments from Medicare by 2015.

In this way, the Affordable Care Act intends to improve the quality of care seniors receive.Quality care is something that professionals in the field will have to focus on. Though it may have gone unmentioned before, health care employees had better take notice or suffer the consequences. Human services will be especially influential in this regard and it is anticipated that more positions in human resources will be created to address the importance of quality care. To learn more about earning a human services degree online, you can research online for a program that fits you. 

Where Are the Medicare Cuts Coming From?

According to the Congressional Budget Office, the anticipated total cost of Medicare over the next 10 years will be about $7.5 trillion. Between 2013 and 2022, the Affordable Care Act plans to cut $716 billion from Medicare. Of that amount, $415 billion comes from federal payments to care providers and private insurance companies. The rest of the cuts come from parts of the program that are not considered to be cost effective, such as the Medicare Disproportionate Share Program, which compensates hospitals for treating lower-income Medicare recipients who do not have supplemental insurance.

How Does the Affordable Care Act Change Medicare Funding?

The Affordable Care Act changes Medicare funding by reallocating the $716 billion in cuts to other parts of the program, where it’s believed the money can be put to better use. The new law will also levy a 0.9 percent tax on members of the top tax bracket in order to raise money for the new law.

The legislation also allows for the creation of an Independent Payment Advisory Board, which will have the authority to recommend reduced provider payments if Medicare spending grows too fast in the future. Payments from Medicare to health care providers will also grow at a slower rate. These two things are intended to keep Medicare costs down in the future. Medicare is expected to cost $900 billion per year by 2022.

The Affordable Care Act has expanded Medicare benefits to include preventive care like checkups, vaccines and cancer screenings. Over the next several years, it will gradually close the coverage gap in Medicare Part D, which provides prescription drug coverage to seniors. It will also cut spending on Medicare Advantage and tie providers’ payments to the quality of the care they give. The Affordable Care Act intends to fund these changes and keep Medicare solvent in the future with $716 billion in cuts to other parts of the program and with a 0.9 percent tax increase on members of the top bracket.

About the Author: Contributing blogger Alisa Martin has more than 15 years of experience in public health policy. She currently works with his local government to improve public health services.

Washington's Debt Crisis Is Over With Social Security and Medicare Spared - For Now

Image via WikipediaThe Congress and the President have come together and deflected the debt crisis. They have worked out a solution that both parties can hold their noses and live with. These last two months have been nerve racking for the folks dependent on Social Security. Not only for them, but the rest of the country is finally seeing how close we are to the precipice of default.

Unconscionable spending over the last 30 years by both parties has led to an environment of thoughtless borrowing. President Obama is the unfortunate president who will take the brunt of the anger of the American people over this insane borrowing and deficit. Luckily for him, the deal that was worked out will spare him another debt crisis before the next election. But before the end of 2012, we will be back where we started.

One point of the debt deal that was made is, Social Security and Medicare are off the table on budget cuts. This is not forever and when the next round of deficit discussions come around Social Security and Medicare could be on the chopping block. The gloves are off for Social Security activists and recipients. They will have to fight long and hard to keep their benefits in the years ahead. It' almost funny that our so called guaranteed benefits will have to be fought for.

What happened to the sacred promise made to the American people by our government about the Social Security Trust Fund. It seems with the stroke of the pen all that could be over. Washington says they might have to reduce benefits to keep the fund viable.

All Americans have paid faithfully to the Social Security Fund only to have it mishandled and raided for it's funds over the years. Now the raiders want to balance the budget on the backs of retiree's. We all know that Social Security and Medicare have not caused this economic crisis and we do not support cutting these programs to pay down the debt. Then why are important programs on the table as bargaining chips as a way to balance the budget?

For over three decades, millions of older Americans have counted on annual Social Security benefit increases to help them afford their basic needs. Unfortunately, the benefits they've earned will again be frozen next year, leaving millions who are struggling in this economy without money they depend on to make ends meet.

I suggest you contact your representatives in Washington DC and let your voices be heard on this matter.

Click Here for a list of your Representatives Email and Phone numbers.

The Mystery Of Medicare

Image via WikipediaI have gone through most of life not thinking about Medicare. I didn't have to, it wasn't for me, it was for those old timers over there. Now that I have become one of those old-timers, I am getting curious. Even though I am to young for it yet, you have to be 65. It's still over the horizon for me, but with a lot of my baby-boomer brothers and sisters closer to it, I thought a little info searching was in order.

So what does it cover? Do I need it? When should I sign up? Lots of questions. So I headed over to the HQ for all things about retirement, our old friends at AARP.org. They have created Medicare Starter Kit to get you up to speed on all things Medicare.

They start out with the Top Eight Do's and Don'ts:

1. Do give yourself time to learn about Medicare: It's a system with many choices and deadlines. Being informed is the best way to avoid mistakes that cost money.

2. Don't expect to be notified when it's time to sign up: Unless you're already receiving Social Security benefits, you must apply for Medicare. But you won't get any official notice on when or how to enroll.

3. Do enroll when you're supposed to: To avoid permanent late penalties, enroll at age 65 if you're not working, don't have employer insurance or live abroad; or, beyond 65, enroll within eight months of stopping work — even if you continue to receive COBRA or retiree health benefits from an employer.

4. Don't despair if you haven't worked long enough to qualify: You may qualify for Medicare on your current or former spouse's work record. Or you may be able to buy into the program.

5. Don't worry that poor health will affect your coverage: If you qualify for Medicare, you receive full benefits. You can't be denied coverage or charged higher premiums because of current or past health problems.

6. Do remember that Medicare is not free: You pay premiums for coverage and copayments for most services, unless you qualify for a low-income program or have other, extra insurance.

7. Don't assume that Medicare covers everything: It covers a wide range of health services (including expensive ones like organ transplants), prescription drugs and medical equipment. But there are gaps.

8. Don't expect Medicare to cover your dependents: Nobody can get Medicare under age 65, except those who qualify through disability. Medicare has no family coverage.

This is only a small taste of what the Medicare Starter Kit has to offer, get over to AARP.org and find out more.