Affordable care: What do we know about it?

Whatever you may be sure of, be sure of this:  that you are dreadfully like other people. — James Russell Lowell, American Romantic poet, critic, editor, and diplomat

The Big Buzz these days is about ACA, the Affordable Care Act, aka “Obama Care” and “Health Reform.”  For those of us who are in or near the half-a-century plus five mark, the answers to our questions are critically important.

The National Council on Aging recently posted “Straight Talk for Seniors on Health Reform” on their web site:  www.NCOA.org.  The article being shared today with Blade-News readers provides 5 key facts about the ACA from NCOA (© 2013 National Council on Aging):

Fact #1:  The law does not cut your basic Medicare benefits.  In fact, some benefits are better than before.  Section 3301 provides more help with prescription drug costs, reduces donut hole payments and phases out that infamous “sweet” confusion-builder completely over a few years.

Additionally, the new, free annual wellness checkup allows you and your doctor to develop a prevention plan to keep you healthy.  A range of prevention services, such as cancer and diabetes screenings are now provided free—no more cost sharing.

80% of older Americans have at least one chronic medical condition such as heart disease, high blood pressure or diabetes.  These people probably see several doctors, who may not always work together.  The law is investing in testing new models for these folks to provide better care, better coordination and more patient-centered services.

If you must be hospitalized, the law also helps you return home successfully and avoid going back into the hospital.  ACA provides incentives for hospitals to make sure that you get the services you need in your community and by teaching you ways to take good care of yourself.

Fact #2:  NCOA says the ACA reduces Medicare spending growth, extends Medicare solvency, and is projected to reduce budget deficits.  Over the next ten years, the rate of growth of Medicare will be slightly slowed down – from 6.8% per year to 5.5%.  Those numbers come from CBO, the Congressional Budget Office.  This independent, non-political group is responsible for health reform cost estimates.

CBO projects that the ACA will save Medicare about $400 billion over ten years and extend the solvency of the Medicare Trust Fund for an additional nine years – until 2026.  If you are a Medicare recipient, you will have the same right to switch to other supplement plans, or go back to original Medicare, just as you do now.  You do not lose your basic Medicare benefits because of the law.

Starting next year, the law will create a new Independent Payment Advisory Board.  This board of experts will recommend specific ways to reduce Medicare costs without cutting benefits or increasing out of pocket costs.

Fact # 3:  The law makes it easier to receive and pay for long-term care at home.  As column readers know, Medicare currently does not cover long-term care, except for maybe a few days in a skilled nursing facility after a hospital stay.  This benefit labors under an amazing number of rules, and difficult requirements.  Now, as you know, many older adults who need help at home must spend every penny they have to get the care they need.

States can “opt-out” of these provisions, but Maryland has opted-in with both feet!  Our state is instituting programs and procedures that make it easier for lower income people who are on Medicaid to get long-term care at home instead of in a skilled nursing facility.  Maryland is receiving extra and matching federal funds to provide these new services.

Starting next year until the end of 2019, the law will increase protections for spouses of people who receive Medicaid home care services.  The well spouse in the community will no longer be forced into poverty so that an ill spouse can qualify for Medicaid home care.  Stay with Senior Moments, and check out www.ByrdandByrd.com, Medicaid planners extraordinaire, for the specific twists and turns of this provision of the ACA.

Fact #4:  The law improves care for older adults in other ways.  Early retirees now receive help to keep their health insurance premiums down.  In 2011 Medicare began paying bonuses of 10% to primary care doctors to improve patient access to them.  Some nursing home quality standards are being improved.  There is more and enhanced training for workers who care for seniors.  Additionally, the law includes new protections against elder abuse, neglect and financial exploitation.

Fact #5:  ACA improves health insurance coverage for most younger Americans who do not have Medicare.  For instances, in 2010, small businesses began receiving tax credits of up to 35% of premiums to make employee coverage more affordable.  Insurance companies are no longer allowed to drop people from coverage when they get sick.

On this subject, just know that when all provisions of the bill have become effective,  almost all Americans will have the kind of guaranteed health care access and security that Medicare beneficiaries have today.  Again, for more information, please visit www.ncoa.org/StraightTalk. You can also send your ACA questions into Byrd & Byrd, LLC via our website – www.byrdandbyrd.com.

Thanks for reading.  Stay well.  See you next week.