The Medicare program for seniors and the disabled will be strengthened in several important ways by the federal health reform legislation, AARP and other advocates said Monday.
While certain Medicare funding would be cut, AARP and other advocates for seniors continue to insist that a landmark health care bill passed by the House on Sunday will strengthen the overall Medicare program and benefit seniors.
The cuts will come from Medicare Advantage plans offered by private insurance companies and operated much like health maintenance organizations. About 25 percent of all Medicare recipients get health care through these plans. The plans generally reduce what people have to pay from their own pockets for medical services. That’s because the government pays the plans 13 percent more than it costs to cover seniors in traditional Medicare.
The plan that won final congressional approval Sunday night calls for reducing this payment differential, which will increase the cost to seniors.
On the plus side, the legislation will immediately reduce the so-called “doughnut hole” in Medicare drug coverage. There will be a $250 rebate to seniors once they have spent $2,830 this year, and the program calls for eliminating the the gap entirely by 2020.
“It’s not all black and white; sometimes it’s gray,” said James Firman, president of the National Council on the Aging. “Overall we think this plan is very good, and will provide some significant benefits for seniors. There will be some pain among some people in Medicare Advantage plans.”
Medicare is the federal health insurance program for people 65 and older and younger disabled people. While there will be some cuts, AARP of Massachusetts says overall it does not expect the changes to reduce services for seniors.
In the run-up to the final House vote, AARP had said the reform provisions will improve health care for older Americans, especially those in the 50 to 65 age group, and help them get the care and medications they need at a price they can afford.
“AARP commends the Massachusetts delegation for its historic vote to improve the Medicare prescription drug benefit so seniors will no longer have to choose between paying for food and other necessities and taking the medication they need to stay healthy,” said Deborah Banda, AARP Massachusetts state director. With the exception of Rep. Stephen Lynch, D-South Boston, the entire New England House delegation voted to pass the bill.
Among the reasons AARP has supported the legislation:
- It places controls on prescription drug costs. Places $2.3 billion in annual fees on drug companies starting in 2011 and increasing over time.
- It will prevent insurance companies from dropping people who develop major illnesses.
- Insurance companies will be barred from placing a dollar limit on lifetime care that someone can receive. This affects seniors almost exclusively.
There was no cost of living increase this year for Social Security. Social Security does not use medical costs in figuring the general cost of inflation. Low inflation triggered this year’s lack of a Social Security cost of living adjustment.
Henry N. Tuttle, chief executive officer of Manet Community Health Center in Quincy, said nearly 180,000 seniors would receive a 50 percent discount on their prescription drugs.
Patriot Ledger writer Sue Scheible may be reached at email@example.com.