Posts filed under ‘Health Insurance’
The Supreme Court moved the arc towards justice and fair access to health care a bit closer with its decision in King v. Burwell (6/25/2015). The 6-3 decision, written by Chief Justice Roberts, sends a clear message that the Affordable Care Act is the law of the land.
As Justice Roberts stated, the intent of the Affordable Care Act is to build up, not diminish health insurance market places. Further, basic legal process calls for statutory provisions to be read to meet the overall intent of the law. This is not legal over-reach; it’s a standard taught in first-year law school. In King v. Burwell this long-accepted legal analysis results in the Court’s conclusion that subsidies to help people pay for health insurance are available in all Affordable Care Act markets, whether they are established by the individual state or federal government.
The Supreme Court followed basic legal analysis to support a basic human right – access to health care.
Now it’s our turn to make it happen.
Misconceptions and misinformation about the Affordable Care Act are still too many to innumerate. However, as advocates for Medicare beneficiaries and a strong Medicare program, we can tell you that the Affordable Care Act (ACA) is good for beneficiaries and good for the stability of a full and fair Medicare program. ACA has already added significantly to Medicare-covered preventive services – with no beneficiary cost-sharing, continues to reduce the cost of prescription drugs for people under Medicare Part D, is phasing out wasteful overpayments to private Medicare Advantage plans and added over a decade to Medicare’s long-term solvency.
Happy Anniversary, ACA. As my grandmother would say, “You should live and be well!”
The Ryan plan for 2013 is the same as the Ryan plan for 2012 and 2011: Privatize Medicare and repeal the Affordable Care Act. Once again the Ryan budget proposes to preserve Medicare in name only. It would change Medicare into a defined voucher system, sending beneficiaries into the marketplace to purchase indiivual insurance plans. These ideas were at the heart of the 2012 election. They are about changing the way government and Medicare work, not about saving Medicare or money. The proposals were rejected at the polls.
If Medicare and the deficit are really our concern, there are real savings possible that would not harm older and disabled people: Bring down the prices Medicare pays for drugs. Stop all overpayments to private Medicare Advantage plans. Add a prescription drug benefit to traditional Medicare. Lower the age of eligibility for Medicare. Let the Affordable Care Act work.
Mr. Ryan, move on! Join us in focusing on real solutions.
Medicare was in the spotlight in the Vice Presidential debate as the candidates outlined their respective plans for the program millions of American families rely on. Unfortunately, some pervasive myths were also highlighted regarding the impact of health care reform and the Ryan plan on Medicare and the 49 million Americans who count on it. [Check out the Center for Medicare Advocacy’s Facebook and Twitter pages (Follow @CMAorg) for a full list of Medicare Myths and Facts from the debate.]
One of the myths that was repeated during the debate is the familiar claim that the Affordable Care Act cuts Medicare by $700 billion – the same claim that has been debunked time and again. In fact the $700 billion in savings are largely a result of rolling back unnecessary, wasteful overpayments to private Medicare insurance plans. Congressman Ryan’s budget plans have included these same $700 billion reductions; however, instead of ending overpayments to private insurance companies with the savings, Ryan’s plans would give private insurance companies an even larger share of Medicare expenditures.
The Ryan Plan to end Medicare would provide each individual with an annual allowance with which to purchase a health plan in the private market, would raise costs for current and future beneficiaries, and would repeal important Medicare benefit improvements, added by the Affordable Care Act (ACA). The ACA Medicare improvements include extending the solvency of the Medicare Trust fund, lowering prescription drug costs, adding new coverage for preventive services, and eliminating cost-sharing for most such services, such as mammograms and prostate screenings.
Mr. Ryan and other policy-makers often talk about waste, fraud, and abuse in Medicare. Yet too often these same policy-makers plan to extend private Medicare to restructure the entire Medicare program. They claim this will save money for Medicare, taxpayers, and beneficiaries. But a new study, once again, confirms just the opposite.
In a forthcoming issue of the International Journal of Health Services, researchers report that “Medicare has overpaid private insurers by $282.6 billion, or 24.4 percent of all MA payments, since 1985. In 2012 alone…MA plans are being overpaid by $34.1 billion, or 6.2 per¬cent of total Medicare spending”. This means nearly a quarter of all payments to private insurance companies in Medicare, subsidized with taxpayer dollars, have been unnecessary overpayments that have gone to profit margins and administrative costs, not health care services. Talk about waste!
The authors of the International Journal study conclude that the decades-long experiment with privatizing Medicare should end. Instead, policies should be developed to focus on the real issues of overall health costs and access to coverage. However, if the Ryan plan takes effect, the wastefully expensive private Medicare program will be expanded. Meanwhile, the cost-effective traditional Medicare program will be allowed to wither, and beneficiaries will become responsible for dramatic increases in out-of-pocket costs.
Mr. Ryan’s plan continues wasteful overpayments to private insurance companies at the expense of beneficiaries and taxpayers. It is not a plan to preserve Medicare, protect older and disabled people, or reduce health care costs.
Originally Published at Nieman Watchdog, in ASK THIS, June 14, 2012 (available at http://niemanwatchdog.org/index.cfm?fuseaction=ask_this.view&askthisid=00569), we offer reporters and editors a checklist for stories when the Supreme Court rules on the Affordable Care Act (ACA):
- What will happen to the Medicare Part D Donut Hole coverage, preventive benefit coverage improvements, Part D income-based premiums?
- Will young adults receiving coverage up to age 26 on their parents’ plans immediately lose their coverage? Will they be able to get coverage elsewhere?
- Will children with pre-existing conditions lose their coverage? If so, how will they get coverage in the future?
- What will happen in states that have started to implement the law, for example by setting up “exchanges”? Will some states try to proceed without ACA?
- What will happen to those who would have been covered by the Medicaid enhancements under the law?
- If so, what was struck down?
- What is left?
- Can the law still work without this requirement?
- Can the law be amended to make it work, without a minimum coverage mandate?
- What demographic groups will be most harmed?
- What will be the effect on costs to the federal government, states, and individuals?
Unless the entire law is upheld, people in need of health care will lose. Be ready to recognize what will be lost – and by whom.
We are happy to celebrate the second anniversary of health care reform. Since the Affordable Care Act (ACA) became law in 2010, significant progress has been made to enhance access to health care for all Americans. This progress touches the lives of millions of American families.—from every state, and every walk of life. We look forward to the law’s full implementation in 2014.
Health care reform has already improved and strengthened Medicare. It’s helping older and disabled Americans in many ways, including:
1. Adding Medicare preventive health care services, usually at no cost, including an annual wellness visit, many cancer screenings, vaccines, smoking cessation and dietary counseling. This means people with Medicare can work to maintain their health and can recognize problems early, when treatment is most effective.
2. Increasing Medicare coverage for prescription drugs for people with the highest medication costs, by providing more coverage during the “Donut Hole” coverage gap. These benefits will continue to improve every year through 2020, when the “Donut Hole” will end, ensuring continued cost savings for older and disabled people.
3. Insisting that private Medicare Advantage plans provide real value to those who enroll, including appropriate Medicare coverage and quality customer service. Beginning in 2014, the law will also require these plans to spend at least 85% of the premiums they collect on medical care, rather than on excessive administrative costs and increased profits. The law also saves Medicare and taxpayers millions of dollars by ending wasteful overpayments to these private insurance companies.
These are just a few of the ways ACA insists on fair value in return for taxpayer dollars, while improving health care for older and disabled people. And this is just the beginning. If the Affordable Care Act is allowed to proceed as designed, it will continue to enhance access to quality health care, increase efficiency, and reduce costs to Medicare and taxpayers.
Spread the word about the value of the Affordable Care Act and the need to see it through to full implementation. Health care reform is good for Medicare, good for families, and good for the country. Let it work!
How much does Mitt Romney really care about Medicare’s solvency? A lot. So much that he has decided not to enroll or use it at all – even though he’s turning 65.
What should we take from this? One thing for sure, Mitt Romney can afford a whole lot more financial risk than most Americans. Unless he has private insurance that will pay as the primary policy even after he’s Medicare eligible, Mr. Romney is accepting a huge liability if he intends to pay for his own heath care. Either way, he’s in a very different position than the vast majority of older and disabled Americans who MUST rely on Medicare to help pay for their health care and can not obtain insurance that will take its place.
Is Romney going to lead a battallion of well-to-do Americans out of Medicare? Leaving behind those who can not afford to pay either for their own care or for preciously rare primary insurance available to people eligible for Medicare. What a shame that would be.
Mr. Romney should enroll and rely on Medicare coverage like most Americans do when they turn 65. As a would-be national leader he should experience firsthand what works and what doesn’t, what coverage is and should be available. He should be part of the Medicare community and help it stay viable for all those who look to this national treasure to help pay for health care.
If Mr. Romney really cares about Medicare he should vote for it with his feet.