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Medicare and the Affordable Care Act: Keep Moving Forward

Barbara B. Kennelly
NCPSSM President/CEO
When the Affordable Care Act became law last March, critics predicted doom for the seniors and people with disabilities who rely on Medicare. They said that coverage would disappear, benefits would be cut, and death panels were on their way – none of which was true. But these lies scared many seniors about the law before it was explained to them.   Now, one year later, as the implementation of the law moves forward, Medicare is still sound – it’s stronger than it was before the law was passed – and millions of people with Medicare are benefitting from the law.   Medicare has gotten serious about cracking down on waste, fraud, and abuse. Last year, the Obama administration announced it had recovered $4 billion in Medicare fraud. And the Affordable Care Act provides tools to crack down even further.   The Affordable Care Act specifically says that Medicare’s guaranteed benefits – hospital care, doctors’ services, home health services, drug coverage, and more – are protected.  Benefits are as good as ever – better, in fact. Prescription drugs are more affordable. This year the nearly 4 million beneficiaries who fall into the prescription drug “doughnut hole” will receive discounts on their drugs. These discounts will increase over the next few years until the doughnut hole is closed.   The Affordable Care Act encourages beneficiaries to get the care they need before they get sick. Now, the more than 44 million people with Medicare can get an annual wellness visit or needed screenings for diabetes or cancers without having to pay a co-pay. Early detection and treatment not only saves money but it saves lives.      The new law ends Medicare overpayments to insurance companies and rewards those that provide high quality care. But as these changes are phasing in starting this year, beneficiaries still have a wide range of plans to choose from.   States have new options to let seniors and people with disabilities stay in their homes rather than having to move to a nursing home when they need help. And in the coming years, thanks to the new law, Medicare will lead the way to better coordinated patient care that should improve the quality of care while reducing costs.   But there is a threat out there. The new leadership of the House of Representatives has dedicated itself to repealing the Affordable Care Act. This would undo all of these improvements. Fraud-fighting tools, coverage in the doughnut hole, free preventive care, better coordinated care, and the chance to stay in your own home would all be gone.   Even worse is their alternative. Some proposals call for increasing out-of-pocket costs for beneficiaries – something the Affordable Care Act does not do. Representative Paul Ryan, chairman of the House Budget Committee, has a more detailed plan he calls a “roadmap.” He calls for jaw-dropping cuts to the program, including raising the eligibility age to 69, slashing Medicare over time by 76 percent, and replacing the program with a cash voucher that would shift most of the cost of health care to individuals. This plan would be devastating both to current beneficiaries and to today’s working families who are counting on the Medicare program they pay into to protect them from unaffordable health care costs when they retire.   Representative Ryan leads the House committee responsible for producing a budget. But his roadmap leads us backwards to a period when our most vulnerable were forced to choose between health care costs and other necessities like food and shelter. We reject this vision, and we hope Congress does too. A year ago, we passed the Affordable Care Act to strengthen and improve Medicare for current and future generations. Let’s keep moving forward on that path.

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Poverty and Seniors

There are just some records you don’t want to break.  Unfortunately, the U.S. has shattered two of them, according to new numbers released this week by the Census Bureau.  The income gap between the richest and poorest Americans is the widest on record and there are now more poor Americans today than in any time since the bureau has measured poverty.   The Associated Press reports: 

"Income inequality is rising, and if we took into account tax data, it would be even more," said Timothy Smeeding, a University of Wisconsin-Madison professor who specializes in poverty. "More than other countries, we have a very unequal income distribution where compensation goes to the top in a winner-takes-all economy." “The poverty gap between young and old has doubled since 2000, due partly to the strength of Social Security in helping buoy Americans 65 and over. Child poverty is now 21 percent compared with 9 percent for older Americans. In 2000, when child poverty was at 16 percent, elderly poverty stood at 10 percent. Safety nets are helping fill health gaps. The percentage of children covered by government-sponsored health insurance such as Medicaid and the Children's Health Insurance Program jumped to 37 percent, or 27.6 million, from 24 percent in 2000. That helped offset steady losses in employer-sponsored insurance.” 
How ironic that as evidence continues to show, over and over again, how critically important our nation’s safety net programs like Social Security and Medicare are for millions of Americans, so many in Washington continue to target these very same programs for cuts.   And at what cost to millions of working Americans?  The Center for American Progress addressed the issue of elderly poverty and seniors economic security in “The Not-So-Golden Years”:
“Social Security is tremendously effective in helping seniors and their families stay out of poverty. Its benefits kept 14 million elderly Americans out of poverty in 2009. The Center on Budget and Policy Priorities estimated in an analysis of 2008 Census data that the elderly poverty rate would actually exceed 40 percent in most states without Social Security benefits. The majority of people kept out of poverty by Social Security are elderly, but the Census data shows almost a third of those kept out of poverty are under 65 and include more than 1 million children.”
The fact that America’s poor are worse off and adding more to their ranks while the wealthiest get richer can’t continue to be ignored in our national economic debate; particularly as some in Washington argue now’s the time to cut safety net programs for working Americans while extending tax cuts to the wealthy.

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Now's the Time

National Committee members and supporters have sent 12 thousand petitions to Capitol Hill urging Congress to pass health care reform, now.  As the clock ticks and a health care vote is expected in the House within days, seniors are mobilizing to ensure their elected representatives understand that doing nothing is not a solution for our nation’s health care crisis.  More than 100 thousand email alerts have been sent to National Committee members today, urging them to contact their Representatives in Washington and push for passage of health care reform legislation.   America's seniors have been in the crosshairs of a campaign to scare them away from reforms desperately needed to preserve and strengthen Medicare; however, National Committee members understand that doing nothing is a political strategy that actually threatens Medicare. Without health care reform, Medicare will continue to suffer from skyrocketing costs associated with general health care costs, until neither seniors nor the government will be able to afford the program. This inevitably will lead to unprecedented cuts in Medicare - cuts that unlike current health care reform proposals - will directly target Medicare beneficiaries. “It’s impossible to exaggerate the importance of this health care reform vote for America’s seniors—it’s historic.  Closing the Part D doughnut hole, cutting waste and eliminating billions of dollars of wasteful subsidies to private insurers in Medicare are just a few of the vital reforms benefiting seniors included in health care legislation. The status quo is not an option for seniors in Medicare.  System wide health care reform such as what it included in this health care reform plan is absolutely vital for the program’s future. “...Barbara B. Kennelly, President/CEO

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The Status Quo is Not an Option for Seniors in Medicare

Capitol There’s been plenty of hand-wringing, Monday morning quarterbacking and fortune telling about what the Democrats’ loss of 60 votes in the Senate really means for health care reform

Any way you cut it...it can’t be good.  The current system doesn’t work and we simply can’t allow political tide shifts to stop vital health care reforms.  American seniors, especially, have a lot at stake in this health care reform debate.  The Medicare provisions included in health care reform bills being debated now are among the most beneficial reforms for seniors since Medicare’s creation.  Closing the Part D doughnut hole, allowing government negotiation of drug prices in Part D, and eliminating billions of dollars of wasteful subsidies to private insurers in Medicare are dollars-and-cents and common sense reforms.  We’ll continue to work hard to mobilize support for Medicare proposals that would improve efficiency and care for millions of Medicare beneficiaries while also providing savings for system-wide health care reform efforts.  We’ll also work to defeat provisions which don’t benefit seniors in Medicare such as the Medicare Commission provision being debated. Contrary to the rhetoric heard from opponents, these bills don’t cut Medicare; rather they includes provisions to ensure that seniors receive high-quality care and the best value for our Medicare dollars.  Without system wide health care reform, the skyrocketing costs of health care will continue to climb unchecked making Medicare unsustainable.   That’s why inaction is the true threat facing Medicare.

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Health Care Reform and Medicare

The National Committee's Policy Director, Maria Freese, talked to C-Span this weekend about Medicare, health care reform and the Senate proposal to allow younger adults to buy-in to Medicare.  This is the beginning of the 30 minute segment.  You can see the full segment on our website at www.ncpssm.org.

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