 | The New Health Care Bill and Medicare |
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Since the enactment of the Patient Protection and Affordable Health Care Act of 2010 there's been much confusion and anxiety about what it will mean.
The law is extensive and quite a few provisions will affect baby boomers and seniors. Medicare beneficiaries especially will benefit from some of the new provisions. Out-of-pocket expenses for prevention and wellness services will be reduced, and a free annual check-up for Medicare beneficiaries will now be included.
Furthermore, the doughnut hole in the Medicare Part D will be eliminated by 2020, including provision for a $250 rebate to those beneficiaries who reach the coverage gap in 2010.
Heath care reform will extend the life of the Medicare Trust Fund. Without some type of intervention, the trust fund was projected to be depleted by 2017. One way this will be done is to reduce payments to Medicare Advantage Plans (Part C plans) to make the payments equal on average to payments made on behalf of beneficiaries on traditional Medicare.
Medicare Advantage plans provide Medicare benefits through private insurers rather than the traditional fee-for-service Medicare run by the federal government since 1965. On average, Medicare Advantage plans receive $135 per beneficiary per month in excess of traditional Medicare. Those on traditional Medicare are paying more to subsidize these private insurance plans. These subsidies are unsustainable, and are threatening the future of the Medicare Trust Fund.
One place to get more information is the Kaiser Family Foundation website. There are also provisions in the health care reform bill to slow the increase in Medicare premiums by developing better methods of delivering medical care.
Long-term care is addressed, including a provision for creation of a Community Living Assistance Services and Supports (CLASS) program which is a national long-term care insurance program funded by voluntary payroll deductions. CLASS benefits are expected to be in the range of $50 per day, and will help family members stay at home.
Criminal background checks will be required on employees of long-term care facilities. Money is being provided for Elder Justice, to reduce the alarming incidence of elder abuse, neglect and exploitation, not just in nursing homes but in the community.
There is a provision to establish the Community First Choice Option, so that more people can stay home, where they want to be, but with affordable assistance. There will be spousal impoverishment protections for spouses of Home and Community-based waiver participants, to encourage families to keep loved ones home and out of the nursing home by providing adequate assistance. All in all, boomers and seniors can be hopeful that they will lose no real benefits and will see improvements in Medicare over the next 5-10 years. |
