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The facts about ObamaCare: Impacts on seniors

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Posted: Wednesday, September 25, 2013 5:43 am

The controversial Affordable Care Act (aka ObamaCare) endures many attempts at repeal, along with masses of misinformation from those who'd benefit from its demise, financially or politically. Yet, it's the law, having passed both Congress and the Supreme Court.

While not perfect, it'll improve health care access. People on Medicare, Medicaid, or employer group plans do not have to shop in the new health Marketplace.

So, let's look at its impacts on seniors aged 65 and over, since most have focused on impacts for those under age 65.

* Closing the Medicare Part D Rx gap or "Donut hole". From 2010-2020, ACA’s reducing the amount seniors on Part D Medicare pay for prescriptions once they get in the gap. 6.6 million folks on Medicare have already saved over $7 billion via ACA. They're now paying 47.5 percent of the plan's gap costs for brand names and 78 percent of generic Rx costs in 2013, reducing to virtually nothing in 2020.

* Preventive Services. ACA increases use of preventive services, lowering health costs for all, with no co-pays to seniors. Included are annual wellness exams, heart, colon, prostate, mammography, diabetes, bone density, other screenings. Also covered are smoking cessation, alcohol misuse counseling, vaccinations. Additional diagnostic tests or treatments are subject to insurance co-pays.

* Extending Medicare Solvency. ObamaCare extends Medicare Solvency from 2016 to 2024. The term "solvency" means when Medicare will start to spend more money than it takes in. It does not mean the program would end then. ACA already raises Part A taxes on wages by 0.9 percent on earnings over $200,000 for individuals and $250,000 for couples; it also raises a 3.8 percent tax on non-wage income i.e., dividends, interest, rents etc. Removing the cap on Medicare taxes for wages over $113,700, would extend Medicare solvency for 75 years.

ObamaCare reduces Medicare spending growth from 6.8 percent now, to 5.5 percent annually, per the Kaiser Family Foundation, resulting in $716 billion in savings. This will not reduce benefits to seniors as misstated by some, but via over payments to hospitals, reducing hospital payments for seeing uninsureds, lower payments to medical equipment and home care, reducing subsidies to Medicare Advantage plans, the rest savings from waste, fraud and abuse.

* Reducing Medicare Advantage plan subsidies. "Advantage" plans (HMOs, PPOs etc) get around 14 percent federal subsidies that traditional Medicare Supplement plans do not. Yet they've not been very successful in driving down health costs; subsidies have averaged approximately $1,000 monthly for each member. ACA is supposed to cut subsidies to advantage plan but lobbyists and allies successfully delayed this for 2014. These plans threaten to privatize Medicare, costing seniors many more $billions for their health care later.

* ObamaCare includes the Elder Justice provisions requiring more disclosure from nursing homes, also making comparisons between them available for seniors and their families. There is also funding available for medical students to help fill future medical provider shortages.

Oregon Birthday Rule (non ACA law). The ACA eliminates pre-existing health conditions and underwriting questions only for those under age 65. Starting in 2013, State Insurance Department rules allow Oregonians on Medicare supplements to switch to the same or lesser plan without any health questions within +/-30 days of their birthday, to save premium. Medicare supplements with health questions are still available year round.

ObamaCare/ACA brings a number of changes to help seniors improve health coverage and lower health care costs. Check with health insurance agents, SHIBA volunteers, navigators from Cover Oregon, accountants, CMS Medicare, other sources for details and information. Despite the loads of misinformation, ObamaCare is what we have now, to make the best of. The various effects of Obama Care on those under age 65 will be addressed later.

 Paco Maribona is a Certified Senior Advisor. He may be reached at 541-764-5155 or at benefits1983@gmail.com, AaaAdvancedBenefits.com.

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Welcome to the discussion.

11 comments:

  • Paco M posted at 3:40 pm on Sun, Oct 13, 2013.

    Paco M Posts: 5

    There is also a 0.9% added Medicare tax for those earning $250.000 + as indivs or over $400,000 as couples, in addition to the 3.8% unearned income tax on dividends, rentals, investment earnings.. at least a lil better. You're right about the $85 BILLION monthly cash infusion the FED is pumping into bonds, etc to keep interest rates low & stock market artificially high: it's supposed to stop very soon.

    So here's a free heads up: not a bad idea to move $$ in the "market" including mutual funds into safety, ie FDIC bank accounts, Treasuries, Annuities Before the next crash, unless u can afford to lose it all or most all.

     
  • Paco M posted at 2:08 pm on Sun, Oct 13, 2013.

    Paco M Posts: 5

    It's generally a good idea to check your plan benefits & premiums periodically. Since you're on Medicare, you're exempted from ObamaCare, since your plan meets its requirements, is better in some ways, so you don't have to shop there. However, folks on Medicare get two different open enrollment periods: 1. Those on so called "advantage" plans have from Oct 15 - Dec 7th to make changes; 2. If yours is a Medicare Supplement, your annual period to make changes without health questions is 30 days before and after your birthday. You didn't say if your BC plan is a traditional supplement plan, or an HMO or PPO type advantage plan, or a group plan. Either way, check with a local agent for advise, whether to stays as is, change plans, and what the potential savings and benefits would be.

     
  • larrymstein posted at 3:08 am on Sun, Oct 13, 2013.

    larrymstein Posts: 1

    we have medicare a b and d and anthem supplements. is there anybenefit to finding new insurance thru obamacare?

     
  • mlc824 posted at 3:16 am on Fri, Oct 11, 2013.

    mlc824 Posts: 36

    WASHINGTON, Aug. 27 (UPI) -- The IRS said Tuesday it has set the penalty Americans will have to pay for not getting health insurance under the Affordable Care Act, or Obamacare.

    Under the so-called individual mandate, beginning Jan. 14, the charge for not obtaining health insurance will be $95 or 1 percent of household income, whichever is larger, The Hill reported. The penalty will increase to $695 per person, or 2.5 percent of household income, in 2016, the Washington publication said. There will be a cost-of-living formula for future years.

    Read more: http://www.upi.com/Top_News/US/2013/08/27/IRS-sets-penalties-for-not-getting-healthcare-insurance-under-ACA/UPI-57071377647895/#ixzz2hPHxll00

    How much will Obama's banksta corporate 'people' buddies on Wall Street, think Goldman Sachs, Morgan Stanley, Citi Bank, ad nauseum, be paying into ACA? Meanwhile helicopter Bernanke keeps printing out $85 billion monthly for the Rothschild cartel.

    Yep force the serfs to pay up. Shine dem shoes sonny!

     
  • mlc824 posted at 3:16 am on Fri, Oct 11, 2013.

    mlc824 Posts: 36

    WASHINGTON, Aug. 27 (UPI) -- The IRS said Tuesday it has set the penalty Americans will have to pay for not getting health insurance under the Affordable Care Act, or Obamacare.

    Under the so-called individual mandate, beginning Jan. 14, the charge for not obtaining health insurance will be $95 or 1 percent of household income, whichever is larger, The Hill reported. The penalty will increase to $695 per person, or 2.5 percent of household income, in 2016, the Washington publication said. There will be a cost-of-living formula for future years.

    Read more: http://www.upi.com/Top_News/US/2013/08/27/IRS-sets-penalties-for-not-getting-healthcare-insurance-under-ACA/UPI-57071377647895/#ixzz2hPHxll00

    How much will Obama's banksta corporate 'people' buddies on Wall Street, think Goldman Sachs, Morgan Stanley, Citi Bank, ad nauseum, be paying into ACA? Meanwhile helicopter Bernanke keeps printing out $85 billion monthly for the Rothschild cartel.

    Yep force the serfs to pay up. Shine dem shoes sonny!

     
  • Paco M posted at 7:43 pm on Sun, Oct 6, 2013.

    Paco M Posts: 5

    p.s. I neglected to list some of the incorrect details in the article JenniferNM asked about, namely: 1. ACA closes the RX donut hole largely but not fully; the main gaps in Medicare isn't the 20% Dr/outpatient bills, but the potentially huge hospital & nursing home bills that can run $200,000 to $1million or more, absent a Medigap policy; OR & CA have a birthday rule, when seniors can change policies within +/- 30 days of their birthdays annually, without any health questions.

     
  • Paco M posted at 6:58 pm on Sun, Oct 6, 2013.

    Paco M Posts: 5

    Full disclosure: ACA plans cut agents' commissions, and single payer might eliminate them all together; yet I support both & focus on the facts because it's the right thing to do. Health Care is a right (life, liberty & pursuit of happiness, which can u enjoy w/o health?); insurance is required to drive, this isn't much different; it's a shared responsibility. The recession, sequestration, now government shutdown disproportionately hurts women, children, seniors, minorities, & the poor. Now you want to take away health care too? Seriously?

    JenniferNM, re the article u posted, it's a start, but has some factual errors & doesn't address college students or those under age 65: here's one:

    http://www.theskanner.com/article/Obamacare-in-Action-State-Health-Exchanges-Open-for-Business-2013-10-02

    also, see the 10/2/13 News Guard's pg A4 for my article on ACA's Impacts on those under age 65.

     
  • JenniferNM posted at 11:42 pm on Sun, Sep 29, 2013.

    JenniferNM Posts: 1

    As a college student and someone who is incredibly close to my grandparents. I have been greatly invested in trying to understanding the new healthcare reform. It has been really hard to find articles that aren't either biased or hard to understand. I have found an article that has been a tremendous help me understand the implementation. The link is listed below, let me know what you guys think! :)

    http://navixmarketplace.com/blog/obamacare-and-seniors/

     
  • Newshound posted at 3:16 pm on Fri, Sep 27, 2013.

    Newshound Posts: 24

    RCRush is right. Paco knows his stuff. And mic824's willingness to repeat the widely debunked and wholly inaccurate claim that the IRS will be imprisoning folks who can't afford healthcare shows that he does not.
    There are enough imperfections in Obamacare that could benefit from our attention without having to linger on scare stories that have no basis in fact.

     
  • RCRush posted at 4:51 pm on Thu, Sep 26, 2013.

    RCRush Posts: 91

    In spite of mic824's opinion, I have found Paco Maribona to be an honest and reliable financial advisor. I tend to trust what he says in his article. He does the research.

     
  • mlc824 posted at 11:00 pm on Wed, Sep 25, 2013.

    mlc824 Posts: 36

    Paco likes Obombinator 'care' cause he's gonna reap all the benefits: financial that is. Cool the IRS will be imprisoning people who can't afford private health care ripoffs! Zip it Paco!

     

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