En español l If you're one of the 50 million Americans who have Medicare, you may be worried about changes under the Affordable Care Act (ACA). AARP has heard from many older people with questions in the wake of the health care law's troubled rollout.
The first thing to know is that the law has language protecting guaranteed benefits: "Nothing in this act shall result in a reduction of guaranteed benefits" under Medicare. Even the well-publicized problems with the Obamacare website won't affect Medicare users, who will continue to use medicare.gov as their online portal. And the ACA adds new Medicare benefits at no additional cost to the beneficiaries.
"The good news for Medicare recipients is new protections and benefits in the health law that strengthen Medicare and give more coverage," says Nancy LeaMond, executive vice president of AARP's state and national group.
The law shifts Medicare's focus to keeping older people healthy. Thus, it provides an annual wellness visit as well as preventive screenings — such as for diabetes and certain cancers — without charge. And it gradually closes the "doughnut hole" — the gap in Part D prescription drug coverage. Supporters say that over time the law will improve hospital care for Medicare beneficiaries by rewarding hospitals that perform best.
But critics have raised concerns about the hundreds of millions of dollars in reduced Medicare spending that will help fund the ACA. They say fewer doctors and hospitals will be available for Medicare users, resulting in a reduced level of care. What is the truth? At this point, there is little evidence, but many opinions. To help you navigate the new Medicare landscape, we've put together a Q-and-A based on your questions, with answers from top experts.
I've read that the Affordable Care Act cut Medicare by $716 billion. Where are the cuts being made?
The nonpartisan Congressional Budget Office estimated that Medicare spending would be reduced by $716 billion over 10 years, mainly because the law puts the brakes on annual increases in Medicare reimbursement for Medicare Advantage, hospital costs, home health services, hospices and skilled nursing services. Hospitals have to absorb most of the reductions, about $260 billion over 10 years. Medicare Advantage will receive about $156 billion less.
Other cuts include $66 billion less for home health, $39 billion less for skilled nursing services and $17 billion less for hospice care — all by 2022.
Medicare costs will still grow, just more slowly than they would without the ACA. But some experts predict that beneficiaries will feel the impact. "The notion that you can take $700 billion out of Medicare reimbursements and not think you will see some impact over time is ridiculous," says economist Gail Wilensky, who directed Medicare and Medicaid in the George H.W. Bush administration and is a senior fellow with Project HOPE, an international health foundation.
But Henry J. Aaron of the Brookings Institution, a liberal think tank, insists that "the ACA is unalloyed good news" for Medicare beneficiaries because it improves the financial health of Medicare Part A, the hospital insurance program.
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