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ACA: Basics, ACA: Medicare & Medicaid

Moving Forward…Protecting Seniors Care

Today we celebrate the accomplishment for older women through the Affordable Care Act (ACA). Because women live longer, they make up more than half of the Medicare population and are more likely to have multiple chronic conditions. As both caregivers and patients, older women have borne the brunt of shortcomings in our health care system – high costs, poor quality, and fragmented, uncoordinated care. They are more likely to suffer from problems related to poor care conditions, need long term care services, and end up in the donut hole.

The Affordable Care Act (ACA) is moving us forward and protecting older women by strengthening Medicare and saving money. The ACA includes a number of provisions that will improve the quality and affordability of care for older women, including:

  • 3 Million seniors in the Medicare prescription drug donut hole received $250 rebate last year. In 2011, seniors who hit the donut hole are eligible for $1,500 in savings, and by 2020 the donut hole will be closed completely. [Families USA, Help in the Donut Hole]
  • Providing over 44 million seniors with free preventative care services, including an annual wellness exam. This means health problems can be detected and treated sooner.
  • Expanding Medicaid services and options that can help seniors with home care. According to the Kaiser Family Foundation, the Affordable Care Act provides “states with new options for offering home and community-based services through a Medicaid state plan.” It also establishes the “Community First Choice Option in Medicaid to provide community-based attendant supports and services to individuals with disabilities who require an institutional level of care.” States will receive a higher federal matching rate to help with the costs of the program. [Kaiser Family Foundation, Summary of the Health Reform Law]
  • Cracking down on waste fraud and abuse in Medicaid. The ACA provides $300 million for stronger enforcement and gives the government more authority to increase oversight of companies participating in Medicare and Medicaid. In FY2010, the federal government recovered a record $4 billion in these efforts. The Affordable Care Act ends Medicare Advantage overpayments to private insurance companies. In 2009, payments for Medicare Advantage plans were 14 percent higher than what traditional Medicare would spend for similar beneficiaries. [AARP, Fact Sheet: What the Health Care Law Does Now for People 65+; MedPac, March 2009]

The Affordable Care Act is about empowering seniors to have more freedom and giving them back control over their health care decisions. This is certainly something to celebrate – it’s time to move forward…older women cannot afford to go back.

Note on the Wisconsin Budget and Older Women – SeniorCare As part of Governor Walker’s budget proposal for the Department of Health Services, Secretary Smith, has made clear his intention to effectively end SeniorCare, Wisconsin’s prescription drug assistance program, in its current form. The proposed change will force tens of thousands of seniors to enroll in the more-expensive private plans available through Medicare Part D. SeniorCare will still be available for supplemental coverage. [State of WI Executive Budget for Medical Assistance, Overview and Milwaukee Journal Sentinel, 3-13-11]

Unfortunately, a large majority of low–income SeniorCare enrollees will not be better off with the Medicare Part D program, and may not even be eligible for the Medicare Part D low-income subsidy. The Administration’s plan will not only boost drug company profits, because Medicare Part D does not negotiate drug prices, but it will cost taxpayers more – the $588 annual federal cost per enrollee of SeniorCare is less than half the $1,690 spent by the federal government to subsidize Medicare Part D.

Wisconsin seniors deserve the highest quality, most affordable care. SeniorCare, the only plan of it’s kind in the nation, must be preserved…our seniors cannot afford to go back.



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