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How will the ACA (Obamacare) Affect Senior Citizens?

How will the AFFORDABLE CARE ACT AFFECT SENIOR CITIZENS? THESE FIVE KEY POINTS The Affordable Care Act (ACA). better known as Obamacare, makes major changes to the way senior citizens receive health care. WILL HELP YOU Information on this topic is often confusing, with drastically differing viewpoints from Republicans and Democrats. UNDERSTAND PROVE BOTH SIDES OF THE DEBATE. ABOUT MEDICARE: Medicare is divided into parts A through D which cover various types of health care. On average. Medicare covers about 48% of health care costs for enrollees. the additional costs are Medicare is a system of federally administered health care available to people age 65 and over. paid by private insurance such as Medicare Supplemental Insurance or private funds. Medicare and the Health Insurance Marketplace - HealthCare.gov IT'S NOT FOR: Medicare recipients who already have Medicare Part A with no premiums and/or Part B IT MIGHT BE FOR: Those who must buy Medicare Part A ($441/month in 2013), because they have not earned enough working credits (Note: if purchased through the Marketplace there may be a late enrollment penalty fee if they enroll in Medicare in the future). O See the glossary below for more information on Medicare and the coverage options. O REPUBLICAN OPPONENTS POINT OUT ACA DEMOCRAT PROPONENTS POINT OUT MEDICARE IMPACT Important Components of Medicare Funding are Cut Costs are Reduced by Reducing Fraud and Utilizing Preventative Services Obamacare will cut Medicare funding by $716 billion over the 2013 to 2022 period. of funds are administrative costs and profits The projected 2013 budget deficit is $642 billion. Plans must maintain a medical loss ratio of 15% $716 BILLION $642 BILLION 85% 2022 2014 Medicare Advantage plans must maintain a medical loss ratio of 85% by 2014. This means that plans can use no more than 15% of their funds for administrative costs and profits. 2013 Medicare funding cuts from 2013 to 2022 Projected 2013 budget deficit THE 2013 SEQUESTER CUT $50 B $40 B- $30 B OTHER AMERICA 25% - 30% COUNTRIES 5% - 10% $20 B Current 25-30% in America, though other countries typically keep this cost in the range of 5-10% for healthcare estimated at $10 B Offering Free Preventative Services will Reduce Care Costs Overall, the available Medicare benefits will not change, and the ACA made many services free including annual wellness visits, flu shots, and screening for chronic diseases. $42.7 $28.7 $9.9 $4 WHAT ACA CUTS FROM MEDICARE TOTAL NUMBER OF MEDICARE BENEFICIARIES IN 2012: 50.7 MILLION $39 B Skilled Nursing Services $33 B All Other Services $17 B Hospice Services In 2012. 34.1 million Medicare beneficiaries took $66 B Home Health Services $260 B Hospital Services advantage of the free preventive services already available as part of the ACA 34.1 M 2012 In the first 6 months of 2013. 16.5 million Medicare 16.5 M beneficiaries received at least one of these $156 B Payment Rates in Medicare Advantage free preventive services, putting this $145 B DSH payments and other Medicare Provisions year on track for a similar turnout. 2013 IMPACT ON INDIVIDUALS Less Costs for Low Income Individuals More Taxes for High Income Earners 25K, High-income beneficiaries will face increased Medicare premiums and higher Medicare taxes. 20K 16K 150% at or below poverty level 4.0% 10K 3.6% 3.0%- IK $11,490 43,880 2.6% 2.35% 2.35% 2.0%- SINGLE PERSON FAMILY UNIT OF A People with an income at or below 150% of the federal poverty level ($11.490 for single person. $23.550 for family unit of 4) will receive a drug subsidy. 1.8% 1.0% O.8% 1.45% 1.45% Cost Savings for All $200,000+ Individuals $250,000+ Couples Filing Jointly 4K Free preventive services, lower drug costs, and other assistance wilLl save 3K The Medicare tax rate will increase from 1.45% to 2.35% for individuals who earned over $200,000 and couples filing jointly who earned over $250,000. 2K Medicare beneficiaries an average of $4,200 over the 2010-2020 1K $4,200 decade 2010-2020 PRESCRIPTION DRUGS Higher Drug Costs for Certain Income Brackets Closure of the "Donut Hole" to reduce drug costs Individuals in certain income brackets will have to pay a higher prescription drug coverage premium for Medicare Part D. $250 2$ REBATE ANNUAL 2011 INCOME How Your Prescription Drug Coverage Premium May Change Individual Tax Return Joint Tax Return Added Monthly Cost to Your 2013 Plan Premium 50% $170K - $214k DISCOUNT ON BRAND NAME PRESCRIPTIONS $85K - $107k $11.60 $107K - $160k $214K - $320k $29.90 $160K - $214k $320K - $428k $48.30 $214k • $428k • $66.60 Seniors who fall into the "donut hole' created by the Medicare Modernization Act of 2003 have been responsible for 100% of their drug costs up to a set amount. Obamacare has provided a $250 rebate to these individuals as well as a 50% discount on brand name prescriptions. Filing Married & Separate Tax Return Added Monthly Cost to Your 2013 Plan Premium $85K - $129k $48.30 $129k + $66.60 By 2020 the donut hole will close HEALTHCARE CHOICES Fewer Plans to Choose From Better Quality Care with a Reduction of Growth in Medicare Spending Seniors will have fewer Medicare plans to choose from. Medicare Advantage payments were frozen in 2011 and enrollment in this program is expected to reduce by half by 2017. Obamacare calls for several new initiatives to improve care quality while reducing costs. Less Providers Accepting Medicare Recipients The rate of growth in Medicare payments to healthcare proiders will be reduced and could make providers less inclined to take Medicare patients. OBAMACARE PROGRAM The Center for Medicare and 100 Medicaid Innovation will test new ways of delivering care such as programs that reduce unnecessary hospital readmissions. 80 15%+ 60 83% 81% 40 2010 2012 2014 In 2010. 83% of family doctors accepted Medicare. This dropped to 81% in 2012, according to an American Academy of Family Physicians study. The Centers for Medicare & Medicaid Services (CMS) estimates that another 15% of Medicare Part A providers will drop out of Medicare due to ACA cuts. Accountable Care Organizations, bundled payments, and medical homes will provide higher-quality care for beneficiaries. 10,000 8,000 6,000- 4,000 2,000- 3,700 9,539 Physicians and certain services will receive bonus payments. 2009 2012 The number of physicians who previously accepted Medicare but opted out of the program rose from 3.700 in 2009 to 9.539 in 2012 DOCTOR SHORTAGE Shortage of Doctors is Not Addressed Offers Provisions that Expand the Primary Care System while Stll Reducing Costs Obamacare is expected to increase patient demand for medical services, but does not address the growing need for physicians and specialists that the country will face in coming years as baby boomers age. Obamacare authorizes money to increase the primary care workforce by: Training more doctors, nurses, nurse-practictioners and physician assistants. S0000 i -159,300 Including more graduate medical education training positions, with priorities for primary care and general surgery. 100000 150000 i -31,000 With Obamacare 200000 Total physicians lost by 2028: Offering more money for |-9- scholarships and loans for all health professionals. -190,300 The Association of American Medical Colleges (AAMC) forecasts that in 15 years the United States will face a deficit of up to 159.300 physicians. The AAMC projects that Obamacare would increase the physician shortage by an additional 31,000 doctors. GLOSSARY OF TERMS: MEDICARE PART A: Coverage for inpatient health care at medical facilities as well as some home health care. PREVENTIVE SERVICES: Medical services that prevent, rather than treat, illness. These include physical exams, flu shots, and mammograms. MEDICARE PART B: Coverage for outpatient care such as lab work and doctor's visits. HEALTH CARE PROVIDER: Any physician or facility that provides health care services. MEDICARE PART C: Also known as Medicare Advantage, this is private insurance that individuals can purchase to supplement Parts A and B. MEDICARE DONUT HOLE: A coverage gap in Medicare Part D where beneficiaries are responsible for 100% of their prescription drug costs. In 2013. the amount was generally $2.970. Once total drug costs reach $2970 in the calendar year, you reach MEDICARE PART D: Coverage for prescription drugs. the donut hole RESOURCES: - ncpssm.org/PublicPolicy/Medicare/Documents/ArticlelD/216/How-the-Affordable-Care-Act-Helps-Seniors • cbo.gov/sites/default/files/cbofiles/attachments/43471-hr6079 pdf • swampland time.com/2012/08/16/fact-check-obamacares-medicare-cuts/ healthaffairs.org/healthpolicybriefs/brief php?brief_id-17 • heritage.org/research/reports/2010/05/obamacare-impact-on-seniors • huffingtonpostcom/sec-kathleen-sebelius/the-affordable-care-act_b_1462694html • thehill.com/blogs/congress-blog/healthcare/205361-rep-larry-bucshon-r-ind foxnews.com/politics/2013/05/15/2013-deficit-estimate-lowered-to-642-billion/ • daytondailynews.com/photo/news/sequester-cuts-breakdown-2013/ppLxk/ blog heritage.org/2012/10/16 obamacares-716-billion-in -to-medicare/ online.wsj.com/news/articles/SB10001424127887323971204578626151017241898 cms gov/apps/files/Medicarereport2012 pdf * ncpssm.org/Medicare/MedicareFastFacts acponline.org/advocacy/where_we stand/assets/i-prescription-drug-discounts.pdf medicare gov/Pubs/pdf/11469 pdf forbes.com/sites/carolynmcclanahan/2012/05/15/what-is-a-medical-loss-ratio-the-check-will-be-in-the-mail/ • merritthawkins.com/clients/BlogPostDetailaspx?Postid-38718 O Assisted LivingFacilities Defense 2nseuog Discretionary -Medicare Bujpuads OBORABOB

How will the ACA (Obamacare) Affect Senior Citizens?

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We have had numerous questions submitted to us asking about the impact of the ACA (aka Obamacare) on seniors. The Affordable Care Act (ACA), better known as Obamacare, makes major changes to the way s...

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