OBAMACARE BREAKS THE PROMISE OF MEDICARE FOR SENIORS TO BANKROLL A MEDICAID EXPANSION FOR ABLE-BODIED, CHILDLESS ADULTS
THE MEDICARE PROMISE OUR SENIORS DEPEND UPON
Medicare is under attack. Created to provide seniors with basic protections as they encounter medical issues during their golden years, Medicare seniors are yet another victim of the federal Affordable Care Act (ObamaCare) and the Washington takeover of health care.
The federal government has made $37 trillion worth of benefit promises to seniors. The Medicare Advantage program in particular has given millions of seniors a choice of several private insurance plans that offer comprehensive benefits, better access to doctors and often lower out-of-pocket costs for health care. ObamaCare’s severe cuts to Medicare have sent a clear message to our nation’s seniors: your health is not worth protecting. Millions of seniors will lose the Medicare benefits they depend on in order to live a longer, healthier life.
BREAKING THE MEDICARE PROMISE
ObamaCare breaks the Medicare promise to our seniors in order to pay for a new promise of Medicaid expansion. ObamaCare assures states that do expand Medicaid eligibility—mostly to working-age, non-disabled adults with no kids—that the federal government will pay 100 percent of their expansion costs from 2014 to 2016 and 90 percent thereafter, indefinitely. The financing for ObamaCare’s Medicaid expansion relies on both cuts to seniors’ Medicare and more than $1 trillion in new taxes. According to the nonpartisan Congressional Budget Office (CBO), $716 billion will be raided from the Medicare program over the next 10 years.
IS OBAMACARE’S MEDICAID EXPANSION WORTH SACRIFICING SENIORS’ MEDICARE?
ObamaCare’s Medicaid expansion is almost entirely designed for working-age, able-bodied adults with no children. A handful of states expanded coverage for this population well before ObamaCare was law, and the results have been astoundingly negative. Two to three times more individuals enrolled than projected, dramatically increasing taxpayer costs. Meanwhile, despite assurances from hospital lobbyists and executives, the level of uncompensated care hospitals provided in the states rose instead of declined after the expansion, with those costs often passed along to patients with private coverage. Most devastating to Medicaid expansion supporters, the uninsured rate did not go down in most of these states either.
For the ObamaCare Medicaid expansion, a significant portion of new Medicaid enrollees will be former inmates just released from prison. Past experience further tells us that 30 to 40 percent of this new expansion population will drop their current private insurance to instead get free, taxpayer-paid coverage under ObamaCare’s Medicaid expansion.
SLASHING MEDICARE PUTS SENIORS’ HEALTH AT RISK
ObamaCare’s $716 billion in cuts to Medicare attack seniors enrolled in Medicare Advantage (Part C). These cuts put critical services on the chopping block, including hospital services, skilled nursing services, hospice services and home health visits. ObamaCare’s Medicare cuts have no concern for value and do not even target areas where waste, fraud or abuse is suspected. Instead, ObamaCare’s Medicare cuts are across the board, disregarding quality or performance.
CUTTING SENIORS’ MEDICARE TO PAY FOR MEDICAID EXPANSION HAS SEVERE IMPLICATIONS:
- Seniors Lose Access to Doctors: Doctors will lose needed revenue by treating Medicare patients, to the point where they will stop seeing them in order to keep their practices open. Experts predict that 15 percent of hospitals and nursing homes will stop accepting Medicare patients over the next 10 years.
- Seniors Lose Access to Hospitals: Experts also predict 40 percent of hospitals will be unprofitable by 2050 due to ObamaCare’s Medicare cuts. Seniors will also face limited provider networks. UnitedHealth, a major insurer with a large Medicare Advantage population, has already announced that ObamaCare will force it to narrow its provider networks by 10 to 15 percent.
- Seniors Lose their Health Plans: Nearly 5 to 7 million fewer seniors will be able to enroll in Medicare Advantage in six years—starting with 105,000 seniors being forced out of Medicare Advantage in 2014— increasing costs and decreasing the level of care for many low-income seniors.
- Seniors Lose Benefits: Cuts in payments in the Medicare Advantage program will lead to seniors losing many of the extra benefits they depend on from these private plans.
THE DANGEROUS IMPACT ON SENIORS ENROLLED IN MEDICARE ADVANTAGE
One of the value propositions of most Medicare Advantage plans over traditional Medicare is that they offer seniors a range of plan options with many different supplemental benefits to address unique medical needs. Because of ObamaCare’s cuts to Medicare in order to fund Medicaid expansion, 5 million seniors will now lose these health options.
One of every four Medicare patients is enrolled in a Medicare Advantage plan, with enrollment growing each year. Nearly half of new Medicare patients (those just turning 65) enroll in a Medicare Advantage plan almost immediately. These plans are popular because they often offer more comprehensive and supplemental benefits than what are available in traditional Part A Medicare. These flexible private plans offer valued access to doctors and have less out-of-pocket costs for seniors. This is especially important for lower-income seniors as they experience lower out-of-pocket costs than seniors enrolled in traditional Medicare. The health outcomes for those on the program are favorable as well.
A recent study found that seniors on Medicare Advantage are more likely to receive higher levels of recommended preventive care and have fewer disease-specific complications. For example, seniors enrolled in Medicare Advantage have fewer ulcers and diabetic foot amputations compared to seniors in traditional Medicare. Medicare Advantage patients also spend 19 percent less time in the hospital during an acute illness than those on traditional Medicare.
BENEFITS ON THE CHOPPING BLOCK BECAUSE OF OBAMACARE’S CUTS TO MEDICARE
- Seniors Lose Preventive Dental
More than half (55 percent) of all Medicare Advantage plans cover some form of preventive dental care. Virtually all local and regional PPOs (preferred provider organizations) provide such coverage (99 percent and 100 percent, respectively).
- Seniors Lose Vision Coverage
All plans provide some vision benefit, particularly glasses and contacts. Almost all (86 percent) cover exams and all plans cover eyeglasses.
- Seniors Lose Hearing Coverage
Nearly two thirds (65 percent) of Medicare Advantage plans cover hearing tests. 37 percent of plans cover hearing aids. In 2010, 51 percent of HMOs, 27 percent of local PPOs, and 15 percent of regional PPOs provided a hearing aid benefit.
- Seniors Lose Out-of-Pocket Cost Protections
In 2010, most (79 percent) Medicare Advantage plans had a limit on how much seniors would be forced to pay out-of-pocket, a protection unavailable in traditional Medicare. In 2013, roughly 50 percent of Medicare Advantage plans had a limit of $3,400 or less.
- Seniors Lose Podiatry Coverage
47 percent cover more expansive podiatry services than traditional Medicare.
- Seniors Lose Chiropractic Services
34 percent cover more expansive chiropractic services than traditional Medicare.
- Seniors Lose Protection When Traveling Abroad
62 percent provide a world-wide travel benefit not provided by traditional Medicare.18 This benefit can include urgent and emergency care coverage anywhere in the world for just a small copay, and coverage for care when traveling for more than 6 months out of your service area.
- Seniors Lose Transportation Benefits
14 percent provide transportation beyond ambulance services, such as transportation to medical appointments and vision exams.
- Seniors Lose Gym Membership and Wellness Education
More than half (57 percent) of Medicare Advantage plans offer some form of coverage for a gym or health club membership. 31 percent provide newsletters or other forms of written health information seniors can use to become more informed about their health.
- Seniors Lose Predictable Visit Costs
Medicare Advantage plans typically offer fixed dollar copayments (i.e. $15 or $25 per visit) rather than traditional Medicare’s unpredictable coinsurance formula (i.e. 20% of cost of the visit). 90 percent of Medicare Advantage plans require no cost-sharing for Medicare-covered preventive services, which include important procedures such as mammograms, pap smears, and prostate exams.
- Seniors Lose Days of Hospital Care
Most Medicare Advantage plans (93 percent) provide unlimited days of hospital care, in contrast to traditional Medicare, which has annual limits and “lifetime reserve” days.
- Seniors Lose Home Health Visit Coverage
Most Medicare Advantage plans (88 percent) do not impose cost-sharing for home health visits, unlike traditional Medicare. For seniors forced off of Medicare Advantage onto traditional Medicare, this will result in higher costs for home health visits. Medicare beneficiaries who use the home health benefit have an average of 37 home health visits per year.
- Seniors Lose Drug Benefits
Most Medicare Advantage plans (82 percent) offer Part D benefits, a benefit that is not rolled together
with coverage on traditional Medicare. Most (88 percent) of Medicare Advantage enrollees in individual plans select a Medicare Advantage plan that has a drug benefit. Cuts may change or limit which medications Medicare Advantage plans can pay for.
ObamaCare not only cuts payments in Medicare, but also will levy a new health insurance tax on most companies offering Medicare Advantage plans. Companies will find ways to pass on that cost to seniors. These increasing costs and cuts will impact enrollees directly, especially those in poor health or dealing with complicated chronic conditions. Long-term reform of Medicare is still needed.
ObamaCare’s Medicare cuts will jeopardize seniors’ access to doctors and hospitals, and limit their choice of health plans that offer many advantageous benefits. Our leaders should fulfill past promises before making new ones. If not, the safety net will break for the most vulnerable as able-bodied adults are piled on top.