Health Reform Blog

Strengthening Medicare and Protecting America’s Seniors

On Tuesday, I joined President Obama at a tele-town hall meeting in Wheaton, MD, to answer seniors’ questions about what the Affordable Care Act will mean for them and to clear up misconceptions about Medicare.  We took questions from seniors watching our event from around the country, and HHS officials fanned out across the country to attend some of their watch parties in person.

The President opened our event by describing how the Affordable Care Act strengthens and renews Medicare, the “promise to America’s seniors that you can live out your golden years with some basic peace of mind and health coverage that you can count on.”  Seniors won’t lose their guaranteed Medicare benefits, whether they are in Original Medicare or Medicare Advantage.

In fact, the Affordable Care Act strengthens Medicare. This year, eligible seniors who reach the “donut hole” – or the gap in Medicare Part D prescription drug coverage – will receive an automatic, one-time tax-free $250 check to help cover their costs.  And the donut hole will be phased out over ten years, starting with 50% savings on Medicare Part D-covered brand-name drug prescriptions in the donut hole next year. You can read about this rebate check here.

Coming next year, the Affordable Care Act will provide seniors free preventive care services like free cancer screenings and a free annual wellness visit.  New community health teams will coordinate care for seniors with multiple doctors and for seniors transitioning from hospital stays back into their communities.

In addition, we are working to strengthen Medicare by fighting fraud, waste and abuse using new resources provided by the Affordable Care Act. Unfortunately, since the passage of the new law, we have witnessed an uptick in scams against seniors. We have a zero tolerance policy for people who prey on seniors. Earlier this week, Attorney General Eric Holder and I sent a letter to the State Attorneys General asking them to join us in mounting a substantial outreach campaign to educate Medicare beneficiaries about how to avoid scams and prevent fraud which will begin this summer. As part of this campaign, The Centers for Medicare and Medicaid also announced some radio ads that will run across the country. Listen here.

To learn more about how the Affordable Care Act will strengthen Medicare and to find resources explaining the new benefits of the law, visit www.medicare.gov. To learn more about our efforts to stop fraud, visit StopMedicareFraud.gov.

Seniors Across the Country Join President Obama’s Discussion on Health Reform and Medicare

Yesterday, seniors across the country participated in President Obama’s tele-town hall meeting on the Affordable Care Act. Tens of thousands of seniors listened or watched the event while others gathered at more than 100 watch parties, some of which were attended by senior Obama Administration officials.

• Watch the full event, with direct links to each question.

At the event, President Obama knocked down the misinformation campaign opponents of reform have been waging for a year.  Here’s what he said:

Now, this debate got pretty contentious at times last year. I think you remember.  And just when you were looking for accurate information about what this reform would mean for you, there were a lot of opponents of health care reform generally that sought to deny you that information.  And they ran some pretty nasty rumors in hopes that it would scare folks.  I know that’s hard to imagine in politics -- but that’s what happened.

So here’s the truth:  First and foremost, what you need to know is that the guaranteed Medicare benefits that you’ve earned will not change, regardless of whether you receive them through Medicare or Medicare Advantage.  Your guaranteed benefits will not change.  Eligibility won’t change.  Medicare will continue to cover your costs the way it always has.  If you like your doctor, you can keep your doctor.

He discussed how the Affordable Care Act will help seniors across the country and strengthen Medicare.

This new law gives seniors and their families greater savings, better benefits and higher-quality health care. That’s why it ensures accountability throughout the system so that seniors have greater control over the care that they receive.  And that’s why it keeps Medicare strong and solvent -– today and tomorrow.

And the President also answered questions about Medicare Advantage:

…Here’s what we did under the law.  What we said was, you can maintain Medicare Advantage, but we are going to say to the insurance companies that you can’t use this just to pad your profits or to pay higher CEO bonuses.  Eighty-five percent of what you spend has to actually be for health services.  We’re going to review the rates that are applied.  We’re going to set a rate that is fair and appropriate so that Medicare Advantage isn’t costing people who aren’t in Medicare Advantage.

This morning, local papers across the country are reporting on the recent events. Some highlights:

Pennsylvania: "Local seniors view live Obama healthcare broadcast," York Daily Record 

“If Obama's intention was to re-assure seniors, it appeared to have worked for the crowd at the White Rose center. Afterward, in response to a request by the National Council on Aging, they conducted a poll by show-of-hands.

“Nineteen of the assembled seniors raised their hands when asked how many feel they will be better off as a result of the new law. None raised their hands when asked how many feel they will be worse off."

New Jersey: "Wyckoff seniors assimilate Obama's view of health care plan at town hall teleconference,"Suburban News

“Following the meeting, which lasted just over an hour, residents of the Christian Health Care Center had mostly favorable things to say about the speech…

“Lorene Snodderly called the speech ‘very good,’ and said she liked the way [President Obama] answered questions.

“‘He hits the concerns older people have,’ she said.”

New Mexico: "Health Care Benefits Come For Some Seniors," KOAT-TV

“‘When the Medicare prescription drug benefit was passed a few years ago because of budgetary concerns, Congress created this gap in coverage,’ said Rima Cohen, counselor to the Secretary for Health Policy at the Department of Health and Human Services, who came to New Mexico to help answer questions…

“Seniors will be enrolled automatically and receive a check when they reach the $2,800 spending cap, so seniors won't won't have to provide their social security number, Medicare number, or any money.”

North Carolina: "President talks with seniors about health care," WWAY-TV

“Today President Obama held a town hall meeting with senior citizens via telecast. Some folks in Southport came to the Brunswick Center to watch.

“The meeting focused on the affordable care act. One of the first efforts to ease the cost of Medicare on senior citizens is a $250 rebate check for those who fall into the prescription drug coverage gap called ‘the donut hole.’ Sally Turner was glad to finally have some answers.

“‘I think it answers a lot of questions about the Medicare bill, the new Medicare bill,’ she said. ‘And it helps kinda clear up the air a little bit about what's happening to Medicare, what's happening to Social Security, what's going to happen to our children as far as Social Security and Medicare, and I was glad to hear the answer was positive.’”

Connecticut: "New London seniors meet with president, virtually," New London Day

“Senior centers around the nation, including one in our backyard, participated in a tele-town hall meeting on the Affordable Care Act with President Barack Obama this afternoon…

“The president discussed what the Patient Protection and Affordable Care Act meant to seniors to ensure that they have accurate information about the new law, which passed in March. The health care legislation gives seniors better benefits, they will see a cost savings and higher quality health care, Obama said. Preventative care services like colorectal cancer screenings, mammograms and annual wellness visits will be available free to seniors.”

Note: This blog was originally posted on The White House Blog.

New Grants to Protect Consumers

Skyrocketing insurance rates have made health coverage unaffordable for many American families.  But thanks to the Affordable Care Act, the balance of power is shifting from insurance companies back to consumers. This week, Secretary Sebelius announced the availability of $51 million in Health Insurance Premium Review Grants through the Affordable Care Act.  These funds are the first round of grants available to states through a new $250 million grant program to create and strengthen insurance rate review processes.

This announcement comes a month after Secretary Sebelius sent a letter to Governors and State Insurance Commissioners urging them to review the authority they have under their state laws to determine whether they have the tools they need to approve health insurance rates before they take effect.

As the Secretary said, “These new grants will help states protect consumers and small employers by holding insurers accountable for unreasonable insurance rate increases that have made coverage unaffordable for many American families. By strengthening oversight of insurance premiums, these grants will help put affordable coverage back within the reach for Americans who have been hit hard by skyrocketing costs.”

Working with State Attorneys General to Combat Medicare Fraud

Today, Secretary Sebelius and Attorney General Holder today sent a letter to state attorneys general urging them to work with HHS and federal, state, and local law enforcement officials to mount a substantial outreach campaign to educate seniors and other Medicare beneficiaries about how to prevent scams and fraud beginning this summer. 

In the letter, the Secretary and Attorney General outline education and outreach efforts where state attorneys general could make a big difference.

Read the full letter here.

Making Coverage More Affordable for America’s Seniors

As part of the Affordable Care Act, in the coming weeks, many Medicare recipients across the country will begin receiving a tax-free $250 rebate check to help pay for prescription drug costs. This important benefit is a first step toward closing the Medicare “donut hole” and making coverage more affordable for Seniors.

If you or someone you know is eligible to receive this rebate check, it is important to know this basic fact:  Medicare will automatically send a check that’s in your name. You don’t need to fill out a form or make any phone calls to receive it. You also don’t need to provide personal information like your bank account or social security number or do anything else. If someone calls you about the rebate check, don’t give out your personal information as it could be a scam. If you suspect fraud, please call 1-800-MEDICARE to report it.

To learn more about the $250 rebate check, read this new brochure (pdf), or visit www.Medicare.gov.

And tune in tomorrow, June 8, at 11:15 am EDT for a special national town hall with President Obama, Secretary Sebelius, and senior citizens to discuss the Affordable Care Act. This event will be shown on WhiteHouse.gov/live.

Changes are Coming for Young Adults

Year after year, more and more young adults go without health insurance. Many lose coverage when they graduate from high school or college and are no longer eligible for the Children’s Health Insurance Program, or are dropped from their parents’ plans.

But all this is changing with the passage of the Affordable Care Act, which the Commonwealth Fund writes about in their new study called: Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help. As the authors point out, young adults between 19-29 represent one of the highest uninsured groups in the country.

“As of 2008, the number of uninsured young adults between the ages of 19 and 29 was nearing 14 million, representing three of every 10 uninsured persons in the United States. But this figure most likely underestimates the problem. Unemployment has soared in this age group over the past year, reaching 17.2 percent among 20–24-year-olds and certainly increasing the number of young adults without health insurance.

Health reform—specifically, the enactment of the Affordable Care Act of 2010—promises to cover approximately 32 million uninsured people over the next 10 years, including the majority of uninsured young adults”

The new law promises to help young adults by:

• Granting them the ability to remain on parents’ health plans up to age 26, unless they have their own offer of coverage in some cases. This begins as early as September 2010, but many insurance companies have agreed to extend this coverage immediately.
• Instituting new insurance market regulations, including a ban of lifetime limits on insurance policies, beginning as early as September 2010

Read here for more information about how young adults will benefit from health reform.

New Report Includes Good News for Early Retirees

Earlier this month, the Department of Health and Human Services announced new information regarding a program in the Affordable Care Act that will make it easier for large employers to provide health benefits to early retirees who aren’t eligible for Medicare. The $5 billion early retiree reinsurance program will provide resources to businesses that offer coverage to retirees age 55-64.

We knew business leaders and retirees were excited about this program and a new study confirms that companies are eager to sign up and continue to provide coverage their early retirees. A new study out today from Hewitt Associates finds that 76 percent of eligible companies plan to apply to participate in the early retiree reinsurance program. The study also estimates that the program will reduce the cost of retiree coverage from 25 to 35 percent – anywhere from $2,000 to $3,000 per retiree, per year

The study is good news for retirees and their former employers. In recent years, high health care costs have made it difficult, if not impossible for employers to offer coverage to early retirees. 66 percent of large firms offered health benefits to their retirees in 1988. By 2008, the percent of large firms offering health benefits dropped to only 31 percent. And retirees without employer-sponsored often found it difficult to afford coverage in the individual market.

The early retiree reinsurance program will help maintain current coverage until 2014, when millions of Americans will have affordable coverage options through the new health insurance exchange. Businesses will be able to apply to participate in the program in June. You can learn more about how the Affordable Care Act will benefit early retirees here.

Donuts, Health Insurance, and Big Businesses

Today’s New York Times takes a look at the Affordable Care Act’s provisions regarding the shared responsibility of health care between taxpayers and employers.   The story claims part of the law will saddle employers with new hidden penalties.   That is not that case.   What it will do is help bring down health care costs and give more Americans the insurance they need and deserve.

Here are the facts:

The Affordable Care Act will strengthen our current system in which most people get their insurance at work. Under the new law, employers with more than 50 fulltime workers will not be required to offer health insurance to their workers.  However, the employer will have to pay a shared responsibility fee if their employee purchases coverage through a new exchange with the help of a premium tax credit targeted toward middle to low income families.  In other words, employers can’t be “free riders” and let the taxpayers pay for the cost of covering their workers.

If the insurance provided by an employer would cost workers more than 9.5 percent of their household income, that insurance is considered unaffordable and workers have a new option: purchase affordable coverage on the new health insurance exchanges, and receive a tax credit to make it easier to get the coverage they need.

Under this scenario, employers would no longer be paying to provide benefits to their employee. Instead, they would contribute to $3,000 to help support the cost of the tax credit provided by the government.

If the employer provides no insurance at all, and any employee obtains premium tax credits through the new exchanges, the employer would pay a maximum of $2,000 per full time employee.  

Whether a large business provides affordable coverage to their employees or their employees purchase coverage in the exchange, employers will make one – and only one – contribution to the cost of their employees’ health care.  It’s an important provision and it ensures large aren’t off the hook if taxpayers are subsidizing health insurance coverage for their employees.

A good way to understand this part of the law is to think about…donuts. When the Commonwealth of Massachusetts passed its version of health insurance reform, many businesses began offering insurance to their workers. Unfortunately, employees at a chain donut shop found that they couldn’t afford the insurance they were offered. But under the Massachusetts law, they could not purchase affordable coverage in the state’s version of the exchange because their employer offered coverage. 

This catch-22 left some without the affordable, quality care they need. So when it came time to pass the Affordable Care Act, we took steps to ensure that this problem would not be repeated in donut shops and other businesses nationwide by making sure workers can get care they can afford and by making sure that employers aren’t relying on taxpayers to subsidize coverage for their employees.
 
The bottom line is that this provision is a common-sense way to ensure more Americans have high-quality care and it’s just one of the many ways the Affordable Care Act will strengthen the health care system for all of us.

What the Affordable Care Act Means for Americans with Disabilities

As the 20th Anniversary of the Americans with Disabilities Act and 11th Anniversary of the Olmstead v. LC decision approach, it is exciting to reflect on how the Affordable Care Act (ACA) advances the principles of equality, barrier removal, and community integration embodied in these landmark events.

Historically, people with disabilities have been severely disadvantaged in accessing private health insurance, subject to discrimination based on pre-existing conditions, benefit limits and exclusions, and at risk of losing coverage on short notice. Medicaid’s institutional bias -- allowing coverage of home and community based long term care services and supports while requiring coverage of nursing home services -- perhaps kept too many people with disabilities in nursing homes, despite clear consumer preference for and the cost-effectiveness of community living. Exam equipment isn’t designed to meet persons with disabilities’ needs and knowledge on existent health disparities has not been used to address these concerns.

The Affordable Care Act makes considerable strides in addressing these concerns and advancing equality for persons with disabilities. This year, the new law will end pre-existing condition discrimination for children with disabilities, dropping people from insurance plans when they become sick and lifetime benefits limits. By 2014, insurance companies will be barred from discrimination on the basis of medical history or genetic information, and precluded from setting unreasonable annual limits. Plans will be required to provide information in a user-friendly manner that clearly explains what is and isn’t covered.

 The  Affordable Care Act advances community living by extending the Money Follows the Person program, improving the Medicaid home-and-community-based services (HCBS) option, and creating new options and incentives making it easier for states to provide HCBS – including Community First Choice. Yesterday, the Centers for Medicaid and Medicare Services (CMS) released a letter to State Medicaid Directors stressing our commitment to Olmstead implementation and community integration. Outside Medicaid, the new law provides for the creation of a new, voluntary, self-insured insurance program (CLASS Act) that helps individuals pay for long-term supports and services if they develop a disability.

 The Affordable Care Act enhances health care delivery by establishing standards for medical diagnostic equipment so people with disabilities can access vital preventative care, instituting data collection, enhancing providers’ cultural competency and improving care coordination between Medicare and Medicaid for people with chronic conditions.

This is just the leading edge of change, which will allow a health care system better attuned to the needs of people with disabilities, while honoring the principles of equality, inclusion and community living!