The Affordable Care Act: Strengthening Medicare, Combating Misinformation and Protecting America’s Senior

The Affordable Care Act passed by Congress and signed by President Obama this year will provide seniors and their families with greater savings and increased quality health care. It will also ensure accountability throughout the health care system so patients and their doctor—not insurance companies—have greater control over their own care.

On Tuesday, June 8, President Barack Obama – in a national tele-town hall meeting answering questions directly from seniors across the country – launched an unprecedented national campaign to combat fraud and misinformation and deliver the facts to America’s seniors about Medicare and the Affordable Care Act. The campaign includes a series of steps to protect seniors by ensuring they have clear and accurate information about the new law and implementing stronger tools to fight waste, fraud and abuse in the Medicare program. Administration officials attended neighborhood meetings where seniors gathered to participate in the tele-town hall to answer additional questions from seniors. More than 100 events were held across the country.

The Affordable Care Act: Important Benefits for Seniors

Medicare is a sacred trust between America and its seniors – the Affordable Care Act, passed by Congress and signed by President Obama this year, guarantees that trust is never broken.  The Affordable Care Act will provide greater savings and increased quality care to America’s seniors, and by ensuring increased accountability throughout the health care system it puts seniors and their doctors, not insurance companies, in control of their health care.  These are needed improvements that will keep Medicare strong and solvent.  America’s seniors will see new benefits, new cost savings, and an increased focus on quality – all to guarantee they get the care they need. You can learn more about the new law here. Some of the new benefits in the Affordable Care Act include:

• A one-time, tax free $250 rebate check for seniors who hit the prescription drug “donut hole” who are not already receiving Medicare Extra Help. These checks will begin mailing on June 10 and will continue monthly throughout the year as beneficiaries enter the coverage gap.
• Free preventive care services like colorectal cancer screening and mammograms and a free annual wellness visit.
• Community health teams will provide patient-centered care so seniors won’t have to see multiple doctors who don’t work together. The new law also helps seniors who are hospitalized return home successfully—and avoid going back—by helping to coordinate care and ensure they have access to support in their community.
• Medicare pays Medicare Advantage insurance companies over $1,000 more per person on average than traditional Medicare. These additional payments are paid for in part by increased premiums for all Medicare beneficiaries—including the 77% of seniors not enrolled in a Medicare Advantage plan. The new law levels the playing field by gradually eliminating Medicare Advantage overpayments to insurance companies while protecting guaranteed Medicare benefits.   Instead of overpayments similar to the last several years to insurance companies, the new law will base payments on the local cost of providing guaranteed Medicare services.  Medicare Advantage plans will also receive new bonus payments based on performance (e.g., for providing care based on preventing diseases before they start, and care that stops diseases from getting worse).  Participating health plans will also be prohibited from charging higher out-of-pocket costs to seniors than traditional Medicare for similar services.
• Over the next 20 years, Medicare spending will grow at a slower rate, as a result of eliminating waste, fraud, and abuse.  This will extend the life of the Medicare Trust Fund by 12 years and provide cost savings to Medicare beneficiaries.  In 2018, seniors can expect to save, on average, almost $200 per year in premiums and over $200 per year in co-insurance compared to what they would have paid without the Affordable Care Act. Upper-income beneficiaries ($85,000 of annual income for individuals or $170,000 for married couples filing jointly) will pay higher premiums.  This will impact about 2% of Medicare beneficiaries.

Fighting Waste, Fraud and Abuse

Stopping misinformation means keeping seniors safe from fraud and scam artists who seek to take advantage of the new law and steal from seniors and taxpayers. The Administration has taken a series of steps to fight fraud:

• The President has directed HHS to cut the improper payment rate, which tracks fraud, waste and abuse in the Medicare Fee for Services program, in half by 2012.
• The Administration has helped support a renewed partnership between the federal government and state Attorneys General. Secretary Kathleen Sebelius and Attorney General Eric Holder today sent a letter to state Attorneys General urging them to vigorously prosecute criminals who seek to steal from seniors and taxpayers and pledged the support of federal officials for state efforts.
• A nationwide series of anti-fraud summits hosted by the Departments of Justice and Health and Human Services will bring federal, state and local officials together with representatives from the private sector to discuss tactics to fight fraud. The first summit will be held in Miami with additional summits in Los Angeles, Las Vegas, Detroit, Boston, New York, and Philadelphia.
• A redoubling of efforts by U.S. Attorneys nationwide to coordinate with state and local law enforcement to prevent and prosecute fraud. Today, Attorney General Holder called on U.S. Attorneys to hold regular forums with local officials to discuss how to better crack down on criminals who commit fraud.

Reaching Out to Medicare Beneficiaries

In recent weeks, Medicare beneficiaries have received important new information in the mail regarding the Affordable Care Act that answers many questions Administration officials have received from the American people. When seniors hit the prescription drug gap known as the donut hole, they will receive additional details along with a $250 rebate check to help cover the cost of their prescription drugs. The mailers follow Medicare’s long-standing practice of communicating with beneficiaries and provide important information about how seniors can take advantage of their new Medicare benefits.

Communicating Over the Airwaves

The Centers for Medicare & Medicaid Services, in conjunction with the Administration on Aging, will be launching an educational media campaign this summer to educate Medicare beneficiaries about the importance of staying vigilant with their personal Medicare information and getting the facts about the new law to seniors so that scam artists are not able to prey on them.

The first phase of the outreach campaign will be a series of radio ads that will run in key areas of the country where there are a large number of seniors who fall in the coverage gap and who could be eligible for the $250 one-time tax free rebate check.  For more information on this campaign, please click here.