Alliance for Retired Americans: Big Changes for Seniors' Health Care

Health Care Reform: What's in it for Seniors

The Senate-passed health care reform bill dramatically cleared the House on a 219-212 vote Sunday night, and President Obama signed it into law on Tuesday. Please see the Alliance for Retired Americans Special Edition Friday Alert of March 23 for more details of the related votes.

The reform phases out the doughnut hole gap in prescription drug coverage, providing a $250 rebate in 2010 for seniors who fall into the hole. Beginning in 2011, seniors will receive a 50% percent discount on their prescription drugs when they fall into the doughnut hole, and by 2020 the doughnut hole will be completely eliminated.

To see the Alliance's one-page write-up listing provisions in the health reform law that will affect seniors, along with the time line for their implementation, go HERE. To summarize that document, the new law also:

• Covers preventive services; in 2011, seniors in Medicare will receive free annual check-ups with no co-payments for mammograms, colonoscopies and other preventive screenings;
• Supports early retiree coverage, providing financial assistance to employer health plans that cover early retirees;
• Encourages doctors to coordinate care and improve quality, creating incentives for providers to work together and reduce wasteful care like repeated tests;
• Removes obstacles to changing Part D prescription drug plans, allowing Part D enrollees to make a mid-year change in their enrollment if their plan makes an unexpected change;
• Expands the Medicare Part D low-income subsidy, which will significantly help struggling seniors afford their health care costs;
• Enacts the CLASS Act, creating new long-term assistance for seniors and the disabled;
• Enacts the Elder Justice Act, authorizing new criminal background checks on long-term care workers who have access to residents or patients; and
• Eliminates wasteful over-payments to Medicare Advantage plans while creating incentives for coordinated, high quality care across the health care spectrum, extending the solvency of the Medicare Trust Fund by 9 years and improving Medicare for generations to come.

For a listing of which changes take effect immediately, go HERE. In short - in addition to the doughnut hole changes - within the next six months alone, the new law:

• Provides a $5 billion reinsurance fund to help employers who provide health benefits to early retirees ages 55 to 64 (goes into effect in 90 days);
• Eliminates pre-existing conditions for non-dependent children up to age 26;
• Prohibits insurers from placing lifetime limits on coverage;
• Restricts new plans' annual limits on coverage;
• Provides $5 billion to states to create a high risk insurance pool for those denied insurance due to pre-existing conditions and who have been without insurance for 6 months;
• Prohibits rescission, or dropping coverage, when individuals become sick;
• Creates a public health and wellness fund and requires new private insurance plans to offer preventive services without co-payments;
• Provides up to 35 % tax credits to small business that offer health care coverage; and
• Creates a new and independent health insurance appeals process for consumers

A USA Today/Gallup poll found that 49% of those polled concluded that the passage was "a good thing," as compared to 40% who concluded its passage was "a bad thing."

Edward F. Coyle, Executive Director of the Alliance, urged seniors to thank Members of Congress who helped to pass reform with personal visits to their offices during the spring district work period, March 29 - April 9. "Thank you again to seniors who worked for decades to pass health reform. Now, let's give House Members who voted courageously for health care reform in the face of violence some words of appreciation, in person or in writing," said Mr. Coyle.

To listen to the audio of Alliance leaders' conference call this week with seniors, click HERE. To see the video of Alliance member Bob Meeks of Brandon, FL and Mr. Coyle on the importance of closing the Medicare drug doughnut hole, go to HERE.

Misinformation has been spread on how the health care reform will affect veterans' care. President Obama has strongly supported a 16% budget increase in 2010 for the Department of Veterans Affairs, the largest in over 30 years. "TRICARE, the U.S. Department of Defense's military health care program, will continue to be available for all eligible servicemen and women, and their families," said Ruben Burks, Secretary-Treasurer of the Alliance.