21 July 2010

Health Care Reform - Big Gains For Seniors

Officially it's called The Patient Protection and Affordable Care Act, but most of us just call it the Health Care Reform Bill--that is unless you're a right-wing nutter, then you stupidly call it "Obamacare".

Regardless of what it is called, it has many, many very positive changes for seniors.

 Let's start with the the "Doughnut Hole".  Starting this year (2010) it provides for a $250 rebate to seniors falling in the doughnut hole. In 2011 it will provide a 50% discount on name-brand drugs and initiate a government subsidy for generic drugs (7% in 2011).  In 2013 there will phase in a 2.5% subsidy for name-brand drugs and by 2020, the doughnut hole will be entirely eliminated.

Free Preventative Services & Improved Care commence in 2011.  Starting next year seniors will receive FREE annual checkups.  And all co-pays and deductibles are eliminated for mammograms, colonoscopies and other critical preventative screenings.

Elder Justice Act & Nursing Home Transparency.  Nursing homes and home-care companies receiving federal money will have to conduct pre-employment background checks on job applicants.  They will also be required to disclose all owners, operators, suppliers, financiers and others with whom they do business.  Complaint procedures will be simplified and $500-million will be earmarked for: Adult Protective Services, A Long-Term Ombudsman Program and Staff Training.

Reins In Medicare Advantage Plans.  It begins in 2011 a phase out of the 14% overpayment to Medicare Advantage plans and requires such plans to spend at least 85% of premiums on patient care, instead of profits.  Such plans can no longer charge higher deductible than original Medicare.

Improves Auditing For Medicare Fraud and Abuse. From streamlining prepayment reviews to increased funding for the Health Care Fraud and Abuse Fund the new bill puts in place stronger reviews and controls.  It also puts into place strong new requirements for community mental health centers that provide Medicare partial hospitalization services. 

Other exciting changes include emphasis on community-based health care and new provisions enabling seniors to age "in place" rather being forced into demoralizing and dehumanizing "Nursing Homes".

These improvements and additions to Medicare, along with other provisions of the bill promises to extend the solvency of Medicare by at least 12 additional years.

All in all, seniors should be proud of what they've obtained in the health care reform process and they should be prepared to tell the insurance and drug company owned Republicans to "take a chill pill and call back if the condition worsens!"

No comments: