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Seniors Are Asking... What's Next for Medicare?

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Now that the Supreme Court has declared the Affordable Care Act to be constitutional, what is the impact going to be on Medicare? The short answer? Not much. No cuts in your benefits. In fact, you will keep all of the benefits that you have gained because of the ACA -- at least as long as Obama is president.

What are some of those benefits? If you take prescription drugs, you may know that the ACA closes the prescription drug "doughnut hole" by 2020. You are also receiving certain preventive services and annual wellness visits without co-pays or deductibles, and you had an actual reduction in your Part B premium this year ($22 less per month than projected). Depending on where you live, you may have seen more choice of Medicare Advantage and supplemental plans (some with zero monthly premiums), and "extra" benefits like gym memberships, discounts on hearing aids or dental insurance, etc.

So why are you being told your Medicare benefits are at risk? Pretty much pure politics. Apparently Republicans think older people scare easily or believe everything they hear. If you are interested in facts and not just hyperbole, read on.

What are some of the things seniors are being told about Medicare and the Affordable Care Act and is it true?

1. $500 BILLION is being cut from your Medicare benefits.

FALSE.It's not being cut from YOUR benefits, although that's the way it is being explained.

In their attacks, Republicans have said in speeches and in television advertisements that the Democrats' projected $500 billion in Medicare savings will "strip," "gut," "rob" or "raid" older people's benefits.

When you hear about $500 BILLION in cuts to Medicare, they are not talking about cuts in your benefits. It is true that there will be $500 billion taken out of the Medicare program over a ten year period, but that money does not come out of your benefits. The money will actually be saved from three main sources: 1) tougher negotiations between Medicare and the managed care plans (Medicare Advantage) with which they contract for your care; 2) reductions in payments to providers; and 3) efforts to make the Medicare program more efficient and reduce waste, fraud and abuse.

Think about it -- why would anyone let Medicare overpay insurance plans? But that is exactly what had been happening up until 2010 when the Affordable Care Act was passed. Medicare had been paying 14% more to these insurance companies, ostensibly as an enticement to keep them in the program. Medicare will now be negotiating with plans on a different basis, thus saving part of that $500 billion.

The Affordable Care Act makes many changes to strengthen Medicare and provide stronger benefits to seniors, while slowing cost growth. As a result, average Medicare beneficiary savings in traditional Medicare will be approximately $3,500 over the next ten years. Beneficiaries who have high prescription drug spending will save much more -- as much as $12,300 over the next 10 years. In comparison, Medicare beneficiaries with low drug costs will save an average of $2,400 over 10 years.

2. Medicare is going broke.

FALSE.

Here is what a physician and Medicare's own Trustees have to say about that:

Medicare's trustees recently confirmed that because of the ACA, the Hospital Insurance (HI) Trust Fund is now expected to remain solvent until 2029, 12 years longer than under earlier projections, and spending on Medicare Part B as a share of GDP over the next 75 years is down 23 percent relative to the costs projected in the 2009 report.

What is the Republican plan for "saving" Medicare? Ironically, it includes some of the same $500 billion "cuts", but guess what? Some of these cuts do come right out of your premium.

"A pox on both their houses," said Ron Haskins, a former Congressional staff member who is now a scholar of social programs and budgeting at the Brookings Institution. Democrats and Republicans "know they have to do something about Medicare, and then they harass each other about cutting Medicare. It's so discouraging to me, but I'm a Republican, so I'm much more distraught about Republicans."

And, Mr. Haskins added, "$500 billion is modest compared to what Ryan would do." Under Mr. Ryan's budget, which Mr. Romney has supported but which has been blocked each year in the Senate, Medicare would not pay for the medical fees of future beneficiaries, as it currently does. Instead it would provide "premium support," limited payments -- vouchers, Democrats say -- that beneficiaries could use to buy insurance policies in the private sector.

3. Medicare premiums will jump to $247 in 2014.

FALSE.

In fact, the Part B Premium was reduced by $22 per month this year and all projections point to a continued slower growth in premiums than had been projected.

4. Medicare regulations require doctors to ask you if you own a gun.

FALSE.

This one comes via an email from what seems to be a personal source. Someone you know sends it along. But it is flat out wrong. Doctors are not likely to ask you about gun ownership and they certainly are not required by Medicare to do so.

5. "Obamacare" will require Medicare to refuse procedures to people over 75 unless an ethics panel reviews them.

FALSE.

This is part of the same "death panel" scare tactic that has been circulating widely on the internet. And there is absolutely nothing in law or regulation that would allow this type of rationing. Some will accuse the Independent Payment Advisory Board (IPAB) of being that "ethics panel" but it is actually a board of independent experts who can recommend ways for Medicare to save money with Congress approving their recommendations. And the IPAB absolutely cannot, by law, recommend cuts to benefits or tell doctors how to treat patients.

There's a real easy way for you to check out these emails and claims. -- you can Google one of the phrases like "Medicare over 75 ethics panels" and find the facts pretty quickly. Or just check out one of these sites: www.politifact.com -- or www.snopes.com or www.factcheck.org

There is no question that Medicare needs to change. But those changes do not necessarily need to mean leaner benefits. Medicare still overpays for many treatments and pays for treatments that have no evidence of effectiveness. There is plenty of room for improvements in Medicare that do not jeopardize the basic program.

What's next for Medicare? Probably not what you are hearing. So hold on to your hats. It's election season. Feel free to share some of the wilder things you have heard and we in the Huffington Post community will try to help you sort it out.

Update August 3, 2012: Here's a handy chart to share from the Center for Medicare Advocacy about the myths and truths about the ACA and Medicare.