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Linda Bergthold

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

Posted: 07/11/2012 8:49 pm

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.

 

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12:25 PM on 07/14/2012
Medical care costs more for the elderly than before they had Medicare, percentage wise. The medical industry made sure of that.
11:56 AM on 07/14/2012
The so called Welfare Empire that the republicans and conservatives like to blame on Obama is actually created by businesses who hire overseas and underpay many of those they do hire here.

We can't let the poor go hungry and we can't let them live on the streets. The businesses are not pulling their part of the load.

There is a financial empire that has been making big bucks off of all attempts to help the poor. Everything a poor family gets gives a big profit to a business whether it is the grocery stores, landlords, colleges. If there is help for the poor the businesses get the most of the money spent on it.

JP Morgan was even handling food stamps as if they didn't make enough money already. JP was sending the food stamp jobs overseas until there were many complaints.

Jerry Sandusky, molestor, who was sent to prison this month got a FERS retirement partly matched by the taxpayer, while our young struggle to pay their college debt. We match his TSP too. Not to mention life insurance. Then federal and military employees complain because they can't draw full Social Security.
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HUFFPOST SUPER USER
arachne646
No more hurting people--Peace
01:25 PM on 07/13/2012
All these scare tactics and more have come and gone repeatedly through the years since Medicare for all was first introduced in Canada in the 50's. Dire predictions that doctors would all flee the country, that paperwork would bury them (it will be easier the more Medicare patients you have--I work for doctors), or there would be no more doctor/patient relationship. I can't think of all of them, since I was a baby and heard about a lot of it from my doctor parents. I hope that America's high health care costs and poor results improve with the ACA--we're really happy and proud of our health care system, for which each Province (State) is responsible.
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10:24 AM on 07/13/2012
Most Medicare participants have contributed a sustantial amount over their liftetime, often decades, into the system. As beneficiaries they pay monthly premiums. Ultimately, direct cost to them is a concern. Most of them are aware that the pure "free lunch" exists only in the lifelong, inherited, generational Welfare culture. With 80 million Medicaid on the near horizon and millions more with "tax credits" the bill will be presented to those that have already paid their share and continue to do so. The five points above are largely a smoke screen. The working and retired middle class, rather than being beneficiaries, will pay for Obama's Welfare Empire(Dem voting base) and five figure incomes will not be exempt from the taxation required to sustain it.
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HUFFPOST SUPER USER
arachne646
No more hurting people--Peace
01:17 PM on 07/13/2012
Well, then, they had better start now, while the actuarial tables say their contributions won't be needed. Stop capping the earnings that are subject to Social Security and Medicare deductions, or raise the cap substantially, and the future will be secure for those Medicare participants. What is your fear, exactly? And who are these "lifelong, inherited, generational, Welfare culture"? They aren't getting any cash now, nor were they getting Medicare prior to my generation.

If Congress would let the President's stimulus plans and other proven job creation methods through, or would act on anything at all, we wouldn't have the G.W. Bush recession still causing the Unemployment Nightmare that requires assistance.
09:15 AM on 07/14/2012
They want to label Medicare as welfare so they can mess it up and make the younger generations think we get a free ride.

My husband and I together pay $600 a month premiums for Medicare, Medigap and the prescription drug plan combined. Then we have to take brand names that have no generics for part of our drugs and that costs us $300 a month for them and the generics we take. Medigap has made a lot of money off of us and the brand named prescriptions are so overpriced that big pharma is getting rich. You can get cheaper premiums, but we bought the best we could buy in our area, rather than worry about losing everything in case we get are stuck in a hospital.

They need to focus on the too high charges for medical care. It is too high of an expense to the government, families and the eldery, too.

Congress sets back and plots against the middle class and the elderly and Obama cannot move forward because they block everything. The way they keep getting elected is to twist things to the point that many vote against their self interest.

A good honest press would call them on their insinuations and lies.
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conveyeroftruth
It’s good to be the herald of truth!
10:22 AM on 07/14/2012
Things like that don't happen if the media asks why they do something like that. Instead the media focus on BS.

Obama has some explaining to do. I worry about him. He is not much above Romney. It may be he knows it will be grabbed and spent instead of making the rich pay taxes, so he may be forcing their hand.
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conveyeroftruth
It’s good to be the herald of truth!
06:32 AM on 07/16/2012
The rich already pay the majority of taxes and they also donate the most money to charities.
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HUFFPOST SUPER USER
Watching rock grow
FE = Iron, and Female = Iron Male :)
08:05 AM on 07/13/2012
Why would republicans be against the ACA? They can't reasonably so they have twisted it publicly into something it isn't. Why, the only reason I can think of is they don't want to share medical care with the American people.
09:18 AM on 07/13/2012
You have lost your mind if you truly believe that. Doctors have already started backing away from new Medicaid patients and this will only leave more elderly left out. In 10 years we will have large institutions that house the elderly run by the gov and these people will be treated very poorly.
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HUFFPOST SUPER USER
Watching rock grow
FE = Iron, and Female = Iron Male :)
11:20 AM on 07/13/2012
They are treated better today?  Look again with open eyes.
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HUFFPOST SUPER USER
arachne646
No more hurting people--Peace
01:35 PM on 07/13/2012
Evidence shows that non-profit, charity, and government homes and hospitals for the elderly provide the best quality of care with the fewest problems on inspection, but for-profit facilities are, on average, in a class by themselves, far below that standard, with poorer care and more violations of requirements of inspecting agencies for hospitals, care homes, and food or business establishments. This is true both in Canada and the USA.
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HUFFPOST SUPER USER
shankapotomus
08:04 AM on 07/13/2012
Less doctors, less options, and more rationing, anything else?
03:07 AM on 07/13/2012
Providers will leave and are leaving Medicare every day. It's not just the lower pay but the rising cost of providing the care in terms of meeting the escalating requirements of the program.
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HUFFPOST SUPER USER
Watching rock grow
FE = Iron, and Female = Iron Male :)
08:06 AM on 07/13/2012
Scare tactic, provide some facts.
HUFFPOST SUPER USER
Former Iowan
A New Way
09:00 AM on 07/13/2012
You are so right. Providers could not make it without Medicare payments. In some parts of rural America the only payments are the Medicare and Medicaid as those less than 65 or above poverty level do not have insurance and cannot pay for services other than emergency and then payment is doubtful. Doctors and hospitals in these areas are the ones arguing for greater reimbursement or they go out of business. My experience in a large metro area is relief from doctors. Their comment is: we no longer have to wait for ever payments from private insurers. Medicare pays within 30 days. Doctors and hospitals are having to cash flow payments from private insurers.
12:56 AM on 07/17/2012
After 20+ years, I'm gone in 60 days. Not trying to scare anyone just stating my own case and what I see and hear from other providers. Follow the issue this next year and if I'm wrong, then I was wrong...
08:00 PM on 07/13/2012
And if American doctors don't want to take Medicare patients, then like all the other professions in the US, we import more H1B visa holders to do the work for less.
HUFFPOST SUPER USER
Sam Bark
It's a MAD world after all...
01:59 AM on 07/13/2012
Please Ms.Bergtholt - how can you dare stating that cutting $500 Billion from Medicare is NOT going to affect the benefits of seniors?
This statement is a total sellout to trumpet nObamacare.... The benefits will be reduces in time either by restricted services, or by Physicians not taking Medicare patients, and/or by eliminating the Advantage program that over 40% of seniors are currently subscribed to..... Such claim is patently ludicrous!
My friends told me that their family doctor announced that they will stop processing all the paperwork the government requests, and patients must pay cash and should then filed a claim themselves with Medicare.....
07:48 AM on 07/13/2012
Hogwash... your type are spreading the false rumors.
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HUFFPOST SUPER USER
Watching rock grow
FE = Iron, and Female = Iron Male :)
08:07 AM on 07/13/2012
My friends tell me they are getting almost daily calls from their old doctors asking to come back because of the ACA. They are willing to take on the Federal program, now.
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ForwardLeaningWoman
Iron Jawed Angels - Alive & Kicking.
01:28 AM on 07/13/2012
Nice read. Marking this one fore reference.

Thanks!
07:23 AM on 07/13/2012
Mark this for reference - she's dead wrong. If your on Medicare and your family Dr. no longer accepts the policy you'll get it. When your stuck in a crowded waiting room trying to see an foreign educated Dr. you don't know - you'll get it. When you have to wait an inapropriate amount of time for a follow-up visit to the same over crowded waiting room - you'll get it. Be careful what you ask for,
07:49 AM on 07/13/2012
Just keep spreading those false rumors and suppositions like a good republican robot.
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HUFFPOST SUPER USER
Watching rock grow
FE = Iron, and Female = Iron Male :)
08:11 AM on 07/13/2012
We already have foreign educated Dr.s in our system. Because of the failure of parents to make their children learn while in school. Even if your scare case comes true, it is better to wait in a crowed waiting room to see a doctor than to have not even that luxury.

I know the concept of republicans waiting sharing medical costs with anyone other than old folks is a hardship for them, get used to it.
12:24 AM on 07/13/2012
It would appear that the "research" that went into this "article" is politically rather than factually based. Premiums for an unemployed family member have increased 50 percent in the past 6 months - for minimum insurance and as a direct result of some of the new provisions in the "Affordable Care Act." A close personal friend went in for lab work THIS MORNING. She was told that if the lab work revealed any new issues beyond her existing condition, Medicare would no longer pay for it. She would be responsible for any costs if she wished to pursue treatment, regardless of the gravity of the situation. If not paid within 90 days, it would be turned over to collections. And this from a physician who is an ardent and vocal supporter of "Obama Care."
07:26 AM on 07/13/2012
We'll see how ardent he is if he takes the 27% cut they threaten. Actually you won't since he will no longer take the policy. Welcome to the crowded Medicare HMO with Dr. Who treating you.
11:19 PM on 07/12/2012
ok
11:10 PM on 07/12/2012
Since the average recipient of Medicare has an average of 100k more spent on them than they contributed, our Seniors can happily tout the wonders of the program. Don't worry about the money you are borrowing from your Grandchildren, they owe it to you anyway. No reform needed here.
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lcr999
scientist
11:03 PM on 07/12/2012
OK,
Arguably, ACA/Obamacare cuts money from medicare.
The GOP wants to eliminate medicare.

Take your choice.
HUFFPOST SUPER USER
Sam Bark
It's a MAD world after all...
02:01 AM on 07/13/2012
lcr999 - That is a lie, the Repubs suggested to replace the current system that is riddle with fraud with a vouchers system that each person manages and chooses his doctors...
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lcr999
scientist
08:18 AM on 07/13/2012
Replacing medicare with a voucher system is pretty much the same as eliminating it. Replacing a system that pays works and pays your medical bills with a voucher that may or may not buy you adequate insurance. In other words, replacing medicare with the same crap that the rest of us have.
HUFFPOST SUPER USER
Former Iowan
A New Way
09:07 AM on 07/13/2012
You need to listen closely to those running for office. A Republican candidate for Senate in MO made the statement at the state convention that if the Republicans take over the Senate the first order of business would be to abolish Medicare. He along with Sen Johnson of WI would propose. Republicans never liked the program. The Kochs detest the program. Why would the Kochs invest a half billion dollars in this election without a pay off. They bought the government in Topeka and in 2013 they will pay no income taxes in KS. What a return on investment!. Don't trust a thing these Republicans say or you may be on the short end for the deal.
07:28 AM on 07/13/2012
Your wrong Icr - stop getting your infotmation from this non news site. the GOP wants reform to ensure the programs vitality. It's about choices for you.
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lcr999
scientist
08:21 AM on 07/13/2012
Choices.... code words for privatizing everything....Just like the rest of us have "choices"...if we can afford it we have lots of choice, if we can't we have no choice.

Strange how the rest of the world moves in the opposite direction. I see no one else in the world running to embrace a for-profit health care system.
HUFFPOST SUPER USER
Former Iowan
A New Way
09:08 AM on 07/13/2012
Yes, abolish the program will bring vitality to the program. You will have choices between insurance premiums and food.
10:37 PM on 07/12/2012
I'll tell you what is next for Medicare if the GOP takes control of Congress:

They will get rid of it, as they have been itching to do for 45 years.

Then Social Security, completing their quest since 1935.
07:28 AM on 07/13/2012
Yeah........Sure Jay.
HUFFPOST SUPER USER
Former Iowan
A New Way
09:11 AM on 07/13/2012
Laxman2, it is being discussed in MO for elimination in the Republican Senate race. Where there is smoke, there is fire. Don't put your head in the sand. They want you too as they eliminate. The Kochs detest and their millions are an investment in their ideology. They expect a return for the investment.