The Affordable Care Act established health care exchanges for people to buy coverage from private insurers, but it would be wrong to say that it does not affect seniors in Birmingham, Alabama who have coverage through Medicare.
The ACA, also called “Obamacare”, contains provisions designed to give seniors greater control over their own health care and strengthen Medicare for the future by reigning in spending.
Most notably, the act impacts millions of seniors affected in 2007 by the so-called “donut hole” in Medicare Part D by paying a $250 rebate on prescription drugs purchases over a certain amount, as well as a 50% discount on brand name drugs. The act will completely close the donut hole for all prescription drugs by 2020.
The ACA also means annual wellness checkups for seniors and eliminates deductibles, copayments, and other cost-sharing for preventive care in Medicare. Previously, seniors paid 20% of the cost of many preventive services and office visits.
In the first 11 months of 2013, 72 percent of Original Medicare Part B enrollees in Alabama received all free services, while 42,778 participated in annual wellness screenings.
The act strengthens the financial health of Medicare. It was designed to extend the program by 9 years. Medicare’s guaranteed benefits are not affected, and reducing subsidies to insurance companies will save Medicare more than $150 billion over 10 years. The act also invests in fighting waste, fraud and abuse by reforming payments to reduce harmful and unnecessary hospital admissions and health care acquired infections.
The ACA was designed to better control chronic disease by promoting better care after a hospital discharge. It links payments between hospitals and other care communities to promote more effective transitional care following discharge from the hospital.
The act creates incentives to reward providers that meet quality goals or show significant progress in improving patient outcome. This should move the health care system to one that rewards better care rather than simply more care.
These are just a few of the impacts of the Affordable Care Act on Birmingham’s senior citizens.