By KATRINA CAMERON-Staff Writer
The Affordable Care Act won’t hurt health care for the baby boomer population, and it will strengthen Medicare, the national insurance program for people age 65 and older.Every day across the nation, 10,000 people are turning 65, said Myron Machula, vice president and CFO of Enloe Medical Center. The total number of people age 65 or older in Butte, Glenn and Tehama counties is 55,000.
“That’s a fair amount of the population,” Machula said. “They count on this Medicare program for the health care that they receive.”
“There has been a misconception that the Affordable Care Act is going to take away benefits from people with Medicare, and it isn’t going to,” said Tatiana Fassieux, program manager at Passages.
Instead of cutting basic Medicare benefits, it improves them, she said.
According to the National Council on Aging, prescription drug costs will lessen because the coverage gap — better known as the “donut hole” — for those with Part D plans will be slowly phased out by 2020.
“Ideally, what’s going to happen is on a general basis nationally people won’t have to spend more than 25 percent for their prescriptions, so that was one aspect of the Affordable Care Act,” Fassieux said.
Medicare beneficiaries will also benefit from more preventative care, such as cancer and diabetes screening, according to the National Council on Aging. A free annual wellness visit allows the beneficiary and doctor to develop a prevention plan to keep the patient healthy. Patients can also get free vaccines.
“Preventative care is what saves money,” Fassieux said.
The law also helps ensure Medicare patients return home successfully from hospital stays, according to the National Council on Aging.
Eighty percent of older American have a least one chronic medical condition such as high blood pressure, heart disease or diabetes.
About 65 percent of Enloe Medical Center’s in-patient care is Medicare beneficiaries, Machula said. About 40 percent of outpatients are on Medicare.
The law also makes it easier to receive and pay for long-term care at home, according to the National Council on Aging. Medicare doesn’t currently cover long-term care, but starting in 2014 the law will increase protection for spouses of individuals who receive Medicaid home care services.
Another benefit is the law allows the Department of Justice to go after individuals or hospitals that have committed Medicare fraud, Fassieux said.
Medicare began paying bonuses of 10 percent to primary care doctors to improve access, according to the National Council on Aging.
The difficulty of getting into a primary physician’s office has already been an issue, but the rising number of people who will soon have insurance through the Affordable Care Act may make it more problematic.
“Why is that occurring?” Machula said. “Well, because again the volume of physicians is shy of what the need is, so the idea is to take the mid-level practitioners to help with what will be this increase for those who need care because they have the card.”
A question still unanswered is what an individual is to do if he or she bought an exchange insurance plan and then becomes eligible for Medicare. Fassieux said it’s unknown if someone can have both Medicare and the exchange plan.
Although there are still many unanswered questions regarding the Affordable Care Act, it appears that it will benefit older Americans.