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How the Affordable Care Act improves Medicare

By Kathleen Sebelius

Palm Beach Post
August 16, 2012

I’m visiting West Palm Beach today to meet with seniors and talk about how the health care law, the Affordable Care Act, is making a difference in their lives. Some of the most important parts of the law are provisions that strengthen Medicare. Here are a few ways that the law is helping Florida seniors:

First, seniors can now get recommended preventive services, such as flu shots, cancer screenings and an annual wellness visit, without paying a dollar at the doctor’s office. More than 1.25 million Floridians have used one of these services this year.

In the past, seniors could face a bill of hundreds of dollars for a single screening, putting preventive care out of reach for many on a fixed income. Now the decision to get preventive care is up to seniors and their doctors.

Second, seniors are saving money on their prescription drugs. Previously, as many as one in four seniors went without a medication each year because he or she couldn’t afford it. But today, thanks to the health care law, seniors in the prescription drug coverage gap known as the “donut hole” receive a 50 percent discount on covered brand-name drugs automatically when they fill a prescription.

Since January, thanks to these discounts, nearly 48,000 people in Florida have saved an average of $665 per person. Under the Affordable Care Act, the “donut hole” will get smaller each year until it’s closed in 2020. Because of the new savings and benefits in the law, the average Medicare beneficiary is expected to save about $4,000 over the next 10 years.

Third, the health care law is strengthening efforts to fight Medicare fraud. Seniors in Florida know that when criminals steal from Medicare, it pushes up their premiums and jeopardizes the program’s future. That’s why the new anti-fraud tools in the health care law are so important, including more law enforcement on the ground, better screening procedures, new efforts to prevent fraud, and stronger penalties.

These efforts are already paying off here in Florida and around the country. In May, a fraud bust in Miami brought down more than 107 individuals who had stolen approximately $452 million from Medicare. In total, anti-fraud efforts led to a record $4 billion in recoveries in the last year, an increase of nearly 60% since 2009.

And here’s the best news: Even as Medicare is getting stronger, many beneficiaries have seen their premiums fall or stay level. The average Medicare Advantage premium has dropped 7 percent since last year, while enrollment has risen about 10 percent. And even as Medicare Part D — the prescription drug plan — has added discounts and benefits, average premiums have remained flat.

This vision for Medicare’s future is very different from the one put forward in the House Republican budget of U.S. Rep. Paul Ryan. Under that plan, the new preventive benefits and prescription drug savings would be taken away. And Medicare’s guaranteed benefits would be replaced with a voucher whose value would grow more slowly than the cost of care, leaving seniors to pay an average of $6,400 to keep their same level of coverage, and to pay even more over time.

In other words, the basic promise that Medicare has made for the last 47 years, which is that every American is entitled to a set of comprehensive health benefits in his or her later years, regardless of health status or finances, would come to an end.

The health care law offers a better path forward for seniors. It keeps Medicare’s promise by protecting seniors’ guaranteed benefits, adds savings for prevention and prescription drugs and lowers Medicare spending by cutting waste and fraud. That means a stronger Medicare for seniors today and tomorrow.