As the Patient Protection and Affordable Care Act (ACA) celebrates its second birthday, the Obama administration reminded senior citizens – one of the most reliable voter blocs — exactly how much healthcare reform has helped them. Coverage of the “donut hole” in prescription drug plans saved five million seniors and disabled people $3.2 billion. According to data from the Centers for Medicare and Medicaid Services (CMS), through the first two months of 2012, roughly 103,000 Americans saved $93 million in the donut hole. “Without the healthcare law, more than 5.1 million seniors would have faced $3.2 billion in higher drug costs,” Health and Human Services Secretary Kathleen Sebelius said. The donut hole is a gap in coverage for prescription drugs under what is called Medicare Part D. Part D covers 75 percent of the cost of prescription drugs until total medication spending for the patient hits $2,800. Then the hole opens, and seniors must pay out of pocket until they have spent $4,550. After that, Medicare pays about 95 percent of drug costs.
The ACA sent all seniors who hit the prescription drug donut hole a one-time $250 check. In 2011 and 2012, seniors in the donut hole receive a 50 percent discount on brand-name drugs. Additionally seniors covered by traditional Medicare received wellness check-ups and screenings for diseases like cancer and diabetes without paying anything out of pocket. Under the law, the donut hole phases out in 2020.
The seniors’ lobby AARP launched its largest-ever outreach effort with ads and town-hall meetings aimed at defending Medicare and Social Security. “We’re not leaving it up to chance” that the public hears about the law’s benefits, congressional Seniors Task Force co-chairwoman Jan Schakowsky (D-Ill.) said. Democrats, Schakowsky said, have made it a “primary organization effort”…”to tell the truth (about the law) over the next several months.”
Writing in The Hill, Julian Pecquet says that “Democrats see the Ryan budget, which is expected to propose replacing Medicare with subsidies for people to buy insurance, as political gold ahead of the November election. Republicans for their part will spend the week hammering the law’s ‘broken promises’ — higher premiums, employers dropping coverage and the soaring cost of insurance subsidies when compared to the earlier budget window Democrats highlighted when they were debating the law two years ago. They’re also arguing that the healthcare law hastens Medicare’s insolvency by removing $500 billion from the program to pay for what they call an unsustainable new entitlements.”
In terms of implementing the law to meet the 2014 deadline, the ACA leaves it up to the states to set up health insurance exchanges. In states that refuse to do that, HHS has the authority to create a federal exchange as a backup — but it could be stretched thin if it has to cover too many states. At the moment, a number of states are not making plans and the federal exchange could end up covering as many as 15 to 25 states.
Other states are biding their time depending on the outcome of the Supreme Court case — and the elections — to decide what to do next. There’s an excellent possibility that many of them won’t be far enough along by January of 2013, when HHS has to either certify the states’ exchanges or prepare to run a federal exchange in those states. HHS has already extended the deadline for states to apply for the grants that will help them run exchanges. And it’s taking other steps to help states that won’t be ready in time. But if a lot of states refuse to create the exchanges –and more time won’t help them — HHS will be forced to act.
White House spokesman Jay Carney told reporters that President Obama is looking beyond past battles. “He is focused on a forward agenda right now, and working with Congress and doing the things he can through executive action to grow the economy and create jobs,” Carney said.
Republican leaders, who once accused the president of focusing too much on healthcare and not enough on jobs, now say the White House is moving away from the ACA because of uncertainty over whether or not its individual mandate is constitutional. In terms of the upcoming Supreme Court oral arguments, Senator Roy Blunt (R-MO) said “I think we’ll win in the end. Now the question is how long is it until the end. There’s no question that the president’s plan will not work.”
A differing opinion was offered by Democratic Caucus Vice-Chairman Xavier Becerra (D-CA). “I think as time goes by more and more people are beginning to support the reform because it starts to apply to them. The more people see what the ACA does, the more they’re going to like it.”