Now that the president has signed the massive healthcare reform bill, many seniors may be wondering what’s in it for them.
Some improvements to Medicare and elimination of the prescription drug coverage “doughnut hole” are on the way, but so are $500 billion in Medicare cuts that will be made over the next decade. For the most part senior center administrators and elder advocates are focusing on the positive and taking a wait-and-see approach to the negative.
The legislation, known as the Patient Protection and Affordable Care Act, is supposed to improve Medicare for over 1 million beneficiaries in New York City, by providing free preventive and wellness care, improving primary and coordinated care and enhancing nursing home care, according to Rep. Anthony Weiner (D-Queens and Brooklyn). The bill will also strengthen the Medicare Trust Fund, extending its solvency from 2017 to 2026, the congressman’s website says.
“Anything that can help the elderly cover their healthcare costs is a good thing,” said Jacqueline Eradiri, the executive director of the Ridgewood Older Adult Center. “Now that the rhetoric is over and people can look at what’s actually in the bill and get down to the truth, I’m sure seniors will like it and embrace it.”
But the Medicare reduction “is a major concern and everyone seems to be ignoring it,” Council Nedd, the chairman of the National Seniors Council, said of the cuts. “I can’t understand why a large number of senior organizations aren’t angry about it.”
Nedd believes the Medicare cuts will be implemented by raising the qualifying age for beneficiaries, thereby “pushing seniors off the Medicare roll in order to make way for younger people.” He added, “If the way to eliminate the doughnut hole is to make less people eligible for Medicare, how is that a solution?”
Nedd suggested that repealing the entire bill would be the best solution, but barring that he suggests that people stay on top of the issue especially now that it has been handed over to regulators and administrators.
“It will be a couple of months before we hear the horror stories and there are going to be lots of them — and most of them will be coming from seniors,” he said. “The government always says they’re going to save money by cutting the fat and waste from programs, but that never happens.”
Bill Ferris the state legislative representative for AARP disagrees. “The law explicitly says Medicare benefits will not be changed,” he said. “The federal bill actually strengthens Medicare benefits and the solvency of programs and completely fills in the doughnut hole.”
The National Senior Council, a conservative group, is sending a letter to members to gauge where they stand on the issue, and then when the true consequences of the bill are actually known, the organization plans to generate petitions and send them to Capitol Hill and the White House.
Eradiri says about 25 percent of the center’s members will be directly affected by the changes and believes once all the details have been disseminated, they will be anxious to participate. “I’m sure they’ll all be asking ‘How can I get it? Do I qualify?’” she said.
Under the Medicare Part D prescription drug plan an individual must pay a $310 deductible and then the government will cover the remaining 75 percent of the tab until the grand total, including the deductible reaches $2,830. After that the the entire amount becomes the responsibility of the beneficiary until the total out-of-pocket expenses reach $4,550, at which point Medicare covers all but 5 percent of the prescription drug costs.
“It’s ridiculous that in Canada the prices are so much lower for the same drugs,” Eradiri said. “They need to get the prices down to where they need to be permanently so that people can afford them rather than just allowing the drug companies to make a huge profit.”
The healthcare bill will start to close the Medicare doughnut hole by providing discounts that escalate over time. Starting this year beneficiaries will receive a $250 rebate to offset their costs and 50 percent discounts on brand name drugs beginning in 2011. The measure will help 80,105 city residents and is expected to completely close the gap by 2020.
“For too long, people in Medicare Part D have had to make tough choices due to the rising cost of prescription drugs,” AARP CEO Barry Rand said in a statement following passage of the bill. “Today, we’re able to tell AARP members and all older Americans that relief is on the way. The days of skipping medications or cutting pills in half are thankfully coming to an end.”
City Councilwoman Karen Koslowitz (D-Forest Hills), who serves on the City Council’s Committee on Aging and supports the healthcare bill vowed to listen to the needs and concerns of her constituents, but declined to address changes to Medicare. “Over the next few years there will be issues that demand a great deal of attention in order to make healthcare for all a truly effective policy,” she said in an email statement on Tuesday.
Priscilla Maysonet, the program director at the Selfhelp Benjamin Rosenthal Senior Center in Flushing, hasn’t had an in-depth healthcare conversation with the members at the center yet, but hopes to hold a forum on the issue in the near future.
“In general, they are pretty happy that the doughnut hole is going to be addressed because that is going to be helpful them,” she said. “They don’t know exactly what the prescription drug part means yet and they are looking for answers on how to stretch their dollars.”