Affordable Care Act providing benefits now for seniors, youth

May 15, 2011

Millions of seniors and young adults are among those who have obtained greater protections against health care costs as a result of provisions in the year-old Patient Protection and Affordable Care Act.

In January, the act began a gradual closing of the gap in Medicare prescription drug coverage known as the "donut hole." In the first two months of the new benefit, nearly 50,000 Medicare beneficiaries with high drug costs saved $38 million — or about $750 per person — in out-of-pocket prescription drug expenditures. The act provides a 50 percent discount on brand-name drugs and increased coverage for generic drugs for seniors who fall into the drug coverage gap, according to the U.S. Department of Health and Human Services.

In addition, approximately 4 million Medicare enrollees received a $250 rebate check last year to help offset the cost of their prescription medications.

"For too long, many seniors and people with disabilities have struggled to choose between paying for needed prescription medication and other necessities, like food, rent and utilities," HHS Secretary Kathleen Sebelius said in a written statement. "The Affordable Care Act is delivering more affordable prescription drugs to seniors and giving everyone on Medicare better benefits."

Other benefits established Jan. 1 by the Affordable Care Act impact people who subscribe to the "original" Medicare plan. These include:

  • A free annual wellness visit
  • The elimination of out-of-pocket expenses for certain cancer screenings
  • A 10 percent rate bonus for primary care providers to ensure they continue to treat patients covered by Medicare

At the Catholic Health Assembly in Atlanta in June, CHA will share stories of individuals and families who have benefited from the law as part of a broader effort to showcase how real people are getting much needed help.

In addition to seniors, families with sick children and young adults already are benefiting from the act. As of Sept. 23, it became illegal to deny coverage to children because of a preexisting condition. That same month, the act required that health insurance plans that offer dependent coverage give parents the option of insuring children up to age 26 on the parents' plan.

Beginning in 2014, it will be illegal under the Affordable Care Act to reject anyone from insurance coverage because they have a preexisting health condition. According to HHS, up to 129 million non-elderly Americans who have preexisting health conditions such as heart disease, high blood pressure, arthritis or cancer would be at risk of losing health insurance if that provision does not stay on the books.

"It is really important that the Catholic health ministry help explain how the Affordable Care Act is already assisting real people including children, young adults, seniors and small businesses," said Jeff Tieman, CHA's senior director of health reform initiatives. "Only half of the American public approves of the law, but the perception of the people who don't approve can change when they see that people like themselves and their families are getting meaningful and needed help."

To help inform people about health reform, CHA is a partner in the Health Care and You Coalition. The group launched a website to explain the law in clear, concise terms. CHA members are welcome to display on their home pages a link to the website, www.healthcareandyou.org. For more information, email Tieman.

 

Copyright © 2011 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Copyright © 2011 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.