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The White House released a report showing that discounts on brand-name drugs for qualified recipients have saved 2.7 million Medicare recipients more than $1.5-billion nationwide. Under the Affordable Care Act, drug makers were required to offer 50 percent discount on all drugs in the donut hole.
The health care reform law has saved Michigan Medicare recipients, in particular, more than $33-million total on prescription drugs, according to the White House. Considering 60,904 recipients in the state, the amount equates to an average of about $556 per person.
Marilyn Tavenner, the interim administrator of the Center for Medicare and Medicaid Services, said: “Thanks to the Affordable Care Act, millions of Americans are receiving free preventive services and getting cheaper prescription drugs.”
Critics are not quicky to change their minds regarding the health care law passed early 2010, though. Joseph Antos, a health-care economist at the libertarian think tank the American Enterprise Institute, said: “The savings comes from requiring drug manufacturers to give a substantial discount. This discount is going to encourage people to stay on the name-brand drug instead of generics, which costs money. Eventually, the price of some drugs somewhere is going to go up somewhere in reaction to this.”
The report also revealed that more than 24.2 million Medicare recipients had used their free annual preventive visit to a physician; some 930,000 had availed this free visit in Michigan. This benefit is part of the health care reform act.
The administration of President Obama has released new rules regarding the allocation of budgets by health insurance companies. The new federal rules that were issued asked for insurers to allocate a bigger budget on medical care and reduce allocations for profits, marketing and overhead expenses, and compensations.
This is the first mandate from the government that stemmed out from the new health care reform law, although some states have issued similar policies before the new law was approved. It targets to benefit consumers as federal authorities can dictate the use of the premiums collected by insurance companies like Humana, Well Point, UnitedHealth, and Aetna.
The Secretary of Health and Human Services Kathleen Sebelius gave the new rules to insurers which will be implemented starting next year. The new law mainly requires individual insurers and small-group markets to allot 80% of their premium revenues to medical care and all other activities that will promote better quality of care. Large group insurers will be asked to set 85% of the same revenues for the same purposes. Sebelius further stated that those who will not be able to meet the new standards will have to pay rebates to consumers by the year 2012.
As a result of this new rule, up to nine million people could receive rebates amounting to $1.4 billion. According to latest statistics, 45% of people individually paying for their purchased insurance are in health plans that do not meet the new limits set by the government. The reason why most insurers don’t meet the standards is due to the fact that they are focused on their profitability and reserves, which are at an all-time high.
But some state officials say that with the new rules, there could be more insurance companies that will be destabilized and could withdraw from the market. This could result to fewer choices and lesser competition among insurance groups.
There is a long road ahead for the implementation of the new health care reform law, and while progress has been made the journey has just begun. But what is there to look forward to four years down the road? A feature by Astrid Fiano on DOTmed.com shares the provisions that we can expect are in place by 2014, and we are sharing some of them with you.
As far as Medicare is concerned, an Independent Payment Advisory Board that will lower the per capita rate of growth in Medicare spending will be put in place. The function of the Board will be to develop and recommend ways to reduce per capita growth rate should Medicare exceed the projected growth rate set forth annually by the Chief Actuary of the Centers for Medicare & Medicaid Services.
An expansion of the eligibility for Medicare coverage will be expanded to include the non-elderly whose incomes are 133 percent of the poverty level or less.
In terms of prevention and wellness, employers are given the option to offer rewards to employees for participation in a wellness program. These rewards may include premium discounts, cost sharing waivers or other benefits that are up to 30 percent of the cost of coverage. The percentage may be increased to 50 percent of the cost of coverage, if deemed suitable.
Taxes will also change by 2014, with the imposition of an annual, non-deductible fee on the health insurance sector; this will be allocated, according to Fiano, by market share throughout the industry.
In the wake of the report released by the trustees of Medicare, which indicated that the new health care reform law will be able to extend the life of the Medicare Trust Fund by 12 years, President Barack Obama talks about the benefits that health care reform will be able to bring to Medicare.
A feature by The Associated Press shares details included in the weekly radio and Internet message given by the President on Saturday. President Obama said: “Medicare isn’t just a program, it’s a commitment to America’s seniors — that after working your whole life, you’ve earned the security of quality health care you can afford. As long as I am president, that’s a commitment this country is going to keep.”
The President reiterated the trustees’ report, sharing how the financial footing of Medicare has been strengthened, thanks to health care reform. This is due to the provisions of the new law, as well as the efforts of his administration, to cut down waste, abuse and fraud in Medicare, thereby cutting health care costs for seniors. The President also pointed out that seniors are already beginning to reap the benefits of the new health care reform law, citing as an example the release of the one-time $250 rebate for Medicare beneficiaries with high prescription drug costs.
There are critics, however, who remain skeptical of the report of the trustees, including the secretary for Health and Human Services. The claims of added financial strength for Medicare were brought into question, since this projection will depend on cuts that may not be implemented.
A feature on CNN shares that the new health care reform law will be able to extend the life of the Medicare Trust Fund by 12 years. This information is based on the annual report released by the trustees that oversee Medicare, following an earlier report released by the Obama administration.
The new health care reform law is expected to lower health care costs, focuses on prevention, and improves service quality, effects that will lead to the curbing of what was termed as the exploding costs of Medicare. In addition, the fact that health care reform will require high-income earners to pay an extra 0.9 percentage point in payroll tax, as well as a new 3.8% Medicare tax on investment income, is expected to generate more revenue for Medicare.
Treasury Secretary and Medicare trustee Tim Geithner said: “This new law gives Americans more control over health care decisions, ends insurance company abuses and will bring down health care costs over the long term.”
While all this point to a bright future for the Medicare program with health care reform, there are critics that targeted the report and said that it serves as proof that Medicare costs continue to bring harm to the economy. They also seemed skeptical about how viable the projected savings due to health care reform is.
One of those who questioned the report is Medicare chief actuary Richard Foster, who wrote: “The financial projections shown in this report for Medicare do not represent a reasonable expectation for actual program operations.”
A press release on HealthCare.gov announced the availability of $2.25 billion in grants that will benefit Americans with disabilities, as revealed by the Centers for Medicare and Medicaid Services (CMS). States can gain access to the funding by applying to become part of the Money Follows the Person (MFP) Rebalancing Demonstration.
Department of Health and Human Services Secretary Kathleen Sebelius sent a letter to the Governors of states as part of the celebration of the 20th anniversary of the Americans with Disabilities Act. In the letter, Secretary Sebelius encouraged states to take advantage of the different community initiatives included in the Affordable Care Act and to actively participate in the MFP demonstration.
Secretary Sebelius said: “The Money Follows the Person Rebalancing Demonstration has been critical to our efforts to deliver on the promise of the Americans with Disabilities Act and expand access to community living services.”
The MFP demonstration essentially provides Americans with disabilities with the assistance that they need to live independently, in their homes and with their communities, as opposed to staying in institutional long-term facilities such as nursing homes. Participation in the MFP demonstration gives states the opportunity to receive an enhanced Federal Medical Assistance Percentage (FMAP) over a period of one year for each person that they are able to transition from an institution into a qualified home and community-based program.
Among those that states can transition through the program, according to the press release, are the “elderly, people with intellectual, developmental or physical disabilities, mental illness or those who have a dual diagnosis.” States can then use the enhanced FMAP funding that they will receive to expand supports and services.
We have talked, for the most part, about what the new health care reform law can bring to the American public. The Patient Protection and Affordable Care Act, however, despite what seems to be an emphasis on patients based on its title, also has specific provisions that will have an impact on health care providers.
HealthCare.gov shares what health care reform will mean for health care providers. One of the main points that were brought up is how health care reform will mean more investments towards improving the quality of health care. The Affordable Care Act does not just provide patients with more control over their health care, but provides the same opportunity to health care providers as well.
With health care reform, health care providers can expect the health care system to become stronger. For one, since previously uninsured Americans will now be assured of health care coverage, the health care system will see a decline in the need to provide uncompensated care. The new rules that will be promulgated out of health care reform will simplify the administrative process, allowing health care providers to focus on what they do best: providing quality care for their patients, as opposed to dealing with insurance company bureaucracy.
Aside from these benefits brought about by patients that are more secure, health care reform also seeks to invest in the development of the health care system workforce. In order to help the health care system meet the demands of a population that will be more capable of seeking health care, the Affordable Care Act will provide support for the training and development of thousands of new primary care providers over the next five years.
One of the main battle cries for advocates of health care reform concerns a specific group of Americans – those who have, for the longest time, dealt with rejection and denial of health care coverage on account of pre-existing medical conditions. These conditions have deemed these patients ineligible for health care coverage, at least until now.
The Patient Protection and Affordable Care Act include the creation of a new program called the Pre-Existing Condition Insurance Plan (PCIP). This program will make health care coverage available to those who have been previously denied health care coverage by private insurance providers due to a pre-existing medical condition.
PCIP is administered by either the state or the U.S. Department of Health and Human Services. It will be able to help those who have been “locked out” of the insurance market, at least until the year 2014, which is when affordable health care coverage choices will be available through health insurance Exchanges. At this point, no one will be discriminated against based on a pre-existing medical condition.
PCIP covers a range of health benefits, which includes primary and specialty care, hospital care and prescription drugs; treatments for a pre-existing condition will be covered as part of benefits. PCIB also ensures that a patient with a pre-existing condition will not be charged with higher premiums. In addition, eligibility for the program is not determined by income.
The program is available in all states, but there may be variations depending on the state. HealthCare.gov provides information on PCIP for each state.
Over the past couple of months or so, we have heard a whole lot about health care reform, including provisions that will not take effect until a few years from now. It is therefore interesting to note the benefits that Americans will get to enjoy immediately because of health care reform. HealthReform.gov shares some of these benefits.
Topping the list is tax credits for small businesses. Since not all Americans – truth be told, it may even be a majority – do not work for major companies or Fortune 500 companies, the new health care reform will offer tax credits to small businesses, which will in turn make employee coverage more affordable. As much as 35 percent of premiums are being offered as tax credits for small companies that choose to provide coverage. This will take effect within the 2010 calendar year.
Set to take effect within six months after the passage of the health care reform law is the prohibition against health insurance providers from denying coverage to children with pre-existing conditions.
Also to take effect within the same time frame of 6 months from enactment of the law is the extension of coverage for young people up to the age of 26 through their parents’ insurance; the ban against lifetime limits on coverage; provision of free preventive care under new private plans; provision of access to a new and independent appeals process; and the prevention of discrimination by new group health plans based on salary by prohibiting these insurance providers from setting eligibility rules for coverage that favor high-wage earners.
The family is considered as the basic unit of society. Building up on that pretext, it follows that the way to a healthy society is to ensure that every family that comprises it is a healthy family.
The Patient Protection and Affordable Care Act seeks to ensure that families are able to have access to much-needed health care by providing them with more control into their own health care. It all starts with an attempt at providing families with more affordable health care.
Health care reform will implement reforms in the insurance industry that will help families save money. It eliminates lifetime limits on how much insurance companies will cover once a beneficiary gets sick and prevents them from dropping coverage for those who get sick.
Working families are provided with tax credits in order to ensure that they are able to afford quality health care coverage. In order to help those who are employed by small businesses, health care reform also provides tax credits to such small businesses in order to ensure that they are able to provide affordable quality health care coverage for their employees and, by extension, to their employees’ families.
The creation of state-based health insurance exchanges means that families will have more affordable choices in terms of insurance coverage. These exchanges will also provide families with standardized and simplified information on various health insurance plans so that families can easily compare the prices, benefits and performance of these plans, information that will help them choose the plan that is best suited for the family’s needs.
