Affordable Care Act Delivers Big Savings For Seniors
Most of the Affordable Care Act won’t take effect for a few years — and if court rulings and the 2012 elections go a certain way, it may not take effect at all — but there’s already evidence that the reform law is working.
It’s making a big difference in providing coverage for young adults; it’s providing treatment options for women like Spike Dolomite Ward; and it’s slowing the growth in Medicare spending.
It’s also, as Jonathan Cohn explained, saving seniors quite a bit of money on prescription medication.
Under the terms of the Affordable Care Act — yes, Obamacare — pharmaceutical companies provide a 50 percent discount on name-brand drugs for seniors who hit the “donut hole.” The donut hole is the gap in coverage that begins once an individual Medicare beneficiary has purchased $2,840 in drugs over the course of a year. At that point, the beneficiary becomes completely responsible for prescription costs — in other words, he or she has to pay for them out of his pocket — until he or she has spent another $3,600.
It may not sound like a lot of money. But the seniors who hit the donut hole are, by definition, the ones with the most medical problems. Saving a few hundred dollars, on average, makes a real difference. And that’s precisely what’s happening, according to data the administration released today. According to its calculations, 2.65 million seniors hit the donut hole — and then saved an average of $569 each. The data runs through October. More seniors will hit the donut hole through year’s end, so the total number of beneficiaries who take advantage of the discount in 2012 should end up higher.
In an interview with USA Today, Jonathan Blum, director of the Center for Medicare, added, “We’re very pleased with the numbers. We found the Part D premiums have also stayed constant, despite predictions that they would go up in 2012.”
Seniors have been some of the biggest skeptics of the Affordable Care Act, but they’ve also seen some of the most direct benefits. Indeed, USAT’s report went on to note that as of the end of November, “more than 24 million people, or about half of those with traditional Medicare, have gone in for a free annual physical or other screening exam since the rules changed this year because of the health care law.”
If Republicans repeal the law, all of these benefits will simply disappear. It’s something voters may want to keep in mind.
By: Steve Benen, Contributing Writer, Washington Monthly Political Animal, December 7, 2011
Is Utah About To Elect Another Senator Who Thinks Medicare Is Unconstitutional?
Last year, Sen. Mike “A Noun, A Verb, and Unconstitutional” Lee (R-UT) upset longtime Sen. Bob Bennett (R-UT) in the Utah GOP’s arcane candidate selection process — allowing the Tea Party to elevate someone to the Senate who believes that everything from Medicare to Social Security to child labor laws somehow violate the Constitution. Since then, Utah’s senior Sen. Orrin Hatch (R) has tripped over himselfto pretend that he is just as radical as young Sen. Lee.
Alas, all of Hatch’s extremist posturing may be for naught, as the Tea Party has found someone who shares their apparent policy goal of ensuring that people who can’t afford health care are left to fend for themselves:
During a recent media blitz in Washington, D.C., Dan Liljenquist, a state senator from Utah, went after Sen. Orrin Hatch, arguing he has done more than any other Republican to promote nationalized health care. […] The skirmish is the first between these potential 2012 opponents. Liljenquist, a Republican, says he won’t make an official decision until early next year, but he has prepared for a possible run for Hatch’s seat. […]
[Liljenquist] argued that Hatch is not committed to returning power to the states, focusing on the State Children’s Health Insurance Program that Hatch spearheaded in 1997. That program, which pays for health coverage for poor children, has come under fire from tea party Republicans who see it as a step toward a national takeover of health insurance. Liljenquist went as far as to call it “unconstitutional.”
Liljenquist’s suggestion that the State Children’s Health Insurance Program (SCHIP) is unconstitutional is absurd. SCHIP works by providing funds to states to help them pay for health insurance for children. Because the Constitution allows the federal government “to lay and collect taxes” and to use those revenues to “provide for the…general welfare of the United States,” there is simply no doubt that it can spend money on providing health care to vulnerable young people.
Moreover, other essential health care programs — such as Medicare and Medicaid — stand on similar constitutional footing as SCHIP. So if Liljenquist thinks one of these programs is unconstitutional, it is likely that he believes that we must eliminate all three.
In other words, if Liljenquist succeeds in taking Hatch’s Senate seat, Utah could become the only state in the union to have its entire Senate delegation believe that the Constitution requires millions of children, low-income Americans and seniors to be cast out into the cold with no meaningful access to health care.
By: Ian Millhiser, Think Progress, November 28, 2011
GOP Super Committee Co-Chair: Lawmakers Failed Because Democrats Refused To Privatize Medicare
Rep. Jeb Hensarling (R-TX) faults the Democrats’ refusal to accept partial Medicare privatization for the super committee’s inability to come up with a bipartisan plan to lower spending in today’s Wall Street Journal. He writes, “Democrats on the committee made it clear that the new spending called for in the president’s health law was off the table” and pretends that the spending in the Affordable Care Act added to the deficit (it actually reduces it). “Republicans offered to negotiate a plan on the other two health-care entitlements—Medicare and Medicaid—based upon the reforms included in the budget the House passed earlier this year,” he continues and lays out the premium support proposal offered by Alice Rivlin and Pete Domenici:
The Medicare reforms would make no changes for those in or near retirement. Beginning in 2022, beneficiaries would be guaranteed a choice of Medicare-approved private health coverage options and guaranteed a premium-support payment to help pay for the plan they choose….These seniors would be able to choose from a list of Medicare-guaranteed coverage options, similar to the House budget’s approach—except that Rivlin-Domenici would continue to include a traditional Medicare fee-for-service plan among the options.
This approach was also rejected by committee Democrats.
The Congressional Budget Office, the Medicare trustees, and the Government Accountability Office have each repeatedly said that our health-care entitlements are unsustainable. Committee Democrats offered modest adjustments to these programs, but they were far from sufficient to meet the challenge. And even their modest changes were made contingent upon a minimum of $1 trillion in higher taxes—a move sure to stifle job creation during the worst economy in recent memory.
Hensarling doesn’t mention that the Rivlin-Domenici premium-support proposal doesn’t so much lower national health care spending as it shifts it to the beneficiary. The plan reduces the federal contribution to Medicare by capping costs for each beneficiary and offering premium support credits that won’t keep up with actual health care spending. The federal government spends less, but seniors will pay more out of pocket for health care benefits every year. The proposal also breaks up the market clout of traditional Medicare and rather than ratcheting up some of efficiencies and payment reforms in the Affordable Care Act, it sets the nation on an untested path of private competition — leaving seniors vulnerable to the manipulations of for-profit health insurers.
Democrats, for their part, offered rather substantial concessions on Medicare spending. As the Center on Budget and Policy Priorities argued, the Democrats’ $3 trillion deficit proposal to the super committee “stands well to the right of plans by the co-chairs of the bipartisan Bowles-Simpson commission and the Senate’s ‘Gang of Six,’ and even further to the right of the plan by the bipartisan Rivlin-Domenici commission.” The plan contained “substantially smaller revenue increases than those bipartisan proposals while, for example, containing significantly deeper cuts in Medicare and Medicaid than the Bowles-Simpson plan.” For instance, Bowles-Simpson offered $383 billion in Medicare and Medicaid, while Democrats put $475 billion on the table.
President Obama introduced $320 billion in health care savings, mostly from the pharmaceutical industry and other providers, including rural hospitals, teaching hospitals, and biotechnology firms. But the plan even incorporated the GOP’s push for greater means testing in Medicare, asking some wealthier beneficiaries to pay more for coverage and sought to give beneficiaries “skin in the game” — as the GOP puts it — to discourage over treatment.
All of these are significant concessions — as are the health cuts included in the trigger mechanism — but Hensarling and Republicans aren’t interested in bipartisan agreement. They’re not accepting anything short of Medicare privatization.
By: Igor Volsky, Think Progress, November 22, 2011
What Does Super Committee Failure Mean For Healthcare?
The medical community is buzzing with concern this afternoon over what the failure of the Joint Select Committee on Deficit Reduction means for healthcare providers and recipients.
Under the ‘trigger’ provisions agreed upon during the August debt default crisis, were the super-committee to fail to arrive at their own formula for getting rid of $1.2 trillion in deficit – a circumstance that has now become reality – Medicare would find itself facing an annual cut of 2 percent each year for a ten year period beginning in 2013.
Should this actually occur it would be disastrous for health of the nation’s senior citizens. Properly configured, the cuts could be made without biting into benefits for the elderly who depend upon the program, but the trigger mechanism does not point to specific areas of the federal health program where the cuts could be targeted in a way that would reduce spending while protecting benefits. Thus, everything would have be cut by the 2% amount, including medical benefits.
Personally, I don’t believe for a moment that the sequester provisions that were the penalty for failure of the deficit committee will ever see the light of day. There are thirteen months to go before these provisions kick in and Congress is already planning way to work around the cuts – particularly with respect to the defense budget. As a result, we can fully expect that the lame-duck session that will take place immediately following next November’s elections will either do away with or drastically modify the anticipated cuts.
It should also be noted that there are many policy experts who believe that had the panel reached an agreement, the damage to Medicare may have been far more serious than the planned 2 percent annual cuts.
There is, however, some real potential for immediate damage as a result of this Congressional failure.
The physician community had hoped that a deal would have brought resolution to the Medicare payment reductions doctors face each and every year as a result of the sustainable growth rate (SGR) formula. While Congress has traditionally delayed the cuts each year, the current decrease scheduled – should it actually happen – would hit physicians with a 27% pay cut for caring for Medicare patients starting January, 2012.
Given the tenor of Congress these days, there seems to be some chance that the Republicans might wish to make their point by allowing the payment reduction to take place. Should this happen, we’ve got a very big problem on our hands.
Physicians are already unable to make much-if any-profit on what Medicare pays them to treat our nation’s elderly. A near 30% cut would cause many-far too many-doctors to close up shop to seniors who are unable to cover the fees doctors require to stay in business out of their own pockets. The disastrous result this would lead to is obvious.
Says American Medical Association president, Peter Carmel:
The failure of the deficit committee forces our nation to continue on an unsustainable path that puts current and future generations of Americans at risk for harsh consequences The deficit committee had a unique opportunity to stabilize the Medicare program for America’s seniors now and for generations to come.
Once again, Congress failed to stop the annual charade of scheduled Medicare physician payment cuts and short-term patches, which spends more taxpayer money to perpetuate a policy everyone agrees is fatally flawed.
As I often point out, doctors are the one element of our healthcare system that are irreplaceable. Having hospitals are of little value when there are no physicians walking the halls to care for us. Drugs aren’t going to reach those who need them if there are no doctors to write the prescriptions.
Let’s hope that Congress is not so foolish as to make their point by hurting physicians and the seniors who depend upon them.
By: Rick Ungar, Forbes, November 21, 2011
The Intransigent “Do Nothing GOP Congress” And Election 2012
The Republicans in Congress have made a wager. They’ve bet the political ranch that they will destroy Barack Obama’s chances for re-election if they can block his proposals to produce jobs.
In fact, it’s the GOP that could lose big when the votes are counted a year from now.
Republicans completely control the House. In the Senate they can use the filibuster to prevent anything from passing.
Last week, for the third time this fall, Republicans successfully blocked Obama’s jobs program in the Senate. Of course this came as absolutely no surprise, since Senate Republican Leader told the world earlier this year — in no uncertain terms — that his top legislative priority was to prevent the re-election of the president.
McConnell, and his House counterpart, John Boehner, don’t lose a wink of sleep over concerns that their intransigence harms the economic prospects of everyday Americans. In their view, the worse the economy gets, the more likely the voters will be to boot President Obama out of the Oval Office.
But a good case can be made that these guys will end up being too clever by half — that in fact they are providing fuel for precisely the argument that could defeat them in 2012.
McConnell and Boehner are right that it is very hard for an incumbent president to win re-election in a bad economy. And unless something dramatically changes, most Americans won’t think much of their own economic circumstances when Election Day rolls around next year.
So next year’s election will turn largely on one question: who does the American people hold responsible for what will likely still be a lousy economy?
Republicans are relying on the simple proposition that the guy in charge — the president — is to blame. But every day of intransigence increases the odds that in fact, they themselves will get the rap.
In 1945 Vice President Harry Truman became president when Franklin Roosevelt died in office. After the War, Truman presided over a substantial post-war recession that helped make him “unelectable” in the eyes of most pundits and politicians. GDP dropped by a whopping 12%. His political viability was complicated further when the Democratic base split into three parts. A portion followed Progressive Henry Wallace and much of the Southern Democratic white vote (the south was a Democratic base at the time) supported Strom Thurmond’s segregationist Dixiecrat Party. In the April before the election, Truman’s overall approval rating in the Gallup poll was just 36%.
But, Truman barnstormed the country, traveling 21,000 miles on a “whistle stop” tour where he decried the “do-nothing Republican Congress.” Though the economy began a modest improvement in 1948, no one — but Truman himself — believed he had a chance to defeat Thomas Dewey — a former Governor cut out of the same elite cloth as Mitt Romney. Truman won.
Obama can do exactly the same thing. Even assuming that the economy continues to experience only modest improvements over the next year, the Obama campaign can lay the lack of progress where it belongs — at the feet of the “do-nothing Republican Congress” that is intent on stalling economic recovery for their own political gain.
And where Truman’s 1946 recession was largely the result of the post war demobilization, Obama can rightly claim that this economic disaster was the product of precisely the same Republican policies that his opponents intend to re-instate if they regain control of 1600 Pennsylvania Avenue.
Not only has the GOP refused to support Democratic measures to put Americans back to work, their alternative “jobs program” features no direct, measurable job creation whatsoever. Instead it relies on the same “trickle down” economic theory that didn’t create one net private sector job in the eight years before the Great Recession – and the same unwillingness to rein in the big Wall Street banks that led to the worst financial collapse in 65 years.
But that’s not all. Everyone agrees that the Republican House Majority was swept into office last November precisely because of the terrible economy. But instead of job creation, they’ve busied themselves focusing on trying to defund Planned Parenthood, protecting Americans from the imaginary threat of Sharia Law, and fending off non-existent attack on the use of “In God We Trust.” The Republican controlled House hasn’t voted on a single job creation measure since John Boehner and his colleagues took power last January.
In the deliberations of the “Super Committee,” Republicans have been completely unwilling to give on the fundamental question of whether millionaires should be asked to pay to put America’s economic house in order. The view of the Republican leadership is that — in addition to defeating President Obama — their principal mission is to act as guard dogs for the exploding incomes of the top 1%.
In the upcoming fight over the next fiscal year’s appropriation bills, there is every indication that the Republicans will demand that riders be attached limiting the power of the EPA and restricting funding for contraception — which surveys show is used by 98% of American women.
Battles like these will do nothing but strengthen the Democratic narrative that the GOP leadership is focusing on bread and circuses for its base, while it intentionally blocks measures that could provide jobs to construction workers, fire fighters, cops, teachers and millions other out-of-work Americans.
Then there is the House schedule. Last week the Boehner team published a House schedule for next year intended to guarantee that very little gets done. The House will be in session only 94 days in all of next year (including many days where votes are postponed until 6PM) and will continue its habit of going into recess virtually every third week. Yet another example of a “do-nothing Republican Congress.”
It’s no accident, that while the polls show that most officials in the American government have fallen into disrepute for their failure to get the economy moving again, Congressional Republicans win the prize for negative ratings. Gallup shows Obama’s approval ratings beginning to edge up — from a very low 38%, up to 43%. Some other polls show it rising to 47%. The average rating from Real Clear Politics currently stands at 45.4%.
Meanwhile, Congressional job approval ranges from 9% to 16%, with a Real Clear Politics average of 12.7%.
The recent Democracy Corps poll shows that favorability for Republicans in Congress trails the Republican Party as a whole, Democrats in Congress, the Democratic Party as a whole, and President Obama.
On the other hand, the president’s agenda itself is overwhelmingly popular. His jobs bill is supported by the vast majority of Americans — and becomes more popular the more voters hear about it. When its provisions were explained, 63% offered their support in the October Wall Street Journal/NBC poll. That’s why it’s so important for the White House to continue pressing Congress to pass the bill as a whole — and to focus on its individual parts.
Funding jobs for teachers, firefighters and cops is very popular. Repairing deteriorating schools is very popular. Building roads, ports and airports is very popular. Providing unemployment benefits for those who are out of work is very popular.
And paying for it all by taxing millionaires and billionaires has the support of two thirds to three fourths of Americans — including a majority of Republicans. An October National Journal poll found 68% of voters support the Democratic proposal for a surtax on millionaires to pay for the jobs bill.
In fact, the whole 99% versus 1% message frame that has dominated the airwaves since everyday people began Occupying Wall Street — is very popular — as are the president’s executive actions to improve the economy without Congressional approval.
And what is unpopular? The Republican plan to abolish Medicare and replace it with vouchers – that is really unpopular. In fact, most polls find that 70% of voters oppose cutting Social Security and Medicare to reduce the deficit.
Creating jobs, making the 1% pay their fair share, and protecting Social Security, Medicare and Medicaid will be the defining symbolic issues next year — and on every one of them Democrats hold the high political ground and Republicans have to walk through the valley of political death.
Finally, of course, is the matter of whom the Republicans will nominate as an alternative to President Obama. Unfortunately for the GOP, Presidential elections are not always referenda on the incumbent — they are choices between two living, breathing people — and in this case two clearly distinguishable futures for our country.
The conventional wisdom holds that Romney is the Republican’s strongest contender. If he is — which I doubt — he is no Rocky Balboa.
There are two lines of attack on Romney that are toxic:
He clearly has no core values.
When voters accuse someone of being a typical “politician” they mean someone is a candidate who has no center — who decides what he believes depending entirely on the political winds. Romney could serve as the dictionary definition of “politician.” He has done “one eighties” on everything from abortion rights to health care. He is a political weathervane whose guiding principle is only one thing: what will advance the political career of Mitt Romney?
In 2004, immediately before the election, Gallup showed George W. Bush with an approval rating of 48% approval to 47% disapproval — not much different than President Obama enjoys today. But a not very popular Bush won re-election — largely by convincing large numbers of swing voters that John Kerry had no core values, that he was a flip flopper. They succeeded even though Kerry was a war hero and had a strong record of standing up for what he believed. How much easier will it be to convince everyday Americans that Romney has no core values – since he doesn’t.
Romney is the poster boy for the 1%.
He feels like the guy who fired your brother-in-law. He is in fact the guy who, some time back, gathered his crowd of young Wall Street hot shots around him after he completed a big deal at Bain Capital and posed for a picture with money dripping from their mouths and pockets and ears. He’s a guy who made his fortune dismantling companies and firing workers.
Of course, none of these facts are intended to make Progressives complacent — far from it. None of them guarantees we will win in 2012 — only that we can.
For the first two years of the Obama Administration, Progressives took a lot of ground.
There was:
Health Care for All Americans
Wall Street Reform
Avoiding another Great Depression
Saving a million jobs in the American auto industry
Expanding Medicaid
Eliminating Don’t Ask Don’t Tell
Expanding Children’s Health
Environmental Reform
Expanding Labor Rights
Expanding Civil Liberties
Equal Pay for Equal Work
Now Obama is ending the War in Iraq.
But last fall the Empire struck back. All of the corporate, special interest money fought back with a vengeance. It fought back because that’s the nature of change. The forces of the status quo don’t just roll over and play dead. They do everything they can to hang onto their money and power and privilege.
Now we have to hold our ground and prepare a winning counter offensive — and it won’t be easy, especially in light of the Supreme Court’s Citizens United decision that magnifies the power of corporate cash.
But if they win — if America has President Romney or Perry or Cain, Senate Majority Leader McConnell and Speaker Boehner — they have made it crystal clear what they will do. They will return America to the Gilded Age. They will roll back the twentieth century — they will rip apart the entire social contract.
They will privatize Social Security, destroy Medicare, emasculate the labor movement, cut taxes further for corporations and the wealthy. They will create new radical conservative facts on the ground that they hope will entrench conservative power for generations.
But they believe their real key to victory is lack of enthusiasm among Progressives. They believe that Progressives — and many in the Democratic base — will stay home next November.
They will be wrong.
That’s because over the next year, the progressive forces in America will rise to the battle. In their own way, the Occupy movement has already shown that Progressives will stand and fight.
They will rise to the battle because they realize that the 2012 election is not just about two people running for President. It is about a moral question. It’s about two competing sets of values. It’s all about how we see ourselves as a nation — as a society. It’s about whether we will be a society based on the precepts of radical conservative social Darwinism, or a society rooted in the progressive values that have always defined the promise of America.
We will not allow them to destroy Social Security, Medicare and Medicaid.
We will not allow them to destroy the American labor movement.
We will not allow them to destroy the middle class.
We will not allow them to destroy the American dream.
And we will remember a central lesson of history: that before change happens it seems impossible. And after change happens it seems inevitable.
American history — human history — is the story of ever-expanding human freedom. There may be ups and downs, but when you back up from the big chart of history, the trend is up.
I believe that our time is no exception — that next year — in this crossroads election — we will do what is necessary to assure that America once again recommits herself to create a brighter future for the next generation than those that went before.
That’s what the revolutionaries that created this nation did. That’s what the soldiers who fought and died to defend it did. That’s what the sit-down strikers who created the labor movement did. That’s what the freedom riders who fought for civil rights did. And that is precisely what we will do again in 2012.
By: Robert Creamer, Political Organizer, Strategist and Author, Published in The Huffington Post, November 7, 2011
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