It is hard to believe that fall is upon us. Summer brought me more time with my family and more time talking with South Floridians about the challenges we’re facing. People are definitely telling me that they feel more optimistic than they did last year, but we all understand that we have a lot more work to do.
Too often we focus only on the challenges that lie ahead, rather than reflect upon some of the successes, and I thought one piece of information in particular was lost in the midst of August.
Every year the Social Security and Medicare Board of Trustees produce a report detailing the health of Medicare and Social Security. Similar to a company’s annual report, the report details the longterm strength and viability of the Medicare and Social Security trust funds. Year after year, these reports have been describing the challenges facing both of these important programs upon which almost every senior in America depends in one way or another.
What was striking news from this year’s report, and should be celebrated by anyone concerned about the long-term viability of Medicare and Social Security, was that the health reform legislation passed earlier this year has “substantially improved” Medicare’s projected finances and that Social Security’s long-term finances also stand to improve due to the passage of health reform legislation. Medicare’s Hospital Insurance (HI) Trust Fund is now expected to remain solvent until 2029. That is 12 years longer than was projected last year—a record increase from one report to the next—more than doubling the life of the fund.
Likewise, Medicare Part D, the prescription drug program, is also in financial balance with projected costs slightly lower overall than in last year’s report. Social Security also improves slightly longterm, although the Bush recession has weighed on revenue coming into the program; the Trustee’s report shows the plan paying full benefits for 27 more years— until 2037—after which benefits would need to be reduced if no corrective measures were taken.
Nearly all of the improvements in projected Medicare finances are due to the Affordable Care Act that President Obama signed into law in March.
Before this August report from the Medicare and Social Security Trustees, many seniors had already begun to see the benefits of the health reform legislation, as $250 checks have been mailed out to more than 1 million seniors in the Medicare Part D donut hole. These checks were the first phase of the eventual elimination of the donut hole altogether. The next phase begins next-year, with 50% discounts on brand-name drugs and 7% discounts on generic drugs. As long as you are enrolled in a Part D plan, you don’t need to do anything to get these benefits.
Additional benefits of the health reform legislation kick in for seniors next year with the elimination of co-payments for preventive care services including:
• Screenings for bone density, diabetes and certain cancers
• Mammograms • Colonoscopies
• Other preventive screenings
Possibly the biggest new benefit will be the free annual wellness visits for Medicare recipients, vital for the long-term health of seniors.
Older Americans are seeing benefits as well. Over the past several years, Americans age 55-64 were the fastest growing group of uninsured Americans and the most likely to be denied coverage due to pre-existing conditions.
The Affordable Care Act changed all of that. Until the national health insurance pool (the exchange) opens in 2014, if you have retiree health coverage through your work and are between 55 and 64, new federal funds will encourage your employer to continue offering health benefits. Ask your former employer or retiree health plan administrator what changes to expect.
Of course, the Affordable Care Act isn’t just benefitting seniors; indeed some of the biggest changes in health insurance kick in for plans beginning on or after September 23, 2010:
NO DISCRIMINATON AGAINST CHILDREN WITH PRE-EXISTING CONDITIONS— Prohibits all employer plans and new plans in the individual market from denying coverage to children with preexisting conditions.
NO RESCISSIONS—Bans all health plans from dropping people from coverage when they get sick.
NO LIFETIME LIMITS ON COVERAGE — Prohibits all health plans from placing lifetime caps on coverage.
TIGHTLY REGULATES ANNUAL LIMITS ON COVERAGE—Tightly restricts the use of annual limits by all employer plans and new plans in the individual market, to ensure access to needed care.
FREE PREVENTIVE CARE UNDER NEW PLANS—Requires new private plans to cover preventive services with no co?payments and with preventive services being exempt from deductibles.
NEW, INDEPENDENT APPEALS PROCESS FOR NEW PLANS—Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions.
EXTENDING COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS’ INSURANCE – Requires plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice.
My office is always open to you. Whether you have a question, a comment, or you are having trouble with a federal agency, my office is here for you. You can reach us in Pembroke Pines at 954-437-3936, in Aventura at 305-936-5724 and in Washington, DC at 202-225-7931. You can also find me on the Web where you can sign up for my e-newsletter, at: http://wassermanschultz. house.gov I’m also on Facebook or on Twitter @DWSTWEETS.