As the 112th Congress gets underway, there are efforts to repeal the Affordable Care Act, a move that would have a devastating effect on seniors, harm the solvency of Medicare and eliminate consumer protections that are important to Maryland families.
Starting on January 1, seniors who fall in the Medicare Part D prescription drug gap or “donut hole,” will receive a 50% discount on all brand-name medications. Also starting on January 1, the new law eliminates all co-payments for Medicare preventive services and it provides for free annual wellness checkups for seniors with no co-pays or deductibles, provisions that I fought to have included in the health care reform law.
These are important new benefits that will significantly reduce costs by keeping seniors healthy. An average Medicare beneficiary will save approximately $3,500 over the next 10 years, and beneficiaries with high drug costs will save as much as $12,300 over the next decade.
Maryland seniors have already substantially benefited from the new health care law. Just last year, more than 32,000 of our seniors received a one-time, tax-free $250 rebate to help them pay for their medicines once they hit the prescription drug donut hole. Between 2011 and 2020, more than 44,000 Maryland seniors who reach this gap in coverage will realize an estimated savings of more than $400 million. The Medicare prescription drug gap will be totally eliminated by 2020 under the health reform law, as long as the law is not rolled back.
A repeal of the Affordable Care Act would adversely affect our federal budget deficit and jeopardize the future finances of the Medicare program. The Congressional Budget Office recently estimated that a roll-back of the law would increase the deficit by $230 billion by 2021. At the same time, the Center for Medicare and Medicaid Services (CMS) has estimated that the new health care law extends the solvency of Medicare by another 10 years.
The Affordable Care Act also provides American families with important and popular consumer protections such as prohibiting insurance companies from dropping your coverage when you get sick, blocking coverage due to so-called pre-existing conditions, ending lifetime limits on coverage, and allowing children to stay on their parents’ health care coverage until age 26. These are benefits that Americans care about and do not want to lose.
I am committed to fighting any efforts to roll back or defund health care reform. From a public policy perspective, the Republican effort to do so is irresponsible, particularly since they have not come up with an alternative proposal that would provide Americans with much-needed consumer protections, expand access to care or lower overall health care costs. Repeal would be a step backward that our nation can ill afford to take.
Cynthia McGinnes says
There is so much inaccuracy and so many half-truths in this op-ed that it is hard to know where to start. Let’s just say that everyone knows that there is no free lunch, and someone must pay for all these “freebies” that “seniors” are allegedly receiving. Common sense will tell you that taxpayers cannot absorb any more cost, and that adding these free medical services will only increase rationing, as there aren’t enough doctors to provide them. Shame on Senator Cardin for writing this oped to try and confuse people as to the real effects of this health care bill.
Cynthia McGinnes
Gren Whitman says
Instead of her airy dismissal of Senator Cardin’s factual remarks, his critic, Ms. McGinnes might instead suggest what she would put in place to provide health care for Americans. But that’s the problem with critics of the Affordable Health Care Act: they don’t like it, but they have nothing to offer in its place, except total repeal, and that won’t happen. It won’t happen because more and more Americans every day are receiving health services and savings denied them under the old anything-goes system.
MBTroup says
Gren, I’ve offered some alternatives, and I’ve invited a discussion of those alternatives. I’m not a policymaker, but I keep reading this “nobody” business from folks around here. Well here I am – somebody. I would expect Senator Cardin to be all-in with the PPACA. If I recall, his trip to the shore included a town hall where he blamed the uninsured for all of our ills.
Will Blake says
Ergo, Cynthia McGinnes believes the following:
That we should
Exclude children under age 19 with pre-existing conditions
Not lift lifetime and annual limits on benefits paid. Because life has a certain dollar value.
Not allow young adults to remain on their parents’ policies.
Not close the Medicare Part D donut hole for seniors.
Also, the health rationing issue. We’re rationed now by private insurers! Even on Faux News we read:
On the August 16, 2010 edition of Fox News Sunday, American Medical Association President J. James Rohack noted:
“Well, there’s a myth that rationing doesn’t occur right now. In the United States, if a woman’s pregnant and on the individual market tries to get health insurance, that’s called a pre-existing condition, and it’s not paid for. That’s why this bill’s important. It gets rid of some of the rationing that’s occurring right now. “[Fox News Sunday, 08/16/10]
And one more:
Kathleen Sebelius Saw Rationing By “Private Insurers” On “A Regular Basis” While Serving As Kansas Insurance Commissioner~
During her confirmation hearings, Health and Human Services Secretary Kathleen Sebelius stated, “I, frankly, as insurance commissioner, where I served for eight years, saw [rationing] on a regular basis by private insurers, who often made decisions overruling suggestions that doctors would make for their patients, that they weren’t going to be covered. And a lot of what we did in the office of the Kansas Insurance Department was go to bat on behalf of those patients to make sure that the benefits that they had actually paid for were, in fact, ones that were delivered.” [Senate HELP Committee hearing via ThinkProgress.org, 3/31/09]
MBTroup says
@Will – While you have put words in Cynthia’s mouth (how do you know she believes in your four bullet points – there are 2700 pages with which one could find disagreement), please allow me the same liberty. Might I infer that you really like the Patriot Act, as one of its far reaching aspects has certainly aided to combat an act of terrorism? Didn’t think so.
President Obama introduced this issue as an economic issue. He tasked Congress with creating legislation that bent back the cost curve and provides access to most Americans. Alas, the bill that passed fails to accomplish those things. What’s humorous to me is the double talk. Pelosi and Reed made this, not about cost curves, but sticking it to insurance companies and their “obscene” profits. Now that it has passed, a defense I keep hearing is “but the insurance companies are really enamored with it.” Huh?
I’ve said over and over that no singular bill was called “New Freedom,” “New Deal,” “Square Deal,” or “Compassionate Conservatism.” This overhaul could have been handled in a series of bills, placing the mandates on insurers that supporters of this bill trot out as being its only elements, while also addressing the real cost drivers of health care.
Those cost drivers are 1)Our misuse of insurance – using it to pay for day to day care, in addition to the catastrophic care it is designed to handle. 2)Related to number one, our reliance on secondary and tertiary health management solutions ($$$ drugs and risky surgeries). 3)Twenty year patent protection for pharma. This is designed to cover R&D which is basically what those companies are. Free up the distribution of these drugs and create a royalty system to cover the R&D. 4)Mandates preventing purchase of plans across state lines. Every Californian’s premium dollar goes to cover acupuncture treatment. Perhaps a Michigan plan would work better (CATO Institute explains this well). 5)Defensive medicine/tort reform. 6)Tax advantages tilted towards employer plans versus off-the-shelf plans.
Finally, the bill’s costs. People keep talking about the CBO’s score. Problem is, the CBO judges bills based upon a ten year outlook. The costs and benefits were rolled out, such that the CBO scored a bill with six years of costs, and seven years of taxes. Over the following decades, the program’s deficit neutrality is highly suspect.
Now, please take the “party of no” label of the box I’ve been put in, and let’s start this thing from the beginning.
Will Blake says
MBTroupe~
It does not appear to me that Cynthia Mcginnes was addressing the the 2,700 pages of which you speak. She was addressing the op-ed by Senator Cardin. Those were the parameters of my response. In fairness to Mrs/Ms. MicGinnes I do not know if she actually beleves in the aforementioned bullet points. I should have said that those points would be the results of a repeal, and left it at that. And I certainly wasn’t addressing the history of the legislation, President Obama’s original intent, only its current incarnation. You are the only one mentioning “the party of No.”
I don’t think we’re too far afield in wanting to redesign a health system that is fair, accessible and sustainable. You may be dead right about your suspicion of deficit neutrality tanking after the first decade. On the other hand perhaps the CBO might be right if H.R, 2 is accepted as final legislation and projecting the impacts after the first decade.
Impact on the Federal Budget Beyond the First 10 Years
CBO estimates that enacting H.R. 2 would increase federal deficits in the decade after 2019 by an amount that is in a broad range around one-half percent of GDP, plus or minus the effects of technical and economic changes that CBO and JCT will include in the forthcoming estimate. For the decade beginning after 2021, the effect of H.R. 2 on federal deficits as a share of the economy would probably be somewhat larger. (Thursday, January 6th, 2011 by Douglas Elmendorf, CBO)
For me, however, the argument is moot. I do not see a for-profit health care system as a sustainable model, and H.R 3590 is far, far from steering the ship away from that.
So what would you offer as a plan from this point on?
MBTroup says
@Will – Forgive the logic leap I made about the first commenter’s intentions. I think it’s safe to assume that if Ms McGinnes found the least detestable parts of the bill to be detestable, then we could fill in the rest of the blanks. HR2 without a companion replacement is not deficit neutral because we would still be in the current environment where programs like Medicare/aid pick up the tab for the inefficiencies of the system (outlined in my initial post). That said, I don’t see how the bill that was passed addresses those cost drivers in terms of those who aren’t on Medicare/aid. I think the assumption is that the mandate will wash everything away. But what if those who would not ordinarily be consumers of health care, decide to seek it since they were made to have some skin in the game (Another CBO stamp concern – they can’t guess consumption)? Then something has to give – cost or care, which rolls into Ms McGinnes’ rationing concerns.
I read over and over again, terms like “imperfect,” “warts and all,” “better than what we had,” etc. Senator Cardin can choose to believe that he passed only the portion of the law that affects seniors. The fact is, we’re talking about the rule of law. All 2700 pages are law.
As far as my idea for a replacement? I wrote to Congressman Kratovil on that subject. Basically, it was a series of ideas rolled out over three years to arrive at the true number of uninsured. We needed to be asking what the barriers were, and target from there. A rifle as opposed to a shotgun, I suppose. HR 3590 solved a problem that was not accurately defined. So we blasted something and hoped we hit it.