Featured Research

from universities, journals, and other organizations

U.S. Health care reform act a mixed bag for seniors

Date:
February 8, 2011
Source:
University of Illinois at Urbana-Champaign
Summary:
Although the effects of the controversial U.S. health care reform act will be somewhat muted for many older Americans, it will inevitably have enough of an impact that seniors will discover that there is plenty to like and dislike about the law, an expert on elder law cautions.

Although the effects of the controversial health care reform act will be somewhat muted for many older Americans, it will inevitably have enough of an impact that seniors will discover that there is plenty to like and dislike about the law, a University of Illinois expert on elder law cautions in published research.

Law professor Richard L. Kaplan says the virtues of the Patient Protection and Affordable Care Act of 2010 are a "mixed bag," and how it will affect any one person depends on that person's specific situation.

"You have to expect some negative aspects to any plan that takes $575 billion out of Medicare, a program that affects primarily older people and the disabled," Kaplan said. "That's invariably going to cut some people's benefits."

Kaplan warns that while some of the touted benefits of the law are real, others come with serious caveats. For example, the much-ballyhooed closing of the "doughnut hole" in Medicare Part D is not as generous as it is usually portrayed.

"First of all, the coverage gap is not 'closed' if you think that means complete coverage," Kaplan said. "What the law does is lower a patient's cost obligation to a 25 percent co-payment from 100 percent. That's a big benefit, but it's not the same as saying that people won't have any cost exposure whatsoever.

"Second, the doughnut hole is closing, but in annual steps over a 10-year period," he said.

"For example, the co-payment for generic drugs is 93 percent this year rather than 100 percent last year."

Kaplan, the Peer and Sarah Pedersen Professor of Law at Illinois, adds that there are some provisions of the law that are unalloyed benefits for seniors. For example, the addition of an annual wellness visit makes Medicare more oriented toward preventative care.

"For many people, when they first get onto Medicare, the initial physical examination may be the first time they've seen a physician in several years," he said. "The new law provides annual follow-up visits. That's an important addition. It makes the Medicare program more prevention-focused than it has been historically. Also, there are no co-pays or deductibles for these wellness visits."

But people who are in managed care plans are likely to be upset with the new law, Kaplan says.

"For the one in four seniors who are in Medicare Advantage plans, there will be many unappealing changes," he said. "Some plans will raise premiums on their enrollees, while others may discontinue their participation in the program altogether. In either case, the result will likely be higher costs, reduced benefits and fewer options for enrollees in Medicare managed care arrangements."

The reason for this change, according to Kaplan, is that Congress wanted to reduce the higher costs associated with managed care plans, which cost the federal government about 14 percent more than the traditional fee-for-service plan.

"Although the plans may not cut back any traditional Medicare benefits, extra benefits typically provided by managed care such as vision and dental care will probably be reduced or eliminated entirely," Kaplan says.

Other changes in the health care reform act are still somewhat ambiguous. Take, for example, the newly created Medicare Independent Advisory Board, a panel whose sole charge is to formulate proposals to lower the cost of Medicare but without rationing care or increasing the amount individual enrollees pay.

"In that case, what can the board do?" Kaplan said. "The implication seems to be that Medicare will just reduce the rate it pays to providers -- doctors, hospitals, nursing homes and home health care agencies. That's been the course that both Democratic and Republican administrations have followed over the years because seniors don't see the effect directly. But providers may limit the number of Medicare enrollees they'll accept, or they might drop out of the Medicare program entirely, which necessarily affects beneficiaries' access to care."

The study, "Analyzing the Impact of the New Health Care Reform Legislation on Older Americans," appears in the current issue of Elder Law Journal and is available online.


Story Source:

The above story is based on materials provided by University of Illinois at Urbana-Champaign. Note: Materials may be edited for content and length.


Journal Reference:

  1. Kaplan, Richard L. Analyzing the Impact of the New Health Care Reform Legislation on Older Americans. Elder Law Journal, Vol. 18, No. 2, 2011; Illinois Program in Law, Behavior and Social Science Paper No. LBSS11-07 [link]

Cite This Page:

University of Illinois at Urbana-Champaign. "U.S. Health care reform act a mixed bag for seniors." ScienceDaily. ScienceDaily, 8 February 2011. <www.sciencedaily.com/releases/2011/02/110208112700.htm>.
University of Illinois at Urbana-Champaign. (2011, February 8). U.S. Health care reform act a mixed bag for seniors. ScienceDaily. Retrieved July 22, 2014 from www.sciencedaily.com/releases/2011/02/110208112700.htm
University of Illinois at Urbana-Champaign. "U.S. Health care reform act a mixed bag for seniors." ScienceDaily. www.sciencedaily.com/releases/2011/02/110208112700.htm (accessed July 22, 2014).

Share This




More Health & Medicine News

Tuesday, July 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Courts Conflicted Over Healthcare Law

Courts Conflicted Over Healthcare Law

AP (July 22, 2014) Two federal appeals courts issued conflicting rulings Tuesday on the legality of the federally-run healthcare exchange that operates in 36 states. (July 22) Video provided by AP
Powered by NewsLook.com
Why Do People Believe We Only Use 10 Percent Of Our Brains?

Why Do People Believe We Only Use 10 Percent Of Our Brains?

Newsy (July 22, 2014) The new sci-fi thriller "Lucy" is making people question whether we really use all our brainpower. But, as scientists have insisted for years, we do. Video provided by Newsy
Powered by NewsLook.com
Scientists Find New Way To Make Human Platelets

Scientists Find New Way To Make Human Platelets

Newsy (July 22, 2014) Boston scientists have discovered a new way to create fully functioning human platelets using a bioreactor and human stem cells. Video provided by Newsy
Powered by NewsLook.com
Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

TheStreet (July 21, 2014) New research shows Gilead Science's drug Sovaldi helps in curing hepatitis C in those who suffer from HIV. In a medical study, the combination of Gilead's Hep C drug with anti-viral drug Ribavirin cured 76% of HIV-positive patients suffering from the most common hepatitis C strain. Hepatitis C and related complications have been a top cause of death in HIV-positive patients. Typical medication used to treat the disease, including interferon proteins, tended to react badly with HIV drugs. However, Sovaldi's %1,000-a-pill price tag could limit the number of patients able to access the treatment. TheStreet's Keris Lahiff reports from New York. Video provided by TheStreet
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins