How Health Care Reform Affects Older Americans



On March 23, 2010, President Obama signed a comprehensive health care reform bill (H.R. 3590) into law. On March 25, Congress passed the Reconciliation Act of 2010 (H.R. 4872) which modifies H.R. 3590. Taken together, these two bills comprise the health care reform package. Important provisions for older adults and people with special needs include:

SOME OF THE MEDICARE CHANGES

*The new law provides a $250 rebate to Medicare beneficiaries who reach the Part D coverage gap in 2010 (Effective January 1, 2010).

*The new law also gradually eliminates the Medicare Part D doughnut hole by 2020:

***For brand-name drugs, the new law requires pharmaceutical manufacturers to provide a 50% discount on prescriptions filled in the Medicare Part D coverage gap beginning in 2011, in addition to federal subsidies of 25% of the brand-name drug cost by 2020 (phased in beginning in 2013)

***For generic drugs, provides federal subsidies of 75% of the generic drug cost by 2020 for prescriptions filled in the Medicare Part D coverage gap (phased in beginning in 2011)

*Under the new law, Medicare will cover an annual wellness visit and creation of a personalized prevention assessment and plan. There is no co-payment or deductible for the annual wellness visit and the assessment. Prevention services include referrals to education and preventive counseling or community-based interventions to address risk factors.

*The new law eliminates Part D cost-sharing for full-benefit, dual eligible beneficiaries receiving home- and community-based services.


The changes to Medicare extend by nine years the life of the Medicare Trust Fund, which was projected to be depleted in 2017.


For a full version of this article, please see the NAELA website. The authors are Brian Lindberg and Gail MacInnes.