A Message from Toni Lynn Davis, Executive Director

Clarifying the Affordable Care Act For Senior Citizens

By Toni Lynn Davis MHA, CNHA, FACHCA
CEO/President Green Hill Inc.

Toni Lynn Davis
Executive Director

“About 17% of seniors incorrectly believe the Affordable Care Act replaces their Medicare with insurance policies purchased on line through the state and federal health insurance exchanges according to a study released exclusively to USA TODAY. ‘The confusion is causing seniors to make unnecessary decisions about spending. Some are even going back to work.’ Kelly Kennedy of USA Today reported.”

As I write this message the Affordable Care Act (ACA) has gone into effect and the government shutdown has begun. There are passionate and differing views about the benefits and detriments of this healthcare law. Politicians, comedians, newscasters and hosts are discoursing and dissecting various elements of the plan, and Facebook and Twitter are burning up with comments, and tweets that include prognostications about the end of healthcare in the United States as we know it. Across the country and in our state of New Jersey, Affordable Care advocates are going door to door, talking to residents and handing out pamphlets. Volunteers are knocking on doors and hosting parties to educate residents about the law. Regardless of one’s position on the matter, The Affordable Care Act is law and legislation that seniors need to understand so they don’t make any unnecessary changes to their healthcare out of ignorance, fear, or as a result of unscrupulous individuals looking to take advantage of the confusion.

To ensure that senior citizens understand what implementation of this law means to them it is important to know the facts. The Affordable Care Act was enacted to enable and require those persons that do not have health insurance, and who are not provided health insurance by their employers, to enroll in a health insurance plan. No one may be turned away for preexisting conditions. All uninsured persons will have to pay a yearly fine if they do not purchase health insurance. This enrollment of the uninsured is believed to reduce the overall cost of health care for the majority of citizens.

For those who do not have healthcare insurance the initial phase begins Oct 1st and runs through March 2014. An uninsured citizen or legal resident may select a health insurer from a list of state or federally assigned providers. New Jersey elected not to participate in setting up its own health insurance co-op so New Jersey residents will choose from the Federal list of providers on a web site exchange on www.healthcare.gov. Rates do vary by region of the country for similar services and one may choose moderate to high levels of coverage. The law provides tax credits based on income levels.

For our seniors it is important to note that selecting a health insurance provider to adhere to the Affordable Care Act does not apply to you if you already have health insurance provided by Medicare. You will not need to do anything. You are already covered and your benefits will not change whether you are enrolled in traditional Medicare or Medicare Advantage Plan. Seniors will still enroll in Medicare directly through www.medicare.gov. “The Affordable Care Act (ACA) in fact prohibits cuts to guaranteed Medicare benefits. There are provisions in the law to help curb the soaring costs of Medicare, but savings will come from reining in unreasonable payments to providers, taxing high-premium plans (beginning in the year 2018), cracking down on fraud and waste, and encouraging patient-centered, coordinated care, says Sara R. Collins, Ph.D., vice president of the Commonwealth Fund, a private research foundation focused on health care.” AARP 11 Myths about Healthcare Reform.

The Affordable Healthcare Act does expand the eligibility for Medicaid which remains accessible through www.medicaid.gov. “New Jersey has about 1.2 million people enrolled in Medicaid. According to the Urban Institute, and additional 307,000 will be eligible because of the law’s expansion of the Medicaid program.” Star Ledger Guide to Obamacare. The Affordable Care Act refers to two separate pieces of legislation, the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010. “…together these bills expand Medicaid coverage to millions of low-income Americans and makes numerous improvements to both Medicaid and the Children’s Health Insurance Program.” Healthcare.gov
For most people, seniors included, prescription drug costs in the ‘doughnut hole’ coverage gap will not increase but is legislated through the ‘Act’ to decrease. “The law closes the infamous Medicare Part D prescription drug “doughnut hole,” in which Medicare beneficiaries paid full price for prescription drugs after exceeding a certain dollar limit each year. Now enrollees who reach the doughnut hole get large discounts, and by 2020, the hole will close.” AARP 11 Myths about Healthcare Reform.
“For people who currently are uninsured and who qualify for financial assistance or enrollment in Medicaid, the federal-state health program for the poor, the average prices look to be low: 56 percent of uninsured will be able to get coverage for less than $100 a month per person” as stated by Gary Cohen, director of the Center for Consumer Information and Insurance Oversight.’ Huffington Post If you think you might be eligible for the Medicaid program log on to medicade.gov before you visit the ACA website.

If you have private health insurance or insurance provided by an employer and you would like to see if you can get similar coverage for lower rates you may consider exploring joining an Affordable Care Act plan.

It is important that senior citizens are aware of the facts of the Affordable Healthcare Act. There will be many ‘scammers’ out there who will try to take advantage of the confusion and misinformation around this new legislation. If you are a senior citizen with Medicaid or Medicare coverage, or a private or employer funded health insurance plan you need to take no action at this time to be in compliance with the Affordable Healthcare Act. For more information about the Affordable Healthcare Act or to enroll visit www.healthcare.gov.

Star Ledger