What terrible things has “Obamacare” delivered since the Affordable Care Act was passed in 2010?  According to the Center for Medicare Advocacy, here is how the healthcare reform law has affected Medicare:

• Closing the Medicare Drug Coverage Gap. 2011 is the first year of a multi-year phase out of the “donut hole”.  For 2011, beneficiaries pay only 50% of the cost of brand name drugs in the donut hole and 93% of the cost of generic drugs.
• Medicare Preventive Services. This provision requires Medicare to eliminate cost-sharing for Medicare-covered preventive services rated as A or B by the U.S. Preventive Services Task Force. It also waives the Medicare deductible for colorectal screening and authorizes coverage for an individualized prevention plan.
• Changes to Increased Medicare Premiums for Higher-Income Beneficiaries. Since 2007, Medicare beneficiaries with incomes above a certain level have been required to pay higher Part B premiums. The ACA froze the income level at which such premium surcharges apply at $85,000/year through 2019 and expanded the surcharge to also apply to Part D premiums.

• Medicare Extra Payments. For the years 2011 through 2015, Medicare will pay a 10 percent bonus for primary care services; it will also pay a 10 percent bonus to general surgeons practicing in areas with a shortage of health professionals.
• Medicare Advantage (MA) Payment Changes. Beginning in 2011, Medicare Advantage payments are restructured at an increasingly smaller percentage of original Medicare rates. Prior to the restructuring, MA payments were, on average, 13% higher than those for traditional Medicare. Also beginning in 2011, MA plans are prohibited from charging higher cost-sharing than original Medicare for skilled nursing facility care, chemotherapy and kidney dialysis.  In 2012, MA plans with four or five stars on a five star quality rating system are entitled to bonuses. The Centers for Medicare & Medicaid Services has expanded the bonus payment program to include plans with three stars. NOTE: This is good news for MA plans in Arizona!

• Medicare Independence at Home Demonstration. This provision creates a demonstration program to provide high-need Medicare beneficiaries with primary care services in their home.
• Medicare Value-Based Purchasing. Beginning October 1, 2012, Medicare will pay hospitals based on their performance on certain quality measures and will move toward making such payments applicable to skilled nursing facilities, home health agencies and ambulatory surgical centers.
• Reduced Medicare Payments for Hospital Readmissions. Beginning October 1, 2012, Medicare will reduce payments to hospitals for preventable readmissions within 30 days.
• Data Collection to Reduce Health Care Disparities. Effective March 23, 2012, the ACA requires the collection and reporting of certain data on race, ethnicity, sex, primary language, and disability status.

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