If there's one nearly-universal truth about Obamacare -- the
Affordable Care Act (ACA) -- it's that misinformation about it abounds,
and most people don't actually understand what it is doing for them at
all. Let's take a bit of time today to specifically dispel some
tenacious myths about how the ACA is going to affect elderly Medicare
recipients.
Myth: Medicare Recipients Must Now Buy Additional Insurance
There is a lot of language in the ACA and the talk about the ACA is how many people are going to have to buy new insurance. But if you're receiving Medicare already, you're covered. Medicare (and Medicare Advantage plans) already qualify for all of the ACA's new rules, so there's no need for you to do anything except reap the benefits of the new law.
Myth: Medicare Recipients Will Have to Change Doctors
This is best described as 'possibly partially true in a way,' actually. The deal is this: Medicare payouts to insurance companies with Medicare Part C clients are going down, so insurance companies are trying to find a way to absorb that decrease in income. One of the ways they may choose to do that is to shrink their networks -- which may mean that some recipients will find out that their doctor has recently been removed from their insurance company's network. This will mean that they have to change doctors. This isn't because of anything the ACA does legally, but is a possible indirect result of changes the ACA are making to the payout structure.
Myth: Medicare Premiums are Going Up Due to the ACA
Make no mistake: Medicare premiums are going up. But it's not because of the ACA. They go up every year, according to the same algorithm. The net effect of the ACA on those premiums is that they're going up more slowly than they would have otherwise -- so the ACA is actually of direct benefit to anyone that has to pay Medicare premiums.
Myth: Quality of Care is Going to Go Down under the ACA
Not at all -- in fact, the exact opposite is happening. Remember when we said just a moment ago that Medicare payouts to insurance companies are going down? Well, they're not going down as much for insurance companies that offer superior coverage. In other words, insurance companies actually have a financial incentive to give you better care than the basic Medicare standards (for the first time.) So quality of care is headed up, not down.
Myth: The ACA is taking $716 million out of Medicare
A complete misunderstanding -- the $716 million figure is the amount that the Congressional Budget Office calculated that Medicare spending would go down. Mostly because of the twice-aforementioned payout drops... which means the $716 million is not going into the pockets of insurance companies, which is actually effectively putting that money back into Medicare. Fortu
Myth: Insurance Companies Are Going to Cut Medicare Advantage Plans
While it might seem like losing $716 in income is a very good reason for a private insurance company to stop offering Medicare Advantage plans altogether, that's not the end result of all of these changes -- it's just one number in a larger calculation. The actual end result for insurance companies given all of the changes Obamacare is making is that Medicare Advantage profitability-per-person is down about 10% -- but Medicare Advantage enrollment is up by about 33%, making the program as a whole more profitable for the insurance companies, not less.
Myth: Medicare Recipients Must Now Buy Additional Insurance
There is a lot of language in the ACA and the talk about the ACA is how many people are going to have to buy new insurance. But if you're receiving Medicare already, you're covered. Medicare (and Medicare Advantage plans) already qualify for all of the ACA's new rules, so there's no need for you to do anything except reap the benefits of the new law.
Myth: Medicare Recipients Will Have to Change Doctors
This is best described as 'possibly partially true in a way,' actually. The deal is this: Medicare payouts to insurance companies with Medicare Part C clients are going down, so insurance companies are trying to find a way to absorb that decrease in income. One of the ways they may choose to do that is to shrink their networks -- which may mean that some recipients will find out that their doctor has recently been removed from their insurance company's network. This will mean that they have to change doctors. This isn't because of anything the ACA does legally, but is a possible indirect result of changes the ACA are making to the payout structure.
Myth: Medicare Premiums are Going Up Due to the ACA
Make no mistake: Medicare premiums are going up. But it's not because of the ACA. They go up every year, according to the same algorithm. The net effect of the ACA on those premiums is that they're going up more slowly than they would have otherwise -- so the ACA is actually of direct benefit to anyone that has to pay Medicare premiums.
Myth: Quality of Care is Going to Go Down under the ACA
Not at all -- in fact, the exact opposite is happening. Remember when we said just a moment ago that Medicare payouts to insurance companies are going down? Well, they're not going down as much for insurance companies that offer superior coverage. In other words, insurance companies actually have a financial incentive to give you better care than the basic Medicare standards (for the first time.) So quality of care is headed up, not down.
Myth: The ACA is taking $716 million out of Medicare
A complete misunderstanding -- the $716 million figure is the amount that the Congressional Budget Office calculated that Medicare spending would go down. Mostly because of the twice-aforementioned payout drops... which means the $716 million is not going into the pockets of insurance companies, which is actually effectively putting that money back into Medicare. Fortu
Myth: Insurance Companies Are Going to Cut Medicare Advantage Plans
While it might seem like losing $716 in income is a very good reason for a private insurance company to stop offering Medicare Advantage plans altogether, that's not the end result of all of these changes -- it's just one number in a larger calculation. The actual end result for insurance companies given all of the changes Obamacare is making is that Medicare Advantage profitability-per-person is down about 10% -- but Medicare Advantage enrollment is up by about 33%, making the program as a whole more profitable for the insurance companies, not less.
Peter Mangiola, RN MSN has been in the health and wellness
industry for over three decades. He has served in Emergency, Recovery,
Cardiac Care, and Electrophysiology departments, as well as three years
as an Oncology Director, three years as director of an adult cystic
fibrosis program, eight years as Charge Nurse for a cardiovascular
nursing unit, and several years as owner/operator of two well known New
Jersey Senior Care agencies. Peter has been a regular speaker for many
groups and organizations over the years covering a wide range of topics.
He has also been a consultant, speaker, and educator in areas such as
Dementia, Alzheimer's, cognitive/behavioral issues, disabled children
& adults and obesity counseling. Learn more at http://www.petermangiola.com
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