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Health Care Law Saves People With Medicare Over $3.5 Billion on Prescription Drugs

Contact: CMS Office of Public Affairs


Under the new health care law – the Affordable Care Act —   seniors and people with disabilities in Medicare have saved a total of $3.5 billion on prescription drugs in the Medicare drug benefit coverage gap or “donut hole” from the enactment of the law in March 2010 through April of 2012.  The Centers for Medicare & Medicaid Services (CMS) released data today showing that, in the first four months of 2012 alone, more than 416,000 people saved an average of $724 on the prescription drugs they purchased after they hit the prescription drug coverage gap or “donut hole,” for a total of $301.5 million in savings.  These savings build on the law’s success in 2010 and 2011, when more than 5.1 million people with Medicare saved over $3.2 billion on prescription drugs.

In addition, CMS announced that this year, from January through April, 12.1 million people in traditional Medicare received at least one preventive service at no cost to them – including over 856,000 who have taken advantage of the Annual Wellness Visit provided in the Affordable Care Act.  In 2011, over 26 million people in traditional Medicare received one or more preventive benefits free of charge.

“Thanks to the health care law, millions of people with Medicare have paid less for health care and prescription drugs,” said CMS Acting Administrator Marilyn Tavenner.  “The law is helping people with Medicare lower their medical costs, and giving them more resources to stay healthy.”

People with Medicare who hit the coverage gap “donut hole” in 2010 received a one-time $250 rebate.  In 2011, people with Medicare began receiving a 50 percent discount on covered brand name drugs and 7 percent coverage of generic drugs in the “donut hole.”  This year, Medicare coverage for generic drugs in the coverage gap has risen to 14 percent.  Coverage for both brand name and generic drugs in the gap will continue to increase over time until 2020, when the coverage gap will no longer exist.

For more information on how the Affordable Care Act closes the Medicare drug benefit coverage gap “donut hole,” please visit: http://www.healthcare.gov/law/features/65-older/drug-discounts/index.html.

Prior to 2011, people with Medicare faced cost-sharing for many preventive benefits like cancer screenings and smoking cessation counseling.  Now, many of these benefits are offered free of charge to beneficiaries, with no deductible or co-pay, so that cost is no longer a barrier for seniors who want to find and treat problems early.

For more information on Medicare-covered preventive services, many of which are now provided without charge to beneficiaries thanks to the Affordable Care Act, please visit: http://www.healthcare.gov/law/features/65-older/medicare-preventive-services/index.html.

To learn what screenings, vaccinations and other preventive services doctors recommend for you and those you care about, please visit the myhealthfinder tool at www.healthfinder.gov.

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Things that make you go hmmmmmmm…

From the LA Times:

The lead plaintiff challenging the Affordable Car Act says she should not be forced to buy health insurance. She apparently doesn’t need health insurance because she doesn’t have any intention of paying for health care to begin with. Why pay for something you can get for free? Turns out, as part of a bankruptcy she filed along with her husband, she managed to avoid paying $4,500 in medical bills last fall, including $2,140 to Bay Medical Center in Panama City.

“This is a very common problem. We cover $30 million in charity and uncompensated care every year,” said Christa Hild, a spokeswoman for the hospital center. “If it’s a bad debt, we have to absorb it.”

So she bankrupts the medical bills, causing the hospital to absorb the bad debt, which the hospital most likely passes on to us in the form of higher prices. No wonder she doesn’t want anyone to make her pay for health insurance.

Who loses if the Affordable Care Act is Struck Down?

Soon, the Supreme Court will decide the fate of the Affordable Care Act. But it’s important to remember that there are millions of individuals who have already benefited from its enactment.  Old and young people, people we work with, people we worship with and people in our circle of friends who now have affordable healthcare could see it suddenly taken away.

There are roughly 2.5 million young adults around the nation under the age of 26 that can stay on their parent’s health insurance plans thanks to the ACA. This allows them to have health insurance even if they are not being offered plans at work.  These young people will lose their coverage if the ACA is struck down.

Millions of older Americans who were unable to afford their prescription drugs once they entered the Medicare donut hole received millions of dollars back to reimburse them for medications.  Thanks to the ACA, they get medications at a lower cost.  Medicare patients also receive preventive care screenings for free.  These older people will lose their coverage if the ACA is struck down.

South Carolina children are protected through the continued funding of the Children’s Health Insurance Program.  This expanded Medicaid program will cover over 70,000 of our state’s children starting in July of 2012.  It also guarantees that no child can be turned down for health insurance coverage due to a pre-existing condition. These young people will lose their coverage if the ACA is struck down.

Small businesses owners receive a tax credit when they make health insurance coverage available for their employees. Hundreds of thousands of businesses have been able to take advantage of this help.  These people we work with will lose their coverage if the ACA is struck down.

Tens of thousands of Americans who were previously uninsured because of medical conditions now have affordable health insurance through the Pre-Existing Conditions Insurance Plans administrated by the states or federal government.  These people in our circle of friends who have finally secured affordable insurance coverage could lose it and go back to the status of uninsured if the ACA is repealed.

Finally, thousands of very ill patients who previously lost their insurance because they reached the lifetime cap get coverage under the ACA. But they will once again find themselves uninsured and facing either financial ruin or death. These people we worship with will lose their coverage if the ACA is struck down.

Who loses if the ACA is struck down?  All of us.  This includes those who are now fortunate enough to feel the benefits, and those of us who would have benefited through affordable coverage and knowing our healthcare needs will be met.

While we wait for the court to decide, we must take inventory of what we have and what we will lose if the ACA is struck down.  This is our chance to ensure affordable, quality healthcare for all. We cannot go backwards!


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