It's Obamacare.

[ProSense]

1. Seniors benefit.

Long before this Supreme Court decision, through the Affordable Care Act, seniors began to see positive changes in their prescription drug costs, access to preventive health care, and more. Thanks to the Supreme Court’s decision the following provisions will continue to be provided to seniors:

Medicare Improvements

The ACA contains several important improvements to the Medicare program, many of which are already helping seniors today.

1) Closing the donut hole

a. Medicare Part D covers the cost of medications up to a certain point. Between that point, and a catastrophic coverage threshold, the older adult must pay out of pocket for medication (this gap in coverage is often called the Part D “donut hole”). One in four beneficiaries fall in this gap, and end up paying an average of $3,610 out of pocket on drug expenses.

b. The ACA requires drug manufacturers to reduce prices for Medicare enrollees in the donut hole. Beginning in 2011, brand‐name drug manufacturers must provide a 50% discount on brand‐name and biologic drugs for Part D enrollees in the donut hole. By 2013, Medicare will begin to provide an additional discount on brand‐name and biologic drugs for enrollees in the donut hole. By 2020, Part D enrollees will be responsible for only 25% of donut hole drug costs.

c. This is a benefit seniors are getting now, and will continue to get as a result of this decision.

2) Improving senior’s access to preventive medical services

a. Prior to the ACA, Medicare beneficiaries were required to pay a deductible and 20% copay for many preventive health services.

b. The ACA eliminated cost‐sharing for many preventive services and introduced an annual wellness visit for beneficiaries.

c. The ACA also eliminated cost‐sharing for screening services, like mammograms, Pap smears, bone mass measurements, depression screening, diabetes screening, HIV screening and obesity screenings.

d. This is a benefit seniors are getting now, and will continue to get as a result of this decision.

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Medicaid Long Term Services and Supports Improvements
Several provisions in the ACA will make it easier for seniors to get long‐term services and supports at home and in the community. Medicaid provides funding for long‐term care services in institutions, such as nursing homes and in the community. Seniors prefer to receive care in their homes, and it is generally less expensive, however, most states spend their Medicaid primarily on institutional care. The ACA includes incentives to encourage states to shift Medicaid spending from institutions to the community, so that individuals who require long‐term care services may receive care in least‐restrictive environment. These incentives are not directly impacted by the Court’s decision to limit the Medicaid expansion. Elements of the ACA that enhance home and community long‐term care include:

1) Community First Choice Option (CFCO) provides participating states with a six percentage point increase in federal Medicaid matching funds for providing community‐based attendant services and supports to individuals who would otherwise be confined to a nursing home or other institution.

2) Balancing Incentive Payment Program targets increased federal matching funds to states that spend less than half of their Medicaid long‐term care expenditures on community‐based care. This spring, six states received grants to improve their community‐based care.

3) Extending Medicaid’s spousal impoverishment protection provisions to spouses of individuals who seek long‐term care in the community. This rule goes into effect in 2014.

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http://www.ncpssm.org/Portals/0/pdf/aca-analysis.pdf