Lots of harm in repeal of health care plan
The Affordable Care Act, otherwise known as Obamacare, has such a vast array of benefits, many people are not even aware of. Why repeal and replace? Would people even know all that would be taken away?
I would like to focus on just one aspect, Medicare, as an example.
There is the obvious benefit which is closing the coverage gap — otherwise known as the doughnut hole — by 2020, this is advancing very successfully. Luckily, our state has the EPIC program but not everyone meets these requirements and many middle class people are left with expensive prescription costs.
This year after your total drug costs reach $3,700 for the year, you can depend on 60 percent savings on brand name drugs and 49 percent on generic. When the gap is completely phased out in 2020, one can typically pay no more than 25 percent at any point once you have met your deductible.
Also, the ACA has produced a shift in payment policy by reducing federal payments to Medicare insurer plans over time. If a senior elects a Medicare Advantage Plan, the government has given insurance companies 14 percent in 2010, in addition to the monthly amount deducted from a senior’s social security check; now, this percentage is being reduced over time, bringing the average costs of care closer to the traditional Medicare program. The ACA also provides for bonus payments to plans based on quality ratings and maintaining a medical loss ratio of at least 85 percent; these bonus payments, in turn, are to be used to provide additional benefits such as eyeglasses, or to reduce premiums.
I remember visiting Newt Gingrich at the Ellicott Square Building when he was going to run for president in 2012. I made my way to the very front near his podium. I asked him how he could guarantee safe and definite health for seniors without Medicare, he mentioned comparative pricing. I had let him know the ACA was doing that very thing and it had saved the Medicare program millions already.
Such comparative pricing came through the Center for Medicare and Medicaid Innovation, created through the ACA for the purpose of testing “innovative payment and service delivery models to reduce program expenditures … while preserving or enhancing the quality of care.”
And, most importantly, there are now many available preventive services with no out-of-pocket costs such as flu shots, screenings for cancer and an annual wellness visit so seniors can talk to their doctor about any health concerns.
With reform through the ACA of the insurance world, for people and the providers, under way and making progress, why decimate and rebuild. It is clearly spiteful and divisive!
With insurance companies being U.S. Rep. Tom Reed’s biggest donor, I ask, how will that regulatory provision be taken away and yet, the people keep such elements as no pre-existing clauses? I am fine with skipping that regulatory provision of no tax for those who do not choose insurance, how about lowering the yearly salary of the CIGNA CEO, for example, from 17.1 million to $170,000.
Natalie Luczkowiak is a Dunkirk resident.