Medicare Blog

how does the new healthcare law under trump effect people on medicare

by Dr. Nicholaus Mohr Published 3 years ago Updated 2 years ago
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Did president Trump sign these Medicare changes into law?

 · Those making more than $500,000 a year ($750,000 for couples) will pay 85 percent of the actual costs of Part B and D in 2019, up from 80 percent this year. Most Medicare enrollees pay premiums ...

How much have Medicare premiums gone up under Trump?

 · President Trump signed an executive order October 3 aimed at strengthening Medicare, including Medicare Advantage, the private insurer alternative to traditional Medicare. Some advocacy groups ...

What is President Trump’s health care legislation?

 · Trump Administration Finalizes Policies to Give Medicare Beneficiaries More Choices around Surgery. Dec 02, 2020. Policy. Today, the Centers for Medicare & Medicaid …

Will president Trump’s Executive Order on health care reform accelerate Medicare premiums?

 · Trumpcare Explained. Trumpcare is another name for the American Health Care Act, which aimed to repeal some aspects of Obamacare (Affordable Care Act, or ACA). Learn …

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How has the Affordable Care Act affect Medicare?

Medicare Premiums and Prescription Drug Costs The ACA closed the Medicare Part D coverage gap, or “doughnut hole,” helping to reduce prescription drug spending. It also increased Part B and D premiums for higher-income beneficiaries. The Bipartisan Budget Act (BBA) of 2018 modified both of these policies.

How does the Affordable Care Act affect patients?

The ACA enabled people to gain coverage by 1) expanding the publicly funded Medicaid program to cover adults with annual incomes up to 138% of the federal poverty level; 2) establishing the Health Insurance Marketplace for individuals and small businesses, allowing them to purchase private health insurance (PHI); and 3 ...

How does the Affordable care Act impact the elderly?

"The ACA expanded access to affordable coverage for adults under 65, increasing coverage for all age groups, races and ethnicities, education levels, and incomes."Under the ACA, older adults' uninsured rate has dropped by a third, indicators of their health and wellness have improved, and they're now protected from ...

How will repealing Obamacare affect Medicare?

Dismantling the ACA could thus eliminate those savings and increase Medicare spending by approximately $350 billion over the ten years of 2016- 2025. This would accelerate the insolvency of the Medicare Trust Fund.

Why is the Affordable Care Act controversial?

The ACA has been highly controversial, despite the positive outcomes. Conservatives objected to the tax increases and higher insurance premiums needed to pay for Obamacare. Some people in the healthcare industry are critical of the additional workload and costs placed on medical providers.

How did the Affordable Care Act benefit individuals?

The Affordable Care Act will give all Americans, including LGBTQ+ Americans, improved access to health coverage through an expanded, stronger Medicaid program and new Affordable Insurance Exchanges, marketplaces for quality, affordable health insurance.

Does AARP support Affordable Care Act?

AARP was an active supporter of Obamacare throughout the 2009 to 2010 legislative session during which the law was debated and ultimately passed.

How does the US view older people?

Americans are less likely than most of the global public to view the growing number of older people as a major problem. They are more confident than Europeans that they will have an adequate standard of living in their old age.

What is one requirement of the Affordable Care Act?

Require individuals to have insurance, with some exceptions, such as financial hardship or religious belief. Require creation of state-based (or multi-state) insurance exchanges to help individuals and small businesses purchase insurance.

Can I stay on ObamaCare instead of Medicare?

A: The law allows you to keep your plan if you want, instead of signing up for Medicare, but there are good reasons why you shouldn't. If you bought a Marketplace plan, the chances are very high that you do not have employer-based health care coverage.

Is the Affordable Care Act the same as Medicare?

The ACA is a sweeping series of laws that regulate the US health insurance industry. Medicare is a federal health insurance program for people 65 and older, as well as certain younger people with disabilities or medical conditions. There are several different types of Medicare coverage.

What are the benefits of repealing the Affordable Care Act?

Many hospitals, family doctors, and other medical providers are already struggling financially because of COVID-19. Without the ACA, the financial pressures would increase, and many more rural and safety net hospitals that serve low- and middle-income families could be forced to close.

When will the coverage gap end?

The much-maligned coverage gap (or donut hole) in these plans has been shrinking for years under the Affordable Care Act, and was supposed to end in 2020, at which time consumers in the gap would pay no more than 25 percent of the costs of their drugs. That end date was moved up a year to 2019.

How much does Medicare pay for Part B and D?

Medicare’s high-income premium surcharges will carry even more of a bite for wealthier enrollees. Those making more than $500,000 a year ($750,000 for couples) will pay 85 percent of the actual costs of Part B and D in 2019, up from 80 percent this year. Most Medicare enrollees pay premiums that equal about 25 percent of these costs.

Does Medicare give discounts to drug companies?

Medicare prohibits such manufacturer discounts, and while pharmaceutical companies do provide hefty discounts to Part D insurers, they are not passed along to consumers.

Does Medicare cover long term care?

That includes allowing such plans to pay for limited long-term care expenses – something that until now has not been covered by Medicare.

How long have people been bumped against the cap?

People with persistent therapy needs have bumped against these caps for more than 20 years, and Congress has regularly eased those rules. While claims above current cap levels may be subject to review, people who legitimately need extensive therapy will not have to depend on year-to-year congressional fixes.

Will Medicare be repealed?

It’s a more significant if largely invisible change. Medicare’s caps on covered expenses for outpatient therapy have been officially repealed.

Who is Phil from Medicare?

Phil is the author of the new book, “Get What’s Yours for Medicare,” and co-author of “Get What’s Yours: The Revised Secrets to Maxing Out Your Social Security.”. Send your questions to Phil; and he will answer as many as he can. Seemingly overnight, big changes to Medicare morphed from being an item on various congressional wish lists ...

What is the executive order for Medicare?

Written by Shawn Radcliffe on October 10, 2019. Share on Pinterest. An executive order aimed at “strengthening” Medicare is mainly focused on providing older adults with more Medicare Advantage plans and options. Getty Images.

What are the benefits of Medicare Advantage?

Most Medicare Advantage enrollees already have access to benefits not covered by traditional Medicare, such as dental, fitness, and vision benefits, reports the Kaiser Family Foundation.

Can non-physician providers provide care?

Non-physician providers would still only be allowed to provide care that falls under their profession’s “scope of practice.”

Do PAs get paid by Medicare?

The American Academy of Nurse Practitioners and the American Academy of PAs were both supportive of the order’s proposal for fewer practice restrictions on these providers, reports MedPage Today. The order also recommends that providers be paid by Medicare based on the services provided rather than their occupation.

Does the executive order mean more face time?

The executive order would encourage more face time between patients and providers. However, this may not mean more time with a doctor.

How many Medicare beneficiaries have MSA?

Only about 5,600 Medicare beneficiaries had a MSA in 2019, according to the Kaiser Family Foundation. The order would also allow older adults who choose not to receive benefits under Medicare Part A (inpatient care in a hospital or other facility) to keep their Social Security retirement insurance benefits.

What does the Medicare order mean for older adults?

The order calls for older adults to have “more diverse and affordable plan choices ” — which largely means more Medicare Advantage plans.

What are the changes to Medicare?

Today, the Centers for Medicare & Medicaid Services (CMS) is finalizing policy changes that will give Medicare patients and their doctors greater choices to get care at a lower cost in an outpatient setting. The Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) final rules will increase value for Medicare beneficiaries and reflect the agency’s efforts to transform the healthcare delivery system through competition and innovation. These changes implement the Trump Administration’s Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors, and will take effect on January 1, 2021.

When will Medicare take effect in 2021?

These changes implement the Trump Administration’s Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors, and will take effect on January 1, 2021. “President Trump’s term in office has been marked by an unrelenting drive to level the playing field and boost competition at every turn,” said CMS Administrator Seema Verma.

When will Medicare stop paying for inpatient only?

In this final rule, CMS will begin eliminating the Inpatient Only (IPO) list of 1,700 procedures for which Medicare will only pay when performed in the hospital inpatient setting over a three-year transitional period , beginning with some 300 primarily musculoskeletal-related services. The IPO list will be completely phased out by CY 2024. This will make these procedures eligible to be paid by Medicare when furnished in the hospital outpatient setting when outpatient care is appropriate, as well as continuing to be payable when furnished in the hospital inpatient setting when inpatient care is appropriate, as determined by the physician. In the short term, as hospitals face surges in patients with complications from coronavirus disease 2019 (COVID-19), being able to provide treatment in outpatient settings will allow non-COVID-19 patients to get the care they need.

How many hospitals are required to report their inventory of therapeutics?

Finally, in order to address the ongoing public health emergency, CMS is finalizing a new requirement for the nation’s 6,200 hospitals and critical access hospitals to report information about their inventory of therapeutics to treat COVID-19. This reporting will provide the information needed to track and accurately allocate therapeutics to the hospitals that need additional inventory to care for patients and meet surge needs.

What is Trump's health care bill?

President Trump’s health care legislation has largely targeted the Affordable Care Act (ACA), which is also called Obamacare. President Trump campaigned on a platform to “repeal and replace” Obamacare, which referred to repealing the ACA and replacing it with a bill of his own.

What is Trumpcare and Obamacare?

When the subject of health care comes up, terms like “ Trumpcare ” and “ Obamacare ” often do too. These names refer to enacted or attempted health care legislation under President Donald Trump and President Barack Obama, respectively. Trumpcare is most often associated with the American Health Care Act (AHCA), ...

How much will Medicare increase with repeal of the ACA?

Trumpcare and Medicare. The Congressional Budget Office (CBO) estimated that a full repeal of the ACA would increase Medicare spending by $802 billion between 2016 and 2025. 1. The increased spending would center mostly around higher payments to health care providers and Medicare Advantage plans.

When was the Tax Cuts and Jobs Act passed?

The Tax Cuts and Jobs Act is the most notable of those efforts. This tax reform bill was passed by President Trump in late 2017. It included the elimination of the tax penalty required for those who did not maintain health insurance, otherwise known as the individual mandate that served as the foundation of Obamacare.

Why was the Health Care Freedom Act dubbed the skinny repeal?

The Health Care Freedom Act (HCFA) was dubbed the “skinny repeal” because it aimed to only eliminate the individual and employer mandates included in Obamacare , as opposed to a complete repeal of the ACA. The HCFA was rejected in the Senate after three Republican senators (along with all Senate Democrats) voted against it.

What was the Trump administration's attempt to reform?

Additional Trump Administration attempts for health care reform. After the AHCA failed to pass in the Senate, the Trump Administration proposed two additional health care reform bills.

What did Trumpcare do to prevent pre-existing conditions?

Remove protections for pre-existing conditions. The ACA prevented health insurers from charging higher premiums to people with pre-existing conditions. Trumpcare would have allowed states to obtain waivers for private insurance companies to charge people more for pre-existing conditions according to risk pools.

When will CMS change the star rating?

Additionally, CMS adopted a series of changes in the March 31, 2020, Interim Final Rule with Comment Period (CMS-1744-IFC) for the 2021 and 2022 Star Ratings to accommodate challenges arising from the COVID-19 public health emergency.

Does Medicare have telehealth?

The Centers for Medicare & Medicaid Services today finalized requirements that will increase access to telehealth for seniors in Medicare Advantage (MA) plans , expand the types of supplemental benefits available for beneficiaries with an MA plan who have chronic diseases, provide support for more MA options for beneficiaries in rural communities, and expand access to MA for patients with End Stage Renal Disease (ESRD). Together, the changes advance President Trump’s Executive Orders on Protecting and Improving Medicare for Our Nation’s Seniors and Advancing American Kidney Health as well as several of the CMS strategic initiatives.

Can ESRD be covered by Medicare?

Today’s rule gives beneficiaries with ESRD more coverage choices in the Medicare program. Previously, beneficiaries with ESRD were only allowed to enroll in MA plans in limited circumstances.

What would happen if the Trump administration changed Medicaid?

These changes would dramatically affect state budgets and could lead to significant cuts to benefits, coverage, and provider payments.

What is Trump's goal with Medicaid?

President Trump has made clear that his goal remains to repeal the Affordable Care Act (ACA), including its expansion of Medicaid to low-income adults, and to impose rigid caps on the federal government’s Medicaid spending. While Congress considered and rejected a series ...

How many people in Arkansas lost medicaid in 2018?

In Arkansas, over 18,000 Medicaid beneficiaries — almost 1 in 4 subject to the new rules — lost coverage in 2018 as a result.

When will DHS reject Medicaid?

Beginning February 24, 2020, DHS immigration officials will be able to reject immigration applicants if they have received, or are judged likely to receive in the future, any of an array of benefits, including Medicaid. Timing for the DoS implementation of the policy has not yet been announced.

How many children would lose Medicaid in 10 years?

After ten years, more than 300,000 children would lose comprehensive coverage ...

What would happen if the poverty line was lowered?

By lowering the poverty line, that proposal would ultimately cut billions of dollars from federal health programs and cause millions of people to lose their eligibility for, or receive less help from, these programs. Many programs, including Medicaid and CHIP, use the poverty line to determine eligibility and benefits, and the cuts to these programs — and the numbers of people losing assistance altogether or receiving less help — would increase with each passing year. After ten years, more than 300,000 children would lose comprehensive coverage through Medicaid and CHIP, as would more than 250,000 adults covered through the ACA Medicaid expansion. Some pregnant women, low-income parents in non-expansion states, and people receiving family planning services through Medicaid would also lose coverage.

What would happen if the federal government capped funding?

Moreover, capped federal funding would shift financial risk to states, with federal funding cuts most likely to occur when states can least absorb them — such as during recessions, public health emergencies, and other times when states face both high demand for coverage and strain on other parts of their budgets.

How much has Medicare gone up under Trump?

(That’s about 20% of Medicare beneficiaries, according to a Congressional Research Service report.) Part B premiums have gone up under Trump by 7.9%, from 2017 to 2020, the most recent figures available.

How much did Obama's Medicare premium increase?

The total dollar decrease in Trump’s term is $10.90 per month for the average premium.

How much did Obama's Part B premiums go up?

Under the comparable time frame for Obama, the Part B premiums went up by 3.6% for 2009 to 2012.

How many people will have 0 premiums in 2020?

Jeannie Fuglesten Biniek, a senior policy analyst for the program on Medicare policy at KFF, told us that works out to 9.3 million people in 2020 in MA plans with drug coverage that have $0 premiums. But among those who do pay a premium, the amounts are noticeably higher than the nationwide average for all plans.

How many parts does Medicare have?

Medicare, the federal health care program that primarily covers those age 65 and older, as well as younger people with disabilities and end-stage renal disease, is made up of four parts, with different costs or premiums for each:

How much is Medicare Advantage 2021?

The Medicare Advantage premium figures vary considerably by state and territory: For instance, the average monthly premium for 2021 is 77 cents in Puerto Rico but $81.79 in Minnesota, based on projected enrollment.

Which expense has gone up under both administrations?

But the larger expense that affects most enrollees is the Part B premium, which has gone up under both administrations. In fact, Part B premiums have gone up faster in Trump’s first three years than they did in Obama’s first three years.

When did Trump sign the executive order to protect Medicare?

Morse Performing Arts Center in The Villages, Florida, October 3, 2019. (Getty/Paul Hennessy)

How does Medicare protect patients from surprise medical bills?

The executive order also directs the HHS secretary to “identify and remove unnecessary barriers to private contracts.” Today, Medicare protects beneficiaries from surprise medical bills by limiting the amount that doctors who see Medicare beneficiaries can charge these patients. Physicians may opt out of the Medicare program and enter into private contracts that set higher prices than Medicare will pay; in these cases, the patient is responsible for the entire billed amount. However, less than 1 percent of doctors have chosen to opt out of the program, in large part because Medicare’s rules protect consumers from these arrangements.

Why would Medicare cream skimming benefit seniors?

Lower-cost, narrower network plans could profit by cream-skimming healthier seniors because healthy individuals benefit most from the trade-off between lower premiums and fewer providers. Enrollees in traditional Medicare, including seniors who need the broad provider access that only traditional Medicare offers, could see their premiums rise as a result of a sicker risk pool and imperfect risk adjustment.

How long do you have to opt out of Medicare?

In addition, if a physician opts out of the Medicare program, they must do so entirely instead of cherry-picking beneficiaries or services. The opt-out period is a minimum of two years. Together, these limits protect beneficiaries by providing greater certainty about their doctors’ status and avoiding confusion about which visits and services Medicare will reimburse.

What would seniors receive under the executive order?

Under so-called premium support plans, seniors would receive vouchers that they would use to purchase either a private Medicare plan or traditional Medicare. Past premium support proposals differ in how they set the amount of the voucher: Some plans set the voucher amount arbitrarily, while others put a thumb on the scale to encourage beneficiaries to choose a private plan.

Will Trump privatize Medicare?

President Trump has laid out a plan to privatize Medicare and undermine the program, breaking his promise that “ no one will lay a hand on your Medicare benefits .” Furthermore, he is trying to scare seniors away from supporting congressional proposals that would genuinely improve Medicare beneficiaries’ access to health care and financial security. Although seniors need better protection against out-of-pocket medical costs and better access to care providers, the changes Trump has proposed will only make things worse.

Is Medicare auto enrolling?

CMS’ existing Medicare Advantage auto-enrollment mechanism, though limited to a small subset of beneficiaries, caused enough problems that the agency suspended expansion of the process in 2016. In some instances, beneficiaries subject to “ seamless conversion ,” which allows insurance companies to auto-enroll their marketplace or Medicaid customers into Medicare Advantage, were unaware what type of Medicare coverage they had until they were assigned a new primary care doctor or they already had received out-of-network care. Even if a future Trump administration plan allowed people automatically enrolled in Medicare Advantage to opt back into traditional Medicare, the switch could cause seniors to miss enrollment deadlines for private Medigap plans. Unable to obtain supplemental benefits for traditional Medicare coverage, those people would effectively be stuck in Medicare Advantage.

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