The Impact of the Affordable Care Act on Montana Seniors

There’s a line I like from the movie, “Smokey and the Bandit” with Burt Reynolds and Sally Field. The two are having a discussion to see if they have anything in common. After several wrong answers to questions from each other, Burt leans down and says, “When you tell somebody something, it depends on what part of the United States you’re standing in as to how dumb you are.”

The comment speaks volumes when applied to our current political climate and the healthcare debate. Rather than compromising on the good points both parties bring to the table, each party rigidly stands their ground with an “all or nothing” position. If you’re not standing in Washington, DC you are pretty dumb according to many of our elected officials.

As proof I offer two commercials, one by the Democrats, and one by the Republicans. Each relates the effect the Affordable Care Act will have on seniors. However, in the end, “granny” still gets thrown off the cliff, in BOTH versions. Is it any wonder that those of us in the sunset of our lives are rather taken aback by this callous disrespect for America’s seniors? Instead, the prime concern of our elected officials seems to be, “crony party politics,” re-election at any cost, and who can produce the most quotable sound bite.

The Affordable Care Act has good, bad and ugly in store for seniors.

Let’s start with the CLASS (Community Living Assistance Services and Supports Act); this plan was to take deductions from employees to be used later if they became disabled or needed long-term care. After a 19 month study, the plan was eventually scrapped by Kathleen Sebelius, HHS Secretary after finding there was no way to pay for it, even with contributions from those that would eventually use it.

Upon retirement seniors have limited options. The employer healthcare no longer applies since you are no longer working for the company. If you are 65 or over at retirement you can go on Medicare. But what if you are downsized and unable to get work that pays at a similar rate before 65? You can get COBRA for a time but it’s very expensive. If you have a pre-existing condition things can get really pricy because the full blown pre-existing condition part of ACA doesn’t kick in until 2014. You can apply for high-risk insurance to cover you until then and premiums will depend on your income and your current health.

Ten thousand “baby boomers” are retiring every day. Medicare is expected to only be solvent until 2029. Unless it’s raided like social security to help pay for the ACA. What people forget is that the bulk of those baby boomers had kids. No Roe v. Wade in 1944-46.  So another wave of seniors is waiting in the wings. In 1966 Medicare was projected to cost $12 billion by now. It’s ten times that. No one could have foreseen MRI’s and CAT Scans. Not to mention pharmaceuticals.

Another double-edged sword is preventative care. Yearly physicals and several tests will be done at no charge to the senior. Great deal right. Catch things before they become serious medical issues. Remember that 10,000 retirements per day above? Taking that into account will it be easier or harder to get into your doctors office in the future? Will there be more blood tests and x-rays? How long will your blood test take to be evaluated? How long before someone can get to your x-ray?

The Medicare Advantage Program is being cut. This is that program that lets seniors on Medicare in rural areas (like Montana) go to their nearest physician and an insurance company processes the billing and submits it to Medicare. The government doesn’t like paying those processing fees from the insurance company so they are being eliminated. I doubt the insurance company is going to provide this service for free so your doctor might not be able to survive in a low population area since there is no reduction in malpractice insurance or operational costs. You and the doctor will take that hit.

Last but not least we have the Independent Payment Advisory Panel (IPAB). This is a group of 15 people appointed by the president. Their purpose (for public consumption) is to hold down Medicare costs. Former Vice President Dick Cheney (71) just received a new heart after 20 months on the waiting list. Many are of the opinion that the heart he received should have gone to someone younger. Today that decision was made between him, his doctor and the organ donor program. In the future would you like to have 15 people making that decision for someone you love?

Like it or not medicine is a business. Doctor’s, nurses, office staff, equipment is not cheap. If you are currently on Medicaid you know that fewer and fewer doctors are accepting Medicaid. Are they heartless, money hungry, scumbags? No, they simply can’t keep the doors open with the level of payments Medicaid provides. And Medicare, depending on costs could be right around the corner.