ORONO, Maine — Advocates of the recent national health care overhaul say older Americans have a lot to gain from its provisions. On Wednesday, federal officials were at the Dirigo Pines retirement community to talk it up.
U.S. Deputy Assistant on Aging Cindy Padilla and Dr. Bill Kassler, chief medical officer for the regional Centers for Medicare and Medicaid and Medicaid Services, spoke to about two dozen residents of the upscale residential facility about the benefits they can expect to see from the Affordable Care Act.
Padilla told her audience of seniors that the act builds on successful initiatives of the past, including the Older Americans Act of 1965, which established the federal Administration on Aging and led to the development a safety net of community-based services that helped people live safely in their homes as they aged.
She also referenced Medicare, Medicaid and the Social Security program as working precursors to the new law, which she said will improve the affordability and quality of health care for all Americans, including the elderly.
Under the provisions of the reform, nearly 1 million Americans age 65 and over have received $250 rebate checks to help them cope with the unpopular prescription coverage gap known as the “doughnut hole” in Medicare Part D, enacted during the first term of President George W. Bush. In Maine, nearly 5,000 seniors have received the nontaxable rebate checks. Next year, Padilla said, seniors will benefit from enhanced discounts in the prescription program and the doughnut hole will be closed altogether by 2020.
The new law also provides an annual physical exam, recommended vaccines and routine cancer screenings to Medicare enrollees at no charge.
“In many cases the difference between life and death is how soon you catch [a cancer diagnosis],” Padilla reminded the audience.
The health care law also includes health insurance regulations that benefit older Americans, including a prohibition on refusing coverage to people with pre-existing conditions and incentives for employers to continue covering retirees who are not old enough to qualify for Medicare. It provides funding to beef up operations at rural medical and dental clinics and encourages all Americans, including seniors, to establish a “medical home” — a clinic or other health care practice that maintains careful records and actively engages patients in their own care.
Kassler told the Dirigo Pines residents that the Medicare program already runs more efficiently than the private health care sector, with 95 cents of every dollar being spent directly on health care services instead of administrative costs. But the program has plenty of room to improve, he said, and is preparing to participate in a nationwide research project on the efficacy of the medical home model.
Participating health care practices will get paid more to provide enhanced services to patients with chronic conditions such as diabetes and heart disease, Kassler said, to evaluate whether more focused care improves the health of patients and drives down spending in the long term. Some states, including Maine, already are embarked on medical home demonstration projects, he said, and Medicare will be joining those studies.
Kassler also discussed the creation of “accountable care organizations” — integrated networks of physicians and hospitals that collaborate on improving patient care with the incentive of sharing the value of any savings. And he said the federal government is helping to fund the use of computerized medical records in physician offices and hospitals across the nation. There is better, more secure technology at work in local supermarkets and automatic teller machines than within the health care system, he said.
Dirigo Pines resident Chuck Wakefield, 83, was among those who listened intently to the presentation.
“I wanted to hear what they had to say about the new health law,” he said. “There’s been so much in the news. It’s a tough problem that has not been fully resolved, and it is being dealt with harshly due to the grind of politics.”
The retired electrical engineer lives with his wife in one of the independent-living cottages at Dirigo Pines. He still isn’t sure how the new health law, which he described as bureaucratic and complicated, will affect them. But he said he fears that whatever its advantages, many elements will be subject to change after the contentious political elections of Nov. 2.