Health Care Law Changing Behavoir

http://www.usatoday.com/news/washing...law/51663580/1

WASHINGTON – More than 2.65 million Medicare recipients have saved more than $1.5 billion on their prescriptions this year, a $569-per-person average, while premiums have remained stable, the government plans to announce today.
Medicare patients are saving $569 per person, on average, on prescription drugs under the new health care law.

That's because of the provision of the health care law that put a 50% discount on prescription drugs in the "doughnut hole," the gap between traditional and catastrophic coverage in the drug benefit, also known as Part D.
And, as of the end of November, more than 24 million people, or about half of those with traditional Medicare, have gone in for a free annual physical or other screening exam since the rules changed this year because of the health care law.

"We're very pleased with the numbers," Jonathan Blum, director of the Center for Medicare, told USA TODAY. "We found the Part D premiums have also stayed constant, despite predictions that they would go up in 2012."
The Department of Health and Human Services announced in August that 2012 Medicare prescription drug plan premiums would average about $30 a month, compared to $30.76 in 2011.
Starting this year, seniors who reach the doughnut hole in prescription benefits receive a 50% discount on name brand prescription drugs. Drug companies must provide the discount to participate in the prescription plan. Before the health care law took effect, Medicare patients had to pay full price for their prescriptions once they reached the gap in coverage.
The prescription data are through the end of October.
Seniors are becoming more engaged in their care, Blum said, citing the hundreds of forums Medicare has conducted about the changes. "The sentiment is that Medicare is trying to keep them healthy and out of the hospital," Blum said.

more by clicking on link.

http://www.latimes.com/news/opinion/...,6794828.story
OP-ED
'Obamacare' to the rescue
A woman who felt President Obama had let the middle class down has changed her mind.
By Spike Dolomite Ward
December 6, 2011
I want to apologize to President Obama. But first, some background.

I found out three weeks ago I have cancer. I'm 49 years old, have been married for almost 20 years and have two kids. My husband has his own small computer business, and I run a small nonprofit in the San Fernando Valley. I am also an artist. Money is tight, and we don't spend it frivolously. We're just ordinary, middle-class people, making an honest living, raising great kids and participating in our community, the kids' schools and church.

We're good people, and we work hard. But we haven't been able to afford health insurance for more than two years. And now I have third-stage breast cancer and am facing months of expensive treatment.

To understand how such a thing could happen to a family like ours, I need to take you back nine years to when my husband got laid off from the entertainment company where he'd worked for 10 years. Until then, we had been insured through his work, with a first-rate plan. After he got laid off, we got to keep that health insurance for 18 months through COBRA, by paying $1,300 a month, which was a huge burden on an unemployed father and his family.

By the time the COBRA ran out, my husband had decided to go into business for himself, so we had to purchase our own insurance. That was fine for a while. Every year his business grew. But insurance premiums were steadily rising too. More than once, we switched carriers for a lower rate, only to have them raise rates significantly after a few months.

With the recession, both of our businesses took a huge hit — my husband's income was cut in half, and the foundations that had supported my small nonprofit were going through their own tough times. We had to start using a home equity line of credit to pay for our health insurance premiums (which by that point cost as much as our monthly mortgage). When the bank capped our home equity line, we were forced to cash in my husband's IRA. The time finally came when we had to make a choice between paying our mortgage or paying for health insurance. We chose to keep our house. We made a nerve-racking gamble, and we lost.

Not having insurance amplifies cancer stress. After the diagnosis, instead of focusing all of my energy on getting well, I was panicked about how we were going to pay for everything. I felt guilty and embarrassed about not being insured. When I went to the diagnostic center to pick up my first reports, I was sent to the financial department, where a woman sat me down to talk about resources for "cash patients" (a polite way of saying "uninsured").

"I'm not a deadbeat," I blurted out. "I'm a good person. I have two kids and a house!" The clerk was sympathetic, telling me how even though she worked in the healthcare field, she could barely afford insurance herself.

Although there have been a few people who judged us harshly, most people have been understanding about how this could happen to us. That's given me the courage to "out" myself and my family in hopes that it will educate people who are still lucky enough to have health insurance and view people like my family as irresponsible. We're not. What I want people to understand is that, if this could happen to us, it could happen to anybody.

If you are fortunate enough to still be employed and have insurance through your employers, you may feel insulated from the sufferings of people like me right now. But things can change abruptly. If you still have a good job with insurance, that doesn't mean that you're better than me, more deserving than me or smarter than me. It just means that you are luckier. And access to healthcare shouldn't depend on luck.

Fortunately for me, I've been saved by the federal government's Pre-existing Condition Insurance Plan, something I had never heard of before needing it. It's part of President Obama's healthcare plan, one of the things that has already kicked in, and it guarantees access to insurance for U.S. citizens with preexisting conditions who have been uninsured for at least six months. The application was short, the premiums are affordable, and I have found the people who work in the administration office to be quite compassionate (nothing like the people I have dealt with over the years at other insurance companies.) It's not perfect, of course, and it still leaves many people in need out in the cold. But it's a start, and for me it's been a lifesaver — perhaps literally.


To read whole article click on link at top of page

What follows is just a quick diary to share a “positive” story about Obamacare.

We have heard more false rhetoric on this policy than just about any law I can remember in a long time. USAToday.com reviewed hard empirical data to determine the success of certain aspects of the plan thus far.

I’ve cut up their article to give you the straight dope to hopefully help you find something useful when you’re battle another misinformed con:

1. More than 2.65 million Medicare doughnut hole seniors have saved more than $1.5 billion on their prescriptions this year.

2. Their premiums have NOT gone up!!

3. Seniors have saved and average of $569-per-person since the policy went into effect.

4. The savings came from Obama’s 50% discount for drugs bought during the doughnut hole period.

5. The current premium for the Medicare Prescription Drug Plan is $30.76. It will go down to $30.00 in August 2012.

6. Seniors are becoming more engaged in their health plans because of thousands of forums by Medicare.

7. As of this past November, 24 million Americans have gone in for free screenings and preventative check-ups.

8. Even Robert Moffitt, Sr. Fellow at Heritage believes all of these early interventions “could” bring down the cost of healthcare.

So folks, it’s pretty obvious from this report that the much maligned Obamacare really is working. I’m sure that of the 24 million people who have already taken advantage of the free check-ups and screenings, it probably has already saved countless lives.

And, the fact that the average doughnut-hole senior saved nearly $600.00 dollars last year, while getting the prescription drugs they needed is really a big deal. I’m sure you’ll never see this story on cable news so I thought I’d share.
Have a spectacular day!!

http://www.kaiserhealthnews.org/daily-report.aspx

USA Today: $1.5 Billion In Medicare Prescription Drug Savings
USA Today notes that the government is expected to announce today that the health law's Medicare doughnut hole provision triggered this savings. In other Medicare news, the federal government announced Monday that Medicare will allow its claims database to be used by employers, insurance companies and consumer groups.

USA Today: Health Care Law Changing Behavior
More than 2.65 million Medicare recipients have saved more than $1.5 billion on their prescriptions this year, a $569-per-person average, while premiums have remained stable, the government plans to announce today. That's because of the provision of the health care law that put a 50% discount on prescription drugs in the "doughnut hole," the gap between traditional and catastrophic coverage in the drug benefit, also known as Part D (Kennedy, 12/6).

The Associated Press: Feds To Allow Use Of Medicare Data To Rate Doctors
The government announced Monday that Medicare will finally allow its extensive claims database to be used by employers, insurance companies and consumer groups to produce report cards on local doctors — and improve current ratings of hospitals. By analyzing masses of billing records, experts can glean such critical information as how often a doctor has performed a particular procedure and get a general sense of problems such as preventable complications (Alonso-Zaldivar, 12/5).

Also in the news, Bloomberg offered this report about the hospice market -

Bloomberg: U.S. Hospice Care Revealed As $14 Billion Market
Janet Stubbs was grateful when the nursing home recommended hospice care for her aunt Midge. ... Stubbs didn't know that her aunt, Doris Midge Appling, was admitted to Hospice Care of Kansas during the company's "Summer Sizzle" promotion drive, which paid employees as much as $100 a head for referrals, according to the U.S. Department of Justice. ... Hospice care, once chiefly a charitable cause, has become a growth industry, with $14 billion in revenues, 1,800 for-profit providers and a base of Medicare-covered patients that doubled to 1.1 million from 2000 to 2009 (Waldman, 12/6).

http://assets.aarp.org/www.aarp.org_...let_6-8-10.pdf
Congress enacted a new health care law which brings a number of benefits to all Americans, including people over 50. Some of these changes you will see this year. Others phase in over the next several years.

I would have thought that Republican bloggers would have loved this saving of money. Must be embarrassed or something. lol

Is this really true? Obamacare "caps" the profit of an insurance company by allowing only 20 cents to the dollar to run operations, pay taxes, and make some money for their shareholders?

Rolling Back ObamaCare: Eliminate the Medical Loss Ratio

The health care legislation requires health insurers offering individual and small group policies to meet an 80 percent medical loss ratio (MLR), meaning they must spend 80 cents of every premium dollar on claims, with the remaining 20 cents going to administrative costs. Large group policies have to meet an 85 percent loss ratio. The MLR is nothing but a price control mechanism that will drive even more of the smaller and medium-sized insurers out of the market, dramatically reducing competition, says Merrill Matthews, resident scholar with the Institute for Policy Innovation.

One of the key questions that has to be answered -- and one that has created immense confusion -- is what would be considered administrative costs? State insurance commissioners debated this and other issues for months and submitted their recommendations to the Department of Health and Human Services (HHS), which accepted many of them, say Matthews.

- Agent commissions, for example, will be lumped into the administrative cost category, which will make it hard to sell individual policies.
- Claims costs in the individual market usually run between 60 percent and 75 percent of total premium, falling afoul of the 80 percent MLR.
- But that's not necessarily a result of inefficiency or profiteering; commissions have to be higher in the individual market to compensate agents for selling a policy to only one family at a time.
- Another problem is that insurers cannot combine several different products, including across state lines, to come up with one MLR for the company.
- Costs will be assessed state by state.

http://www.ncpa.org/sub/dpd/index.php?Article_ID=20258

Wow - I suppose liberals like that - the government telling private business how much money they can make. One small step for socialism. Welcome to the new America lol.

http://www.usatoday.com/news/washing...law/51663580/1

WASHINGTON – More than 2.65 million Medicare recipients have saved more than $1.5 billion on their prescriptions this year, a $569-per-person average, while premiums have remained stable, the government plans to announce today.
Medicare patients are saving $569 per person, on average, on prescription drugs under the new health care law.

That's because of the provision of the health care law that put a 50% discount on prescription drugs in the "doughnut hole," the gap between traditional and catastrophic coverage in the drug benefit, also known as Part D.
And, as of the end of November, more than 24 million people, or about half of those with traditional Medicare, have gone in for a free annual physical or other screening exam since the rules changed this year because of the health care law.

"We're very pleased with the numbers," Jonathan Blum, director of the Center for Medicare, told USA TODAY. "We found the Part D premiums have also stayed constant, despite predictions that they would go up in 2012."
The Department of Health and Human Services announced in August that 2012 Medicare prescription drug plan premiums would average about $30 a month, compared to $30.76 in 2011.
Starting this year, seniors who reach the doughnut hole in prescription benefits receive a 50% discount on name brand prescription drugs. Drug companies must provide the discount to participate in the prescription plan. Before the health care law took effect, Medicare patients had to pay full price for their prescriptions once they reached the gap in coverage.
The prescription data are through the end of October.
Seniors are becoming more engaged in their care, Blum said, citing the hundreds of forums Medicare has conducted about the changes. "The sentiment is that Medicare is trying to keep them healthy and out of the hospital," Blum said.

Wow - I suppose liberals like that - the government telling private business how much money they can make. One small step for socialism. Welcome to the new America lol.

http://www.kaiserhealthnews.org/daily-report.aspx

USA Today: $1.5 Billion In Medicare Prescription Drug Savings
USA Today notes that the government is expected to announce today that the health law's Medicare doughnut hole provision triggered this savings. In other Medicare news, the federal government announced Monday that Medicare will allow its claims database to be used by employers, insurance companies and consumer groups.

USA Today: Health Care Law Changing Behavior
More than 2.65 million Medicare recipients have saved more than $1.5 billion on their prescriptions this year, a $569-per-person average, while premiums have remained stable, the government plans to announce today. That's because of the provision of the health care law that put a 50% discount on prescription drugs in the "doughnut hole," the gap between traditional and catastrophic coverage in the drug benefit, also known as Part D (Kennedy, 12/6).

The Associated Press: Feds To Allow Use Of Medicare Data To Rate Doctors
The government announced Monday that Medicare will finally allow its extensive claims database to be used by employers, insurance companies and consumer groups to produce report cards on local doctors — and improve current ratings of hospitals. By analyzing masses of billing records, experts can glean such critical information as how often a doctor has performed a particular procedure and get a general sense of problems such as preventable complications (Alonso-Zaldivar, 12/5).

Also in the news, Bloomberg offered this report about the hospice market -

Bloomberg: U.S. Hospice Care Revealed As $14 Billion Market
Janet Stubbs was grateful when the nursing home recommended hospice care for her aunt Midge. ... Stubbs didn't know that her aunt, Doris Midge Appling, was admitted to Hospice Care of Kansas during the company's "Summer Sizzle" promotion drive, which paid employees as much as $100 a head for referrals, according to the U.S. Department of Justice. ... Hospice care, once chiefly a charitable cause, has become a growth industry, with $14 billion in revenues, 1,800 for-profit providers and a base of Medicare-covered patients that doubled to 1.1 million from 2000 to 2009 (Waldman, 12/6).

Wow - I suppose liberals like that - the government telling private business how much money they can make. One small step for socialism. Welcome to the new America lol.

Now it is not a duplicate.

http://seniorjournal.com/NEWS/Medica...lthCareLaw.htm

Medicare News
New Health Care Law Creating Big Savings for Senior Citizens: CMS Data
Through July about 1.3 million with Medicare save on donut hole drug discounts; 18.9 million get free preventive care - links to info to help you save

Sept. 8, 2011 – More senior citizens and people with disabilities on Medicare are seeing a big drop in important health care costs because of provisions in the Affordable Care Act, according news today from the Centers for Medicare & Medicaid Services.

The savings are due to discounts on brand-name drugs in Medicare Part D changes to “donut hole” coverage and the new free preventive care added by the health care bill.

"Today's news confirms that the Affordable Care Act is saving money for millions of seniors and people with disabilities who are enrolled in Medicare," said CMS Administrator Donald M. Berwick, M.D.



"These new benefits are encouraging patients to talk to their doctors about their care, and to get the preventive services they need.”

So far this year, over 18.9 million people enrolled in traditional Medicare have used preventive services with no cost to them. Many of these services will help prevent chronic diseases that can cost Medicare billions to treat.

Also, thanks to the Affordable Care Act, more Americans on Medicare are getting help affording prescription drugs -- nearly 1.3 million people have received a 50 percent discount on their brand name prescription drugs when they hit the donut hole, saving a total of $660 million so far this year.

For people who hit the coverage gap (known as the “donut hole”):

● 1.28 million have received discounts on brand-name drugs this year through the end of July, up from 899,000 through the end of June and 478,000 through the end of May;

● These discounts have totaled $660 million in savings for seniors and people with disabilities so far this year; up from $462 million through June and $260 million through May;

● Individuals who have received this discount saved an average of $517 so far this year.

In addition, today CMS announced that more seniors are taking advantage of preventive services, most of which are available at no cost to them:

● 18,907,851 people with Original Medicare, or 55.6 percent of those enrolled in the program, received one or more free preventive services this year, through the end of August.

● During the same time period, 1,295,373 Americans with Original Medicare have taken advantage of the new Annual Wellness Visit, up from 1.06 million through the end of July and 780,000 through mid-June.

Donut Hole Benefits for Next 10 Years
What additional discounts and savings will I have over time in the coverage gap?
Over the next 10 years, you pay less in the coverage gap until it’s closed by 2020. By 2020, you will pay only 25% for covered brand-name and generic drugs during the gap, the same percentage you pay from the time you meet the deductible (if your plan has one) until you reach the out-of-pocket spending limit (up to $4,550 in 2011).
Year
You Will Pay This Percentage for Brand-name Drugs in the Coverage Gap
You Will Pay This Percentage for Generic Drugs in the Coverage Gap
2011
50%
93%
2012
50%

86%

2013
47.5%

79%

2014
47.5%

72%

2015
45%

65%

2016
45%

58%

2017
40%

51%

2018
35%

44%

2019
30%

37%

2020
25%

25%

More information in “Closing the Coverage Gap— Medicare Prescription Drugs Are Becoming More Affordable”
Under the Affordable Care Act, people with Original Medicare can receive recommended preventive benefits and a new Annual Wellness Visit without paying a co-payment or any cost-sharing.

2.5 Million Young Adults Gain Health Care Insurance
The number of young adults lacking medical coverage has shrunk by 2.5 million since the new health care overhaul law took effect, the AP reports.

However, for those who are little older, ages 26-35, the uninsured rate went up during the same period.

Jonathan Cohn: "Why would adults younger than 26 be so much more fortunate than those who are older? The only possible explanation, according to administration officials and most health care experts I know, is the Affordable Care Act. One of the first provisions to take effect is a requirement that insurers offering family coverage include dependents up through the age of 25."