Editor’s note: This is the first of a three-part series on the Affordable Care Act, the government’s attempt to provide healthcare for every U.S. citizen. Today’s focus is on senior citizens. Thursday will include the uninsured. Saturday’s will feature small businesses.
Sheldon Weisgrau’s sole purpose these days is to inform Kansans about the Affordable Care Act, also known as Obamacare. FOR THOSE enrolled in Medicare, seniors are in no danger of having to leave it, Weisgrau said.
Weisgrau will be in Iola next week to help explain the benefits of the new Act, and who will benefit most from signing on.
“I’ll also work to dispel a few myths,” Weisgrau said from his Topeka office in a phone interview Monday afternoon.
Top of the list is the rumor that Obamacare will wipe out Medicare, the health insurance program for senior citizens, or at the least negatively affect its services.
“None of that is true,” Weisgrau said. “If anything, some seniors may see expanded benefits and reduced out-of-pocket costs because of lower co-pays,” he said. Weisgrau also debunked the rumor of pre-assigned care.
“Nothing says you can’t choose your own doctor,” he said.
Other advantages for senior citizens is that the much maligned “doughnut hole” for the prescription drug program will be closed.
Up until 2012, when the first parts of Obamacare were instituted, Medicare D covered the initial $2,970 of prescription drug charges. Patients then were forced to pay for their drugs out of pocket until their prescription costs soared to= $4,750, at which point insurance coverage began again.
In 2012, patients started receiving a 50 percent discount on prescription drugs and a 14 percent discount for generic drugs covered by the Medicare D program. The discounts are on track to get deeper under Obamacare until the year 2020 when the coverage gap will be completely eliminated.
Seniors also will enjoy free preventive care and wellness programs under Obamacare including cancer screenings, wellness visits, flu shots, vaccines and more.
These kinds of visits work to reduce the overall spending on health care. Many chronic conditions, including diabetes, obesity, heart disease, lung disease and high blood pressure, can be better controlled, if not prevented, with routine visits to a doctor.
Before the Affordable Care Act was implemented, those enrolled in Medicare had to pay for cancer screenings, cholesterol checks and other screenings out of their own pockets.
Obamacare does not cut any benefits for seniors enrolled in Medicare Advantage, a program run by private insurance companies that includes extra benefits.
“The Marketplace, a venue for new insurance programs, has nothing to do with Medicare,” he said. Traditional Medicare and Medicare Advantage will continue to offer the same benefits and security.
A pernicious rumor Weisgrau is eager to debunk is that under Obamacare, physicians will plot to end an elderly person’s life as a cost savings.
Opponents to universal care have twisted end-of-life consultations between a physician and patient into “death panels,” Weisgrau said.
Truth is, all physicians consult their severely ill patients about their end-of-life care. Under the ACA, the thought was to help physicians coordinate supportive advice and programs for patients and their families when that time nears.
Because of the negative connotation, the programs have since been scrapped.
“Twenty-five percent of seniors still believe ‘death panels’ exist,” Weisgrau said. “My goal is to reassure people the world is not ending under Obamacare.”
Weisgrau is working on behalf of six statewide health organizations to inform residents and private businesses and organizations about the Affordable Care Act.
He has a background of working in health care in rural and undeserved communities, such as those in Allen County.
In a “previous life,” he worked to devise the designation of Critical Care Access for hospitals such as Allen County’s. The designation enables hospitals to qualify for higher reimbursements from the federal government.
Weisgrau recognizes the reticence by the public to embrace Obamacare.
“Change is always threatening and hard,” he said. “I take the long view. I know it will be difficult at the beginning, but in the long term I see this as a great service for the American people.”
