elderly couple looking at papers

ObamaCare’s Influence on Medicare

The Affordable Care Act (ACA), also known as ObamaCare, has affected all aspects of health insurance. While the law was primarily aimed at reforming private and small-group coverage plans, there were also other effects. Some of the effects touched on Medicare, a federal health insurance plan for Americans who are 65 and older, as well as certain younger Americans with disabilities.

For the most part, Medicare was not directly affected by the ACA. Medicare Part A, or a combination of Part A and B, is considered sufficient health insurance under the law. As a result, those using Medicare do not need to change their coverage or obtain additional health insurance.

Medicare and Hospital Stays

The ACA did reform how Medicare pays health care providers. With the ACA, doctors have additional incentives to offer high-quality care to all patients, including Medicare recipients. Hospitals have financial incentives to provide care that prevents frequent readmission. In addition, doctors are encouraged to participate in care coordination programs, making it easier for both you and your doctor to keep track of your medical needs and treatment plan.

There have been some changes in the reimbursement rates Medicare pays for medical care, which may result in some doctors no longer accepting Medicare patients. However, the true effect is not yet known.

ObamaCare’s Effect on Medicare

The ACA did have several positive effects on Medicare. Some of these include:

  • The closing of the Medicare prescription drug ‘donut hole’ that costs seniors a great deal of money each year. By 2020, instead of having a period of time where the prescription drug copayment goes up significantly, the standard Medicare prescription drug plan will have the same copayment all year.
  • Medicare has expanded to include a range of preventive services that are available without cost-sharing – that is, with no copayment or deductible from the patient. As a result, those with Medicare have access to certain checkups and screenings free of charge.
  • Improved access to preventive services such as cancer screenings, mammograms, and colonoscopies.
  • An annual wellness visit, as well as improved access to vaccines and flu shots as-needed.
  • A greater emphasis on care coordination due to incentives offered to doctors to help ensure a person’s treatments are consistent.
  • No benefits were cut from Medicare Advantage, but ObamaCare reduced payments to Medicare Advantage to incentivize private insurance providers who offer a higher quality of coverage.

Overall, Medicare recipients will continue to receive care as they always have. The ACA continues to guarantee Medicare coverage to those eligible, and has made some important changes to improve the coverage. The effect of Medicare cost savings in the ACA will become more apparent over time, but overall, the ACA has had large, positive impacts on seniors and other Medicare recipients.