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Today, the Department of Health and Human Services (HHS) issued a memo clarifying that all beneficiaries in private Medicare plans have access to equal coverage when it comes to care in a nursing home where their spouse lives. This is the first guidance issued by HHS in response to the recent Supreme Court ruling, which held section 3 of the Defense of Marriage Act unconstitutional.
“HHS is working swiftly to implement the Supreme Court’s decision and maximize federal recognition of same-sex spouses in HHS programs,” said HHS Secretary Kathleen Sebelius. “Today’s announcement is the first of many steps that we will be taking over the coming months to clarify the effects of the Supreme Court’s decision and to ensure that gay and lesbian married couples are treated equally under the law.”
“Today, Medicare is ensuring that all beneficiaries will have equal access to coverage in a nursing home where their spouse lives, regardless of their sexual orientation,” said Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner. “Prior to this, a beneficiary in a same-sex marriage enrolled in a Medicare Advantage plan did not have equal access to such coverage and, as a result, could have faced time away from his or her spouse or higher costs because of the way that marriage was defined for this purpose.”
Under current law, Medicare beneficiaries enrolled in a Medicare Advantage plan are entitled to care in, among certain other skilled nursing facilities (SNFs), the SNF where their spouse resides (assuming that they have met the conditions for SNF coverage in the first place, and the SNF has agreed to the payment amounts and other terms that apply to a plan network SNF). Seniors with Medicare Advantage previously may have faced the choice of receiving coverage in a nursing home away from their same-sex spouse, or dis-enrolling from the Medicare Advantage plan which would have meant paying more out-of-pocket for care in the same nursing home as their same-sex spouse.
Today’s guidance clarifies that this guarantee of coverage applies equally to all married couples. The guidance specifically clarifies that this guarantee of coverage applies equally to couples who are in a legally recognized same-sex marriage, regardless of where they live.
Watch the Obamacare videos & get the facts
Obamacare is making health care work better for all of us, even if you already have insurance. It puts the health of your family first—ensuring access to free preventive care and protecting consumers from insurance company abuses.
|71 Million Kids & Adults With Private Insurance Have Received No-Cost Preventive Care.
“HHS estimates that, as a result of the ACA, 71 million children and adults with private insurance, and 34 million Medicare beneficiaries have received no-cost preventive care. Enhanced federal matching funds in Medicaid are available to states providing all USPSTF-recommended preventive benefits without cost-sharing, but, to date, few states have made the changes required to gain the higher match rate.” “Health Reform-The Affordable Care Act Three Years Post-Enactment,” Kaiser Family Foundation, March 2013.
|Discrimination By Insurance Companies For Children With Pre-Existing Conditions Was Banned.
“Coverage exclusions for children with pre-existing conditions were prohibited as of September 23, 2010. Insurers are no longer permitted to deny coverage to children due to their health status, or exclude coverage for pre-existing conditions. Protections for adults will take effect in 2014. In addition, lifetime limits on coverage in private insurance have been eliminated and annual limits are being phased out.” “Health Reform-The Affordable Care Act Three Years Post-Enactment,” Kaiser Family Foundation, March 2013.
|Consumers Received $1.1 Billion in Rebates From Their Insurance Companies.
“Insurance companies that don’t spend at least 80 percent of its customers’ premium dollars on health care are required to provide rebates to policy holders. In 2012, the first year this rule was implemented, 12.8 million consumers received $1.1 billion in rebates.” “Health Reform in Action,” WhiteHouse.gov, accessed 6/5/13.
|3.1 Million More Young Adults Have Health Insurance Through Their Parent’s Plan.
“Under the law, most young adults who can’t get coverage through their jobs can stay on their parents’ plans until age 26.” “Health Reform in Action,” WhiteHouse.gov, accessed 6/5/13.
|Seniors Have Saved More Than $6.1 Billion on Their Prescription Drugs Since 2010.
“Seniors who hit the gap in Medicare’s prescription drug coverage, often called the ‘donut hole’ now receive 50 percent discounts on covered brand name drugs. The new health reform law will provide additional savings each year until the coverage gap is closed in 2020.” “Health Reform in Action,” WhiteHouse.gov, accessed 6/5/13.
Much has been said over the past few weeks about the budget proposal in the House of Representatives, offered by Rep. Paul Ryan, and backed by Republican members, but not much has been said about how it will affect our veterans. As you know, the Paul Ryan plan will end Medicare, making it a voucher program, leaving seniors to buy their own insurance in the private system. It will therefore end one of the most popular and successful initiatives ever offered.
This plan will also punish veterans – harshly – and it’s important that you spread the word on how it will do so.
Here are the facts:
- Millions of veterans over 65 rely on Medicare, Medicaid or private insurance for their health care. In fact, according to the last survey of veterans by the Department of Veterans’ affairs, 39.3% of veterans use Medicare, compared with 14 percent of the general population.
- Many of these veterans are relying on Medicare as their sole health care provider. The Ryan plan would have an immediate impact on these veterans, forcing those falling into the “donut hole” with high-cost prescription drug costs to pay more for their medications in addition to paying more for preventative health services.
- Veterans who rely on Medicaid would not escape cuts either. The Republican plan could slash $1.4 trillion in health benefits over the next ten years. Forty-four states are already facing significant budget shortfall in Fiscal Year 2012,and the cuts could force the state to either ration health care benefits for veterans across the country, restrict eligibility rules and leave thousands uninsured, including veterans, or raise taxes to cover the shortfall.
- Finally, many veterans rely on private insurance, mostly through their employer. Because Republicans want to repeal the recent health insurance law, these veterans will no longer have guaranteed access to health insurance regardless of pre-existing conditions and may see annual or lifetime caps on coverage under the Republican budget.
In short, Republicans and Paul Ryan will strip away care for our veterans, in the name of budget cutting. These proposals are draconian, cruel, and unfair to those men and women who put their lives on the line for this country. But, unless we spread the word about how severely the Ryan/Republican plan will hurt veterans, most Americans won’t ever know.
Take some time to read their propaganda and get to know what they’re trying to do. Be an informed voter, not someone who swallowed their propaganda, hook, line and anchor.
|GOP 2012 Platform||GOP Growth Opportunities||2009 Road to Recovery||2010-Better Solutions|
|2010-Pledge to America||P2P v1.0||P2P v2.0||P2P v3.0|
Read/compare a few to see what you think — and if you’d like you can compare the actual budget numbers between plans here.
The Democratic Congressional Campaign Committee today is continuing the drumbeat against House Republicans who voted for the radical Republican budget, releasing a new web video to highlight the chasm between mainstream Americans’ priorities and House Republicans’ radical approach. In the video – “Radical Republican Budget: Robin Hood in Reverse” – Republicans describe the budget as the best way to communicate their “governing philosophy.” The video goes on to show the GOP Doctrine for Governance in clear terms: higher taxes for the middle class, bigger medical bills for seniors on Medicare, more expensive student loans and a tax break for millionaires.
Under the Republican doctrine for governance, the Ryan budget, middle class Americans could pay $3,000 more in taxes and the Medicare guarantee, paid for with deductions from every dollar earned by working Americans …. will END. Thus, their governance philosophy will take that money to fund other things like a $245,000 tax for millionaires, and force seniors to pay more for their care — if they can find an insurance company to cover it and if they can find a doctor to provide it. And, while the middle class would be paying more in taxes, folks like Mitt Romney, whose tax liability is imposed primarily by capital gains taxes, would see their tax liabilities plummet with Ryan’s slash to capital gains taxes. Valuing making money off the fruits of others’ labors, without having to exert an ounce of labor yourself, is not an “American” value.
“Republicans themselves tell us that their budget is the best way to communicate their ‘governing philosophy’ and that’s exactly what they did – more for millionaires and corporate special interests, less for the middle class and seniors,” said Emily Bittner of the Democratic Congressional Campaign Committee. “Americans rejected the philosophy of this radical Republican budget in the last election because it ends the Medicare guarantee for seniors and asks the middle class to pay more – all while cutting taxes for millionaires and corporate special interests. It might be the Republicans’ governing philosophy but it isn’t the right philosophy for America’s middle class.”
Ryan’s Path to Poverty budget is the third in a series, all espousing their out of touch governance doctrine. The GOP hasn’t learned that their “philosophy” isn’t what Americans want. Instead, thick-headed GOP members of the House are continuing to push philosophies the American people don’t want. Bound to their millionaire donors and determined to implement their demands, the GOP intends — to impose their revolutionary doctrine — to convert America into a Plutocracy ruled over by the uber-rich — using budgets — without firing a single bullet.
Here’s their “philosophy” documents introduced since 2008 along with their platform. Read/compare a few to see what you think — and if you’d like you can compare the actual budget numbers here.
|GOP 2012 Platform||GOP Growth Opportunities||2009 Road to Recovery||2010-Better Solutions|
|2010-Pledge to America||P2P v1.0||P2P v2.0||P2P v3.0|
- Paul Ryan’s “The Path to Prosperity, A Responsible Balanced Budget.”
- Paul Ryan’s class warfare on behalf of the rich.
- The top 5 worst things about the GOP budget.
- GOP budget keeps Obamacare’s cuts and taxes, repeals all the benefits.
- The GOP budget maintains 100 year-old tax breaks for Big Oil.
- How the GOP budget will undermine the recovery.
- Even Paul Ryan admits that we’re not facing a debt crisis.
- Latest GOP budget gives millionaires at least a $200,000 tax cut.
— by Kathleen Sebelius, Secretary of Health and Human Services, March 21, 2013
In the three years since the Affordable Care Act became law, the slower growth of health care costs is saving money in Medicare and the private insurance market, helping to curb previously skyrocketing premiums and making Medicare stronger.
The nonpartisan Congressional Budget Office recently estimated that Medicare and Medicaid spending would be 15 percent less — or about $200 billion— in 2020 than was previously projected, thanks to this slower growth. Medicare spending per beneficiary rose by just 0.4% in 2012, while Medicaid spending per beneficiary actually dropped by 1.9% last year. We are making Medicare stronger, too, by spending smarter, promoting coordinated care, and fighting fraud. Not only does this ensure that taxpayer dollars are spent wisely. It means that those who count on Medicare — our grandparents, parents, our friends, and neighbors – will have it for years to come.
Today, we are announcing that thanks to the Affordable Care Act, more than 6.3 million seniors and people with disabilities on Medicare have saved more than $6.1 billion on prescription drugs since the health care law was enacted three years ago. This is the result of the law’s closing of the prescription coverage gap known as “the donut hole.”
Nearly 3.5 million people with Medicare saved an average of more than $706 each on their prescriptions in 2012.
In the case of Helen Rayon of Pennsylvania, the savings on her medications is enough to help her contribute to the education of her grandson. She says: “I take seven different medications. Getting the donut hole closed … gives me a little more money in my pocket.”
David Lutz, a community pharmacist from Hummelstown, PA, described his elderly customers, “splitting pills, taking doses every other day, missing doses, stretching their medications.” But he says this has begun to change with the savings resulting from the Affordable Care Act, and that’s good for their health as well as their budgets.
After the law was passed, the Affordable Care Act provided a one-time $250 check for people with Medicare who reached the Part D prescription drug coverage gap in 2010. Since then, individuals in the donut hole have continued to receive savings on prescription drugs. In 2013 individuals in the donut hole are saving over 50% off of the cost of branded drugs. The savings on both brand name and generic drugs will continue to increase until the coverage gap is closed in 2020.
Along with savings on their medications, American seniors have also benefited from access to vital preventive services — such as mammograms, cholesterol checks, cancer screenings, and annual wellness visits — with no Part B coinsurance or deductibles. In 2012, more than 34 million seniors and people with disabilities with Medicare received at least one free preventive service. Having easier access to preventive services without worrying about the cost helps seniors stay healthier and identify health conditions before they become more serious and costly.
Helen works as a health-and-wellness coordinator at a senior center, arranging for health and fitness activities for seniors older than herself. She knows they struggle with the costs of staying healthy. “If it weren’t for the health care reform, many of our seniors would not get to a doctor,” to get a check up, Helen says. “It is expensive for us to keep good health.”
Affordable Care Act initiatives are also ensuring that if Medicare beneficiaries do end up in the hospital that their care is coordinated and they stay out of the hospital once they’re discharged. This also gives Medicare beneficiaries – and other taxpayers – more value for their health care dollars. In fact, hospital readmissions in Medicare have fallen for the first time on record, resulting in 70,000 fewer readmissions in the last half of 2012.
The Affordable Care Act is helping us keep our moral commitment to ensure that our grandparents and other seniors get the high-quality, affordable health care and security they need and deserve.
To learn more about how the Affordable Care Act is saving seniors on prescription drug costs by closing the donut hole coverage gap, visit www.hhs.gov/news/press/2013pres/03/20130321a.html
NOTE: Today, in the U.S. House of Representatives, GOP members of that House, on a purely partisan vote, passed the Ryan Budget which, if it were to become law, would repeal the Affordable Care Act, and all of it’s provisions which help not just those folks on Medicare, but those of us who might have what the insurance industry has termed a “pre-existing condition” that they can then use to deny coverage. It would also allow insurance companies to once again impose both annual and lifetime limits on coverage. Those of you with children under 26 would no longer be able to continue to carry them on your existing health insurance policy once they reach age 18. And that’s just a few of the provisions that make a difference in ordinary Americans’ lives. Please take the time to review exactly “what” is covered under Obamacare and then help us bury Senator Heller in emails, tweets, and letters letting him know you will not forget any vote he takes to repeal this needed and necessary law by voting for Ryan’s Path to Poverty budget.
Paul Ryan is still stuck in the same old rabbit hole.
Apparently, Rep. Paul Ryan missed the outcome of last November’s presidential election. Oh, wait — wasn’t he on the ballot in that election as Mitt Romney’s running mate?
Well, yes, but less than five months later, the Wisconsin Republican seems to have forgotten that he and the Mittster were soundly rejected.
Maybe the trauma of losing big — including failing to win a majority of the votes cast in his own hometown of Janesville, Wisconsin — has his memory slipping.
Whatever the cause, it’s embarrassing to see him now trotting out the very same Republican budget proposal that he wrote last year and put at the center of the Romney-Ryan presidential campaign — the same nauseating budget extremism that induced the great majority of Americans to throw up their hands.
Ryan recently headlined a Washington media event for the re-release of this bucket of right-wing hash. It includes turning Medicare into a “WeDon’tCare” privatized voucher scheme that would deliver seniors into the tender clutches of giant insurance corporations, forcing the elderly to pay more for less.
Also, to save the super-rich from even the slightest tax increase, Ryan again served up a mess of cuts to food stamps, Medicaid, and other vital programs for the poor, while simultaneously jacking up the tax burden on both the working and middle classes.
Then, to make his package even more odious to the general public, he cluelessly re-issued the far right’s cry to repeal the Affordable Care Act. Hello, Paul, it’s reality calling: Obama thoroughly thumped you and Willard on this issue last year. Remember?
And since the election, Obama’s signature health care reform has grown in popularity. Several Republican governors are now seeing the political light and embracing it.
Maybe it’s time for his family and friends to pull the gentleman from Janesville out of the rabbit hole where he’s gotten stuck.
OtherWords columnist Jim Hightower is a radio commentator, writer, and public speaker. He’s also editor of the populist newsletter, The Hightower Lowdown. OtherWords.org | RMoney/RAyn Photo credit to DonkeyHotey/Flickr