Democratic Views on Medicare

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Medicare and Medicaid were signed into law by President Lyndon B. Johnson in 1965. These programs—which were designed to help the elderly, the disabled, and those with low-income acquire quality and affordable healthcare—are celebrating their 50th anniversary year. Prior to the creation of these programs, the majority of senior citizens lacked health insurance. Getting sick or injured was a debilitating experience, often resulting in financial hardships like bankruptcy or the loss of life savings. Many seniors had to depend on their family members for long-term care, or else went without. Considered essential by many, today Medicare and Medicaid help provide aid to nearly 117 million Americans, including more than 26 million children, who would not have had the means to pay for their care without these programs.

Democratic views on Medicare revolve around the goal of ensuring that quality and affordable healthcare is available for all citizens, as evidenced by President Obama signing the controversial Patient Protection and Affordable Care Act into law in March of 2010. About 16.4 million Americans gained health care coverage as a result of this act, including 2.3 million young adults in the workforce who were previously uninsured. The benefits of the Affordable Care Act— also commonly referred to as Obamacare—are many, and include allowing children to stay on their parents’ health care plans until they are 26 if they are not able to obtain their own through their employment. Discrimination based on pre-existing conditions is also illegal, and insurance companies are not allowed to remove someone from a plan simply because they get sick. Insurance companies cannot place annual or lifetime limits on coverage, an act which puts individuals and families in compromising positions should they be unable to pay out-of-pocket.

Along with the full implementation of the Affordable Care Act, the strengthening of Medicare is a priority for democrats. Some of the improvements to the Medicare program since 2010 include free mammograms and preventative services such as free immunizations and screenings for diabetes and cancer. Seniors are entitled to a 50% discount on name-brand drugs if they enter the Medicare Part D ‘donut hole’ coverage gap, and this discount will increase until the coverage gap is expected to close in 2020.

Expand Coverage Rather Than Privatizing

One of the primary purposes of the Patient Protection and Affordable Care Act is to move away from the privatization of Medicare, Medicaid, and health care in general. America’s seniors have paid into a lifetime of benefits and, according to the party, have earned the right to Medicare and Social Security by the time of their retirements. The Democratic Party adamantly opposes efforts to voucherize or privatize Medicare, viewing it as unfair to ask the American people, especially seniors, to pay into a system only to watch their benefits evaporate with each passing year. The new law is expected to make Medicare stronger in the long run, and the average beneficiary is expected to save $4,200 within the next 10 years.

By expanding coverage, individuals and business are offered tax credits to make quality health care more affordable. For over 4 million eligible small businesses, tax credits are offered should they choose to offer insurance to their employees, with the ACA covering up to 35% of the costs. Those approaching retirement age and those who are between jobs are provided tax credits to apply towards their care. Low-income adults are offered expanded coverage through federal-state health care programs.

The Pros and Cons of the Affordable Care Act on Medicare

As previously mentioned, the Patient Protection and Affordable Care act is highly controversial, with conservative opponents objecting to the tax increases and higher insurances needed to pay for it. Some employees in the health care industry are critical of the additional workload, paperwork, and costs placed on medical providers, as they think it affects the quality of care. The ACA is frequently being called into reevaluation, with the most extreme calling for the repealing of the new law. There are many positives to the act, however. 

The Department of Health and Human Services estimated in 2014 that more than 8 million seniors and Americans with disabilities saved a collective $11.5 billion on prescription drug costs due to the Affordable Care Act. One of the benefits to Medicare that the act is working to fix is the closing of the ‘donut hole,’ a loophole in Medicare Part D plans that leaves a coverage gap. Medicare Part D requires individuals to pay out-of-pocket monthly premiums throughout the year as well as 100% of drug costs until the deductible amount is reached. After reaching the deductible, the patient is only responsible for 25% of drug costs while the plan pays the rest, until the total spent by both parties is $2,800. This limit is what’s known as the ‘donut hole,’ and individuals then become responsible for the full cost of their drugs until out-of-pocket expenses reaches $4,550, upon which Medicare Part D once again takes on the brunt of the responsibility of paying for drug care. On average, seniors who are benefitting from the closing of the ‘donut hole’ save about $1,407 per beneficiary.

In addition to closing the ‘donut hole,’ the Affordable Care Act is working to keep rates down, expand benefits, coverage options, and free preventative services. The ACA extended the life of Medicare Trust Funds slowing the growth of Medicare spending by eliminating wasteful spending, abuses, and fraud within the system. While the ACA generally has a positive impact on Medicare, it is not without its cons. Some Medicare payments to doctors and hospitals has been limited, and since Medicare pays doctors more than any other type of coverage, complex problems have arisen which are driving the costs of health care up for everyone. In addition, keeping supplemental Medicare options means more confusing options for seniors.

While tens of millions of seniors are getting better access to quality health care and saving money on medications, the ACA does cut money from Medicare. $716 billion is cut from the program, but later reinvested back into it, resulting in the necessity for a committee to oversee spending and effectiveness.

2016 Democratic President-Hopefuls Views on Medicare

Since the Affordable Care Act passed in 2010, it has remained at the forefront as a primary topic of both campaigns and elections. President-Hopefuls Hillary Clinton and Bernie Sanders have both addressed healthcare reform in the United States as part of their campaigns. In September of 2015, Clinton released her affordable healthcare and prescription drug platform. A patient under her plan could visit a doctor up to three times before it counted towards their annual deductible. Families ineligible for Medicare could receive up to a $5,000 tax credit for out-of-pocket healthcare expenses. A $250 month cap on prescription drugs for patients with chronic or serious health conditions would also be imposed. Her plan would also legalize prescription drug imports from Canada because, as she states “If the medicine you need costs less in Canada, you should be able to buy it from Canada — or any other country that meets our safety standards.”

Bernie Sanders has a long history of voting for healthcare reform in the US. In 1996, he voted yes for HIPPA, the Health Insurance Portability and Accountability Act. He also voted yes for the Patient Protection and Affordable Care Act. In 2013, Sanders sponsored the American Health Security Act of 2013, which recognized health care as a human right, aimed to give state flexibility in designing health care programs, and enacted Medicare-for-All Single Payer Health Care Systems. In September of 2015, he and Representative Elijah Cummings (D-Md) introduced the Prescription Drug Affordability Act of 2015, saying “There is no rational reason why Americans should pay by far the highest prices in the world for prescription drugs. The result of that is people are dying and becoming much sicker because they can’t afford the medicines they need.”

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