Health Reform for Seniors
Health Reform for American Seniors
The Affordable Care Act Gives
America's Seniors Greater Control Over Their Own Health Care.
Lower Costs for America's Seniors
 Thousands in Savings by Closing the Medicare "Donut Hole"
o More than 8 million seniors in 2007 hit the "donut hole," which is the gap in prescription drug
coverage in Medicare Part D. This year, provides a $250 rebate to Medicare beneficiaries who hit
the donut hole in 2010. Beginning in 2011, the Act institutes a 50 percent discount on brand name
drugs in the donut hole, and the Act will completely close the donut hole for all prescription drugs
 Reduces Unwarranted Subsidies to Private Health Plans
o Phases down payments to Medicare Advantage plans to bring them more in line with the costs in
the original Medicare program, provides for bonus payments for plans that improve quality and
enrollee satisfaction, and reduces payments to plans with inflated risk adjustments that are not
documented. Medicare's guaranteed benefits are not affected, and reducing these unwarranted
subsidies will save Medicare more than $150 billion over 10 years.
 Strengthens the Financial Health of Medicare
o Invests in fighting waste, fraud, and abuse. Reforms payments to reduce unnecessary hospital
admissions and health care acquired infections. Together, these proposals will extend the financial
health of Medicare by 9 years. Not a penny of Medicare taxes or trust funds will be used for health
 Preventive Care for Better Health
o Eliminates deductibles, copayments, and other cost-sharing for preventive care, and provides free
annual wellness check-ups starting in 2011. Today, seniors must pay 20 percent of the cost of
many preventive services and office visits.
 Affordable Long-Term Care
o Creates a voluntary long-term care insurance program, which will provide a cash benefit to help
seniors and people with disabilities obtain services and supports that will enable them to remain in
their homes and communities.
Quality, Affordable Health Care for Seniors
 Control Chronic Disease
o Invests in innovations such as medical homes and care coordination to improve the quality of care
that seniors receive and to better spend the more than 90 percent of Medicare costs are spent on
treating chronic conditions.
 Promote Better Care After a Hospital Discharge
o Links payments between hospitals and other care facilities to promote coordinated care after
discharge from the hospital and encourage investments in hospital discharge planning and
 Improve Quality of Care
o Invests in developing and reporting quality of care measures across the health care delivery system
to help beneficiaries make more informed choices among providers for the care they may need and
to reduce the one in seven hospitalized Medicare patients who experience a complication.
o Creates incentives to reward providers that meet quality goals or show significant progress in
improving patient outcomes. This focus on quality improvement will move our health system
toward one that rewards better care rather than more care.