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Answering Your Questions About Health Care Reform And Medicare


Location: Unknown

Dear Friend,

Earlier this week, over 5,900 seniors in the 8th District joined me for a telephone discussion about the continuing effort to reform our nation's health care system and its potential impact on older Americans. I want to thank those who took the time to contribute to this critical conversation: voicing their concerns and sharing their own ideas for protecting and strengthening Medicare.

I know many seniors are worried and confused about how the health care reform proposals in Congress will affect them. Unfortunately, there has been an effort underway to scare older Americans with false or misleading information about health care reform. I believe you deserve an open and honest conversation about these issues, so I wanted to address some of the most common questions I heard during the discussion this week:

"I'm concerned that Congress will cut Medicare funds for doctors, and doctors will no longer be able to treat Medicare patients. How can you promise I can continue to see my current doctor?"
None of the current proposals before Congress would reduce the fees paid to doctors who treat Medicare patients. The House bill actually prevents a payment cut to doctors treating Medicare patients and prevents similar cuts from happening in the future; ensuring that doctors are paid fairly for their services going forward. It also increases Medicare payments to primary care doctors to expand access to primary care services for seniors.

"What does the bill do to address the ‘donut hole' in Medicare Part D?"
The so-called donut hole is a gap in Part D prescription drug coverage that forces many seniors to pay thousands of dollars out-of-pocket for medications. According to a report by the non-profit Kaiser Family Foundation, an estimated 3.4 million Americans fell into the donut hole in 2007 and 15% of those who did stopped taking their prescription drugs as a result. I have always supported closing the donut hole as soon as possible, and am glad that all of the current proposals make significant progress in closing the donut hole and reducing out-of-pocket expenses for seniors. For instance, the House bill would cut the cost of brand-name drugs bought in the donut hole in half and shrink the size of the coverage gap until it is completely closed.

"My wife and I are very happy with our Medicare Advantage plan. Will health care reform eliminate this program or cut our benefits?"
None of the current proposals would end the Medicare Advantage program, but some reforms are necessary to encourage innovation, improve care, and lower costs. The reason? The current Medicare Advantage program costs the taxpayers about 15% more than traditional Medicare, and only a fraction of the extra cost (about 14 cents of every dollar) actually goes toward providing better care to seniors. The rest goes toward overhead and the profit margin of private insurance companies. The current health care proposals in Congress would redirect that money toward closing the donut hole and extending the solvency of Medicare instead. Meanwhile, seniors will still have the choice of multiple Medicare Advantage options, which will have new protections to limit out-of-pocket spending.

For more information or to follow the debate on health care reform, please click on "Understanding Health Care Reform."


Brad Ellsworth

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