When pollsters ask Americans what they know about the Affordable Care Act, the typical response is a quizzical shrug. The ACA, also known as Obamacare, remains a great mystery to many people, even though it was signed into law in 2010.
When AARP holds town hall meetings, officials have found that the public is equally unclear about Medicare, the government health insurance program for Americans with certain disabilities or who are more than 65 years old, and whether it will change under the ACA.
Until now, the country's 50 million-plus seniors on Medicare have mostly felt the impact of health care reform in their doctors' offices, where preventative services such as annual wellness checkups, immunizations and tests for cancer, cholesterol and diabetes are now covered without co-payments. But with full implementation of the law on the horizon, questions about how one will affect the other abound.
"There always has been confusion about Medicare," says Gail Wilensky, a policy analyst who directed Medicare and Medicaid from 1990 to 1992 and served as a senior health and welfare adviser to President George H.W. Bush. "Now there's more confusion than usual because of the focus on the Affordable Care Act and how it does or does not relate."
Here are five myths and facts surrounding Medicare and Obamacare.
Medicare is ending. False. Obamacare is not replacing Medicare. In fact, AARP representatives say Medicare will become stronger once the Affordable Care Act is in full swing. "Medicare's guaranteed benefits are protected in ways they hadn't been protected in the past," says Nicole Duritz, AARP's vice president for Health Education and Outreach.
Seniors on Medicare must buy more health insurance to comply with the ACA. False. This stems from misunderstandings about the individual mandate, a key provision of the Affordable Care Act, requiring people who are currently uninsured to buy coverage or pay a penalty. Medicare is health insurance, so beneficiaries don't need to buy anything during the Obamacare open enrollment period that starts Nov. 15, when the federal exchange and state-run health insurance marketplaces open for business. Seniors on Medicare can change their plans and prescription drug coverage during the Medicare open enrollment period, which runs from Oct. 15 through Dec. 7, 2014. Medicare beneficiaries who are satisfied with their current plans don't have to do anything.
Medicare beneficiaries will pay more for their medications under Obamacare. Partially true. Under the ACA, higher-income Medicare beneficiaries – those who earn more than $85,000 per person or $170,000 per couple – pay slightly more for their prescription drug coverage, or Medicare Part D. But this only affects about 5 percent of beneficiaries, AARP's Duritz points out. The vast majority of seniors on Medicare will see their drug costs go down as the ACA begins to close the "doughnut hole," a coverage gap that forces Medicare beneficiaries to pay 100 percent of their prescription drug costs up to a certain amount. This gap is expected to be fully closed by 2020, but those who fall into the gap this year will get a 55 percent discount on certain brand-name drugs and a 35 percent discount on generic drugs until they reach the out-of-pocket limit. In 2012, roughly 3.5 million Medicare beneficiaries saved an average of $706 each, the Department of Health and Human Services reported in March. As the doughnut hole closes, the savings will increase.
Updated on Nov. 14, 2014: This article was originally published on Aug. 19, 2013 and has been updated to reflect policy changes.
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