By Kathleen Sebelius - 02/08/12 12:28 AM EST
When President Obama delivered his State of the Union message last month, he talked about American values: the idea that if you work hard and play by the rules, you should be able to make a good life for yourself and family, and have something left for retirement. Part of those values is Medicare’s promise that older Americans won’t have to spend the last part of their lives worrying about going broke from hospital bills.
The Affordable Care Act is one of the most powerful tools we’ve had in decades to make sure America can honor that promise for years to come. With more than 9,000 baby boomers turning 65 every day, it’s critical that these new beneficiaries, their families and the millions of seniors and people with disabilities who already rely on Medicare know about the law’s new protections and benefits. For millions of Medicare beneficiaries, the law is already making a big difference.
Second, the law improves access to prescription drugs and puts money back in the pockets of seniors that they can use for necessities such as rent or groceries. Medications are a growing part of healthcare costs for many seniors. Those who fall into the Medicare Part D coverage gap known as the “doughnut hole” can pay as much as $4,700 out of their own pockets. In the past, this has led some beneficiaries to split pills, skip doses or not even fill their prescriptions in the first place.
But now, thanks to the law, beneficiaries who fall into the gap get a 50 percent discount on covered name-brand drugs. Last year, this benefit saved 3.6 million beneficiaries more than $2.1 billion on their prescription drugs. That’s an average of more than $600 back in the pockets of seniors and people with disabilities. And they don’t have to do anything special to get the discount. Just show up at the pharmacy and the savings are already applied. Even better, the discount will continue to grow until the doughnut hole is closed in 2020.
Third, the law has made a historic investment in cutting waste, fraud and abuse from the Medicare program. It’s strengthened the penalties for criminals who steal from Medicare and it’s put more law enforcement on the ground to find them. The Obama administration is also supporting technology that can help us stop fraud before it happens, and we continue to work with the Senior Medicare Patrol program, in which seniors teach their friends and neighbors how to stop Medicare fraud.
Combined, these efforts have returned billions of dollars to the Medicare Trust Fund, and last year, fraud prosecutions jumped by almost 70 percent — a record increase. We’ve sent a clear message that defrauding vulnerable beneficiaries and stealing from taxpayers will no longer be tolerated.
Fourth, we’re giving hospitals and doctors new ways to improve care while spending our healthcare dollars more wisely. We’re working with leading health systems to help them spread innovations to hospitals around the country. We’re supporting health information technology that will allow doctors and hospitals to work together to coordinate care. And we’re giving doctors and nurses the tools to practice medicine the way they want to, and the freedom to spend more time with their patients.
Here’s the best news: Even as benefits improve and the program is strengthened, many beneficiaries have seen their premiums fall. For example, Medicare Advantage enrollment around the country went up about 10 percent last year, while premiums fell by an average of 7 percent. And a report our department released last week showed that thanks to the law, the average Medicare beneficiary is expected to save $4,200 between 2011 and 2021.
At a time when some are saying we need to make dramatic cuts to Medicare or get rid of guaranteed benefits altogether, the healthcare law is showing a better way forward. The Obama administration will continue to work to make Medicare stronger and more sustainable for today and tomorrow.
Sebelius is secretary of Health and Human Services.