Health Care Blog

Weekly Address: Fair Pay for Doctors

With doctors facing deep cuts in their reimbursements from Medicare unless Congress acts to correct long-standing problems, the President calls on Senate Republicans to stop blocking the remedy and pledges to work toward a permanent solution.  The cuts would potentially mean widespread trouble for seniors getting needed care.

Answers to More Tough Questions about Medicare and Health Care Reform from Seniors

Earlier the week, President Obama and HHS Secretary Kathleen Sebelius participated in a health care tele-town hall with seniors at the Holiday Park Multipurpose Senior Center in Wheaton, Maryland.  In coordination with dozens of participating organizations, seniors across the country gathered at watch parties, called-in to ask questions, and got answers from the senior administration officials on hand at various local events.  Many more questions came in than could be answered during the tele-town hall but there are a number of ways that seniors, or their friends and family, can get the answers they need. 

The Medicare website and hotline (1-800-MEDICARE) are best places to get the facts about new benefits that will soon be available under the Affordable Care Act.  In an effort to continue sharing accurate and reliable information, here are answers to some of the questions that were submitted to the White House Facebook page in advance of the event:

Vic Eng:  Can more be done for seniors who want family to care for them in their later years?  Families need to be compensated as much as health care assistants.

Yes, more can be done.  The Affordable Care Act includes an important new program to help seniors and others stay in their homes by making community-based care an alternative to nursing homes.  The program, called the Community Living Assistance Services and Supports (CLASS) Program, is a voluntary, enrollment based insurance program that provides Americans with a cash allowance to help subsidize costs of staying at home if you get sick or disabled.   This program will be available in 2012.  For more information about the CLASS Program, click here.    

The new law includes a number of additional provisions that make it easier for seniors to stay in their community, rather than a nursing home.  For instance, the new law gives States the option to extend full Medicaid benefits to certain individuals receiving home and community-based services.  In addition, the “Community First” Choice provision allows States to offer community-based services to Medicaid beneficiaries with disabilities who would otherwise require institutional care.

Marcia Killingsworth: At what age is one a senior?

While there is no technical definition of a “senior,” typically, the term refers to Americans who qualify for Medicare, ages 65 and older.

Alan Sutovsky: The most common question amongst seniors from organizations I have worked with as of late is – will the new laws be flexible enough to accommodate existing solutions that worked well in the local communities? Many feel it would be a shame to discount or eliminate patterns that have already helped to save costs and provide care.

The Affordable Care Act builds upon our existing system to strengthen health care for all Americans.  It does not change the structure, nor put government in charge – it puts consumers in control of their own care.  Under the new law, States will have the option of pursuing their own reform plans, including running exchanges, adopting delivery system reform in Medicaid, and working with local providers to test innovative ideas through the Medicare and Medicaid Center for Innovation.  The new law also invests in local communities by providing new funding to support the construction and expansion of community health centers, allowing these centers to serve some 20 million new patients across the country.

JL Richardson:  Good to hear you will be talking about Medicare. It is so sad to hear that it may be gone by 2030.  Cutting doctors' payments is leading to more doctors opting out of caring for Medicare patients.  How will Medicare be kept solvent, Mr. President?

The Affordable Care Act strengthens Medicare’s financial health for the future.  Over the next 20 years, Medicare spending will grow at a slower rate as a result of rooting out waste, fraud, and abuse.  This will extend the life of the Medicare Trust Fund by 12 years and provide cost savings to Medicare beneficiaries. 

In addition, to further protect Medicare and taxpayer dollars, the President has directed HHS to cut the improper payment rate, which tracks fraud, waste and abuse in Medicare, in half by 2012, and .  U.S. Attorneys nationwide are redoubling their efforts to coordinate with state and local law enforcement to prevent and prosecute fraud.

The President is also committed to reforming the way in which we compensate doctors under Medicare, because right now it doesn’t make any sense.  He’s going to keep fighting for doctor pay that is more cost-effective and efficient.  The President has urged Congress to pass a short-term fix now, and to continue working toward a more permanent, long-term fix for the future.  Here’s what he said just tihs week: 

“If you like your doctor, you can keep your doctor.  In fact, we’re taking steps to increase the number of primary care physicians so that seniors get the care that they need.  And I’m committed to reforming the way in which we compensate doctors under Medicare, because right now it doesn’t make any sense.  I don’t think -- some of you may be aware of the fact that we’ve got this patchwork system where Medicare doctors each year have to see if they’re going to get reimbursed properly or not.  And we’ve got to change that, and that’s something that I’m committed to doing.  And I’m going to keep fighting for doctor pay that is more cost-effective and efficient, and I urge Congress to pass a short-term fix today and then we need to fix this thing over the long term tomorrow.”

Cleveland Gibbs:  What’s in it for the veterans?

The Affordable Care Act builds upon the Obama Administration’s historic investments  in veterans’ health care to ensure efficient, timely, and predictable medical services for veterans.  Veterans eligible for VA benefits remain eligible under health reform—nothing in the legislation affects veterans’ access to the care they currently receive. Nor does the new law change TRICARE or TRICARE for Life.  In addition, The Act does not require anyone to change their health insurance coverage, but it does ensure increased health insurance options as well as expanded consumer protections to prevent insurance companies from denying or setting limits on coverage.  Millions of veterans have access to the essential creditable coverage through the VA system and therefore have met the individual responsibility requirement.  However, for those that want to purchase coverage in the Exchange with their own dollars, they may do so.  The law expands protections to prevent insurance companies from denying or setting limits on coverage, an important issue for veterans with a disability or chronic conditions.

Michael Quallet:  Ask him how he's going to pay for it.

The Affordable Care Act is fully paid for by reducing waste, fraud and abuse in the current system and by instituting reforms that will make our health care system more efficient and provide higher quality care. The law puts our budget and economy on a more stable path by reducing the deficit by more than $100 billion over the next ten years – and by more than $1 trillion over the second decade.

Robyn Scott:  Why should I pay for my healthcare and then have to pay for someone else's as well?  Why is it ok for the Federal government to force me to do this, and to force any American to make a purchase? Hello, has anyone read the Constitution?

The new law will make health insurance affordable for everyone, with tax credits for those who need help buying coverage and a hardship waiver for those who still can’t afford it.  But it is important that everyone be covered.  Otherwise, the cost of caring for the uninsured will continue to be shifted to people with insurance, as it is today.  Right now, families with insurance pay a $1000 hidden tax to pay the cost of caring for the uninsured. 

Beginning in 2014, when the law is fully implemented, state Exchanges will offer individuals and small businesses more affordable and higher quality health care choices, the same choices as Members of Congress.    Most individuals will be required to maintain minimum coverage or pay an assessment equal to the greater of $95 or 1 percent of income in 2014, $325 or 2 percent of income in 2015, $695 or 2.5 percent of income in 2016 and indexed thereafter.

Watch the video or read the transcript to learn more about the tele-town hall event and get the facts.   Join the White House Facebook page to get updates and participate in upcoming events.

Stephanie Cutter is Assistant to the President for Special Projects