The Impact of the Affordable Care Act on Medicare

The botched rollout of the federal insurance exchange and the stream of media coverage surrounding the Affordable Care Act have left many Americans feeling overwhelmed and confused about the impact of the healthcare reform law.

A study commissioned by Express Scripts found that Medicare-eligible seniors have significant misconceptions about the Affordable Care Act and its effect on their existing Medicare coverage.

Of the seniors polled, 20% thought that they were eligible for an insurance plan through an exchange, even though enrollment ends at age 64, and 17% mistakenly believed that the health insurance exchange’s plans could replace the Medicare program.

The Affordable Care Act, however, does impact Medicare in two important ways. First of all, it will end the coverage gap by 2020. Seniors in the coverage gap pay a higher portion of their medication costs because their prescription drug costs are over the initial coverage limit but under the catastrophic coverage threshold.

Many preventative services are also now covered by Medicare Part B, including cancer screenings and bone mass measurements. Medicare Part D will cover vaccines necessary to prevent illnesses that are not covered under Part A or B.

Medicare open enrollment ends December 7, 2013, so it is vitally important to understand the options available to you. If you have any questions about Medicare coverage or need to enroll in a plan, visit http://medicare.gov/.

In an effort to minimize office expenses, I use the free version of WordPress.com to blog. Unfortunately, this means my office has no control over the content or placement of ads on this site. Thank you for understanding. 

Lax Rules for Insurance Navigators Put Consumers at Risk

When purchasing insurance through the federal exchange, Americans are supposed to be able to rely on navigators for impartial information and assistance as they move through the complex process.

The recent glitches in the exchange website and the bloated bureaucracy created by the Affordable Care Act make it even more imperative for citizens to have access to trusted and expert support.

Health and Human Services Secretary Kathleen Sebelius admitted to a congressional panel on Wednesday, November 6 that it is possible for convicted felons to become navigators. Federal law does not require navigators to undergo criminal background checks even though they could come into contact with sensitive personal information about the clients they are meant to serve.

The organizations that hire navigators are supposed to screen them, but Americans have no guarantee that they will do their job effectively.

To better protect Missourians, the General Assembly passed Senate Bill 262 last year. This law requires navigators working in our state to become licensed by applying, passing an examination, and paying a fee.

Before the Director of the Department of Insurance, Financial Institutions, and Professional Registration approves an application, he or she must determine that the applicant has not committed any acts that would cause an insurance producer’s license to be revoked. Applicants would be disqualified for a variety of offenses, including committing a felony, violating insurance law, or improperly withholding money.

SB 262 goes further to protect consumers than federal statute but does not specifically require a background check for all applicants.

Purchasing health insurance requires the transmission of highly personal information that deserves the highest level of security.

Problems have plagued the exchange since its inception, so states must diligently protect the privacy and security of their citizens.

In an effort to minimize office expenses, I use the free version of WordPress.com to blog. Unfortunately, this means my office has no control over the content or placement of ads on this site. Thank you for understanding. 

Mismanaged Medicaid Payments Demonstrate Need for Reform

Proponents of Medicaid expansion seek to add over 300,000 adults to the already broken Medicaid system without any true reforms. Such rash expansion would cost Missouri millions without solving the problems that currently plague the program, such as waste, fraud, and improper payments. A recent federal audit found that Missouri should return $21.4 million in Medicaid payments to the federal government because the funds were improperly administered.

Of the $22.7 million given to Hawthorn Children’s Psychiatric Hospital from 2005 to 2009, $21.4 million was called into question because the state-owned hospital failed to provide proof of staffing requirements and lacked proper records for mental health patients. While Missouri can appeal the recommendation, this will only waste more taxpayer money defending the payments.

Adding more cases to the bloated system through expansion will not solve Medicaid’s administrative problems or increase its efficiency. Meaningful reforms are needed to ensure that funds are used properly in the future and to increase the quality of care given to Medicaid recipients.

Currently, three state departments oversee elements of Medicaid, which makes the system very difficult to manage. Moving all elements of Missouri’s Medicaid program to one entity or department would allow for better oversight and more efficient administration.

Simply expanding Medicaid will do nothing to improve the system, which is currently wasting taxpayer money while underserving recipients. If we truly want to provide Missouri’s most vulnerable citizens with better care, we must implement meaningful Medicaid reforms.