Medicare Part B Increases

The new health reform law changes and extends the annual enrollment period for Medicare Part D plans.  Anyone interested in switching plans should keep in mind the new enrollment period is now October 15 – December 7.

Note that the Centers for Medicare and Medicaid Services (CMS) provides for a Special Enrollment Period for contract violation if a prescription drug plan (PDP) violated a provision of its contract under Part D in relation to the individual.  Violations include: failure to provide on a timely basis benefits available under the plan; failure to provide benefits in accordance with quality standards; or the PDP sponsor (or its agent) materially misrepresenting the PDP when marketing the PDP.  The enrollment period begins when CMS determines that a violation has occurred.

For other details on the new health reform bill, what it does, especially for seniors, and when provisions go into place, check out fact sheet here: http://bit.ly/ccGLay.

2010 Campaigns Heating Up: Retirees Must Know the Facts
Political developments in three states this week were a reminder of how retirees – expected to be the largest voting bloc this fall – must be well versed on the issues and where the candidates stand. Alliance President Barbara J. Easterling traveled to Arkansas to endorse Lt. Gov. Bill Halter for the U.S. Senate and rebut television ads that falsely claim he supports Social Security privatization.  Noting that Halter ran the Social Security Administration under President Clinton and has consistently worked to help retirees, Easterling said, “Bill Halter is a great friend of Social Security and Medicare.  He is a great friend to seniors.”  Write-up here: http://bit.ly/bA0D7P.

In the first U.S. House election since health reform was signed into law, voters in a heavily-senior Florida congressional district elected Democrat Ted Deutch by a 2-1 margin over his Republican opponent to fill a vacant seat.  In Missouri, U.S. Rep. Roy Blunt, a Republican candidate for the U.S. Senate, criticized a provision in the new health law that prohibits adults from being denied coverage because of pre-existing conditions.  Video here: http://bit.ly/ce5t5S.   In May, both Pennsylvania and Hawaii will be holding closely contested special elections to fill vacant U.S. House seats.  “More than ever, we must be a nation of politically savvy seniors,” Easterling commented.

CEO Pay at the Big Health Insurance Companies: Enough to Make You Sick
According to new data from the AFL-CIO

The Senate-passed health care reform bill dramatically cleared the House on a 219-212 vote Sunday night, and President Obama signed it into law on Tuesday.  Please see the Alliance’s Special Edition Friday Alert of March 23 at http://bit.ly/dttZ01 for more details of the related votes.  The reform phases out the doughnut hole gap in prescription drug coverage, providing a $250 rebate in 2010 for seniors who fall into the hole.  Beginning in 2011, seniors will receive a 50% percent discount on their prescription drugs when they fall into the doughnut hole, and by 2020 the doughnut hole will be completely eliminated.  To see the Alliance’s one-page write-up listing provisions in the health reform law that will affect seniors, along with the time line for their implementation, go to http://bit.ly/9mja6j.  To summarize that document, the new law also:

• Covers preventive services; in 2011, seniors in Medicare will receive free annual check-ups with no co-payments for mammograms, colonoscopies and other preventive screenings;
• Supports early retiree coverage, providing financial assistance to employer health plans that cover early retirees;
• Encourages doctors to coordinate care and improve quality, creating incentives for providers to work together and reduce wasteful care like repeated tests;
• Removes obstacles to changing Part D prescription drug plans, allowing Part D enrollees to make a mid-year change in their enrollment if their plan makes an unexpected change;
• Expands the Medicare Part D low-income subsidy, which will significantly help struggling seniors afford their health care costs;
• Enacts the CLASS Act, creating a new, voluntary long term care insurance plan;
• Enacts the Elder Justice Act, authorizing new criminal background checks on long-term care workers who have access to residents or patients; and
• Eliminates wasteful overpayments to Medicare Advantage plans while creating incentives for coordinated, high quality care across the health care spectrum, extending the solvency of the Medicare Trust Fund by 9 years and improving Medicare for generations to come.

For a listing of which changes take effect immediately, go to http://bit.ly/ag60lc.  In short – in addition to the doughnut hole changes – within the next six months alone, the new law:

• Provides a $5 billion reinsurance fund to help employers who provide health benefits to early retirees ages 55 to 64 (goes into effect in 90 days);
• Eliminates pre-existing conditions for non-dependent children up to age 26;
• Prohibits insurers from placing lifetime limits on coverage;
• Restricts new plans’ annual limits on coverage;
• Provides $5 billion to states to create a high risk insurance pool for those denied insurance due to pre-existing conditions and who have been without insurance for 6 months;
• Prohibits rescission, or dropping coverage, when individuals become sick;
• Creates a public health and wellness fund and requires new private insurance plans to offer preventive services without co-payments;
• Provides up to 35 % tax credits to small business that offer health care coverage; and
• Creates a new and independent health insurance appeals process for consumers

A USA Today/Gallup poll found that 49% of those polled concluded that the passage was “a good thing,” as compared to 40% who concluded its passage was “a bad thing.”  Edward F. Coyle, Executive Director of the Alliance, urged seniors to thank Members of Congress who helped to pass reform with personal visits to their offices during the spring district work period, March 29 – April 9.  “Thank you again to seniors who worked for decades to pass health reform.  Now, let’s give House Members who voted courageously for health care reform in the face of violence some words of appreciation, in person or in writing,” said Mr. Coyle.  To see the video of Alliance member Bob Meeks of Brandon, FL and Mr. Coyle on the importance of closing the Medicare drug doughnut hole, go to http://bit.ly/a3SPUz.

Misinformation has been spread on how the health care reform will affect veterans’ care.  The health care bill provides protections for veterans and the health care they have earned through their service.  President Obama has strongly supported a 16% budget increase in 2010 for the Department of Veterans Affairs, the largest in over 30 years.  “TRICARE, the U.S. Department of Defense’s military health care program, will continue to be available for all eligible servicemen and women, and their families,” said Ruben Burks, Secretary-Treasurer of the Alliance.

Senate, House Pass Final Health Care Reconciliation Bill
The Senate passed the final piece of the health care package on Thursday, 56-43, and sent it back to the House, after Republicans identified two minor violations of reconciliation rules that forced changes to a provision on student loans.  For a tally of that vote, go to http://bit.ly/aFpCZq.   Three Democrats voted against the bill: Sens. Blanche Lincoln and Mark Pryor, both of Arkansas, and Sen. Ben Nelson of Nebraska. In total, 29 Senate amendments were easily rejected, meaning that the health-care package survived essentially intact.  The House approved the Senate’s reconciliation bill later on Thursday, 220-207 ( http://bit.ly/9bDdAG ).

Twelve Days Until the National Convention in Las Vegas
On Monday, April 5, Alliance members will be able to personally thank Senate Majority Leader Harry Reid (D-NV) for shepherding health reform through the Senate.  On that day, Reid will address the Alliance’s 2010 national convention in Las Vegas.  Other speakers will include AFL-CIO Secretary-Treasurer Liz Shuler, Rep. Shelley Berkley (D-NV), and the Honorable Hilda Solis.  The theme for the April 5-8 convention is “Building Retiree Power.”  To register, go to http://bit.ly/1jIzz2 .

Note: Due to Good Friday, the next Friday Alert will be published on Thursday, April 1, 2010.