What do U.S. seniors lose if Affordable Care Act is repealed?

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While millions of people in the United States will lose access to health insurance in 2014 should the Affordable Care Act be struck down by the Supreme Court, seniors stand to lose significant benefits already in place by the health reform law.

PBS Newshour reports 49 million Medicare beneficiaries will see benefits such as prescriptions savings and preventative screening services vanish if an unfavorable ruling is held by the Court.

U.S. Hispanic seniors

49 million Medicare beneficiaries will see benefits such as prescriptions savings and preventative screening services vanish if a ruling against the Affordable Care Act is held by the Court.

Should the ACA be repealed, seniors stand to lose:

  • Annual wellness visits with no copay or deductible, geared toward assessing health risks and developing personalized prevention plans.
  • Preventative screenings such as mammograms and colonoscopies, also with no copays or deductibles.
  • Prescription assistance programs designed to provide 50 percent discounts on name-brand drugs. The ACA plans to provide full prescription coverage to seniors by the year 2020.
  • The ability to choose a doctor without insurance plan restrictions.
  • A guarantee that Medicare-covered benefits won’t be reduced or taken away.
  • An extension of the Medicare Hospital Insurance Trust fund, one of two funds used to finance Medicare benefits.

Of the benefits slated to be lost, prescription coverage has been one of the most praised, with USA Today reporting 4 million seniors saved approximately $2.16 billion through prescription discounts in 2011.

Seniors in the U.S.

The coverage assistance allowed more seniors access to the medications needed, thus resulting in fewer cases requiring hospital stays.

The coverage assistance allowed more seniors access to the medications needed, thus resulting in fewer cases requiring hospital stays, related to asthma attacks, heart attacks and low blood sugar, says Jonathan Blum, director of the Center for Medicare.

“Before [the ACA], many beneficiaries were forced to stop taking the drugs,” he said. “[The discount] is a very popular part of the Affordable Care Act. It’s targeted to those most in need.”

While prescription coverage is important to many seniors, the benefit wouldn’t be available indefinitely without another provision of the ACA extending the life of the Medicare trust fund. This fund, to which citizens pay a certain amount from their income annually, is extended under the ACA because the health reform law enables a crackdown on fraud, abuse and wasteful spending. Without the ACA, the Medicare fund would become insolvent around the year 2017.

By reducing spending in other areas of Medicare, the health reform law was able to extend the life of the program to the dismay of ACA opposers, who claim shifting monies hurt seniors instead of helping them (by allocating funds once meant only for seniors to coverage plans aimed at those under age 65.)

Senior's health in the U.S.

If the Affordable Care Act is repealed, seniors in the U.S. will likely lose benefits. (Shutterstock photos)

But the biggest Medicare savings actually come from reduced payments to hospitals and other medical providers, as well as reduced payments to HMO and PPO policy holders who were currently receiving more Medicare funds than those in the traditional program. This attempt at equalizing the payment scales accounted for most of the Medicare cuts, not the shifting of money toward a larger pool of healthier people.

“If the law is struck down, there will be a high level of chaos and confusion the very next day, especially in Medicare,” said to Reuters Bonnie Washington, senior vice president of Avalere Health, a health policy consulting firm. “Every single provider payment that Medicare makes now has been modified one way or the other by the Affordable Care Act.”

Forty-nine million people over the age of 65 or disabled will be affected one way or the other by the Supreme Court’s decision.

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