On Shore with Obamacare: On Board with Medicare- Part A

Jeff Belle

Jeff Belle

By Jeff Belle

The value Americans place on having choices, extending life and ensuring quality of care are critical considerations in how the U. S. health care delivery system meets the needs of its citizens. Failure on part of policymakers to recognize this will result in lack of support for “radical changes” in the health care system—even if its intent is noble. In order to discover new oceans, one has to leave the shore. In 2010, we boarded a new voyage-“ Affordable Care Act” (ACA) with the intent of improving health care for all U. S. citizens. The ship has left shore and headed into deep waters beginning next year (2014). Medicare and Medicaid as we know it today will never look the same beginning 2014. Are we on the right course? Is the U.S. health care system treading into dangerous waters? Have we gone too far to turn the ship around? Is our health care system headed into uncharted territories?

Let’s go on board and look at Medicare-the nation’s health insurance program for Americans 65 and older, and for young adults with permanent disabilities. As the U.S. population grows older, 52 million people currently relying on Medicare will increase drastically. Medicare has four parts, each covering different benefits. Part A-Hospital Insurance (HI) program covers inpatient hospital services, skilled nursing facilities, home health, and hospice care. Part A is funded by a tax of 2.9 percent of earnings paid by employers and workers (1.45 percent each). Obamacare increased the Medicare HI payroll tax from 1.45% to 2.35% for higher-income taxpayers ($200,000/individual and $250,000/couple) and businesses. This tax went into effect last January. Most individuals do not pay a monthly premium for Part A services, but are subject to a deductible before Medicare coverage begins.

Beneficiaries are generally subject to a coinsurance for benefits covered under Part A. Although Medicare Part A imposes tax increases on those earning $200,000 or more and businesses, there is no such thing as a free lunch. In fact, BIG, BIG changes occur in Medicare Parts B, C, & D.

Unlike Part A, Part B deals with outpatient hospital care, physician visits, and other medical services. There are significant changes in Medicare Part B. I will devote next month’s entire column on Medicare Part B. If you think that Medicare changes are confusing, we dare not open the door to Medicaid changes! Now that you have boarded the voyage-ACA, you are well on your way to a new destiny. Today, skies are sunny and blue; however, forecast indicates thunderstorms are ahead and some are even predicting a tsunami over the horizon. One thing that’s certain– you will never see the shores of yesterday’s health care system again.

Source: Center for Medicare and Medicaid Services (CMS).

Jeff Belle is a senior fellow at Institute for Public Policy and Leadership Development. He researches, writes and lectures on health policy and leadership development issues.


One Comment to “On Shore with Obamacare: On Board with Medicare- Part A”

  1. Terence Conklin says:

    This post was a bit heavy on the metaphors. I am a senior and don’t welcome the ACA one bit. When I bought car insurance I was happy to get my “Safe driver discount” and its lower premiums. The ACA lumps everyone together and makes us all pay more. I was happy to be able to shop around and decide what kind and how much insurance I wanted. ACA mandates I buy at least a “Bronze” plan. I want to be in charge of my own health care decisions. ACA and my new insurer will decide for me. I want to decide what care I need to buy. ACA and my insurer will charge me based on what they payout for everyone in the pool plus their operating costs and profit of 18%. In short, I’m sorry I am on the USS “ACA” headed god knows where because I have been forced into buying tickets for half of those aboard. My children (had I had any) should be really pissed off because they will be paying for all us old guys and everyone who cares or doesn’t care about how they live. ACA wasn’t an improvement for health care. It was a scheme to spread the load of our overused health care system (and bills) to the young.

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