PREMISE: The law was supposed to help seniors by maintaining access to care through Medicare and creating a new long-term care insurance program.
HOW IT'S WORKING: In reality, the Affordable Care Act uses significant cuts to the Medicare program to pay for other parts of the law. Furthermore, the law puts into place an unelected cost-cutting board called the "Independent Payment Advisory Board" that will continue to cut Medicare payments to doctors into the future.
- The Affordable Care Act cuts $716 billion from Medicare over the years 2013-2024 (Congressional Budget Office).
- In Section 3403 of the law, the Independent Payment Advisory Board (IPAB) is established. This 15-member board is to submit a proposal each year for cuts to Medicare payments. Unless supermajorities in both houses of Congress vote to stop these cuts and replace them with equal cuts, the IPAB proposal automatically becomes law. (Text of the law)
- These cuts endanger seniors' medical care. According to actuaries at the Centers for Medicare and Medicaid Services, if the Affordable Care Act's cuts go into effect, many doctors will close their doors to Medicare patients. By 2050, the actuaries predict that these cuts will make it unaffordable for 40 percent of Medicare providers to continue to see Medicare patients. (CMS report)
HOW IT'S WORKING: On top of these cuts to the Medicare Program, seniors will face a substantially higher tax burden because of the Affordable Care Act.
- There are more than 20 new or higher taxes in the law. (Text of the law)
- Some of these new taxes disproportionately hurt seniors. Because seniors rely on drugs and medical devices more than people of other ages, the increased taxes on drugs and medical devices will hit seniors the hardest. Furthermore, the law changes the tax deductibility of medical expenses from 7.5 to 10 percent of adjusted gross income (starting in 2013). Seniors are exempt from this provision only from 2013 to 2016, meaning this tax deduction will be harder for seniors to take as of 2017.
HOW IT's WORKING: As for the long-term care insurance program that seniors were promised - the "CLASS" Act? It was never implemented.
- The Community Living Assistance Service and Supports program (otherwise known as the CLASS Act) was supposed to be a voluntary long-term care insurance program.
- A forward-thinking Senator put into the law a requirement that the CLASS program be fiscally sound before launching it. (Wall Street Journal)
- Because the government agencies in charge of the new program could not provide a model in which it would operate in a financially sound way, the CLASS Act had to be cancelled. Although the program and its benefits turned out to be another empty promise to seniors, the program itself was originally scored as "savings" for the law, which means it was a helpful accounting gimmick to help get the Affordable Care Act passed. (The Hill)