Knoxville Roundtable with Seniors on the Donut Hole

KNOXVILLE SENIORS HOLD ROUNDTABLE DISCUSSION ON THE CRITICAL IMPLICATIONS OF THE MEDICARE “DONUT HOLE” IF CONGRESS REPEALS THE AFFORDABLE CARE ACT WITHOUT A REPLACEMENT

Hundreds of thousands of Tennessee seniors are currently benefiting from the Affordable Care Act, including lower costs for prescription drugs and free preventative services. Repeal of the Affordable Care Act Will Creates Chaos, Raise Costs And Limit Protections for Seniors

Knoxville, TN — Knoxville senior citizens gathered today, December 29th to discuss the devastating implications to those on Medicare if the Affordable Care Act is repealed without a replacement.  Local seniors shared how they are benefiting from the Affordable Care Act’s protections for seniors, as well as how closing of the “donut hole” has benefitted them and just how devastating it will be to their families if ACA is repealed without a replacement.

Mary Linda Schwarzbart, an active Knoxville community member,  shared

“Thanks to the ACA, we paid 11% less in 2014 than 2013 for our Medicare premiums and saved almost $900 on prescription costs.”  At that time, they found themselves in the “donut hole” as early as June.

Linda Haney, told the group that

“If it hadn’t been for the ACA, I don’t know how we would have payed for my husband Dan’s insulin. We were in the donut hole by April. We saved $3,000 last year and will save at least $2,000 this year.”

She went on to explain that because of the ACA, they only have to pay $700 of the cost of Dan’s insulin, without the ACA, they would be required to pay almost $1,700.

Richard Henighan, a family nurse practitioner from Sevier County, pointed out that

“If you are in the donut hole now, you are paying only 45% of brand name drugs. If we repeal the ACA, we are looking at paying 100% for that same drug.”

The Congressional Budget Office has estimated repeal would lead to higher Medicare premiums, deductibles, and cost sharing for beneficiaries, while accelerating the insolvency of the Medicare Part A trust fund.  Before the Affordable Care Act, when beneficiaries fell into the ‘donut hole’, they had to pay 100% of costs for their prescriptions. The ACA provides drug discounts and subsidies to help fill in the donut hole, completely filling it in by 2020.   If the Affordable Care Act is repealed without a replacement protections for seniors that make prescription drugs more affordable and often offer free preventative care would all go away.  

Knoxville seniors are calling on Senator Alexander and Senator Corker to oppose the irresponsible move by Republicans to repeal the Affordable Care Act without a replacement, a decision that would rip away from Tennessee seniors access to prescription drug discounts and free preventative care.

WHAT’S AT STAKE FOR TENNESSEANS?

  • 526,000 Tennesseans would lose health coverage, a 79 percent increase in the number of uninsured. [Urban Institute]
  • Tennesseans would lose $10.777 billion in federal financial assistance through the insurance marketplaces from 2019-2028, leading to a dramatic spike in the number of uninsured. [Urban Institute]
  • 203,112 Tennesseans would lose an average monthly advanced premium tax credit of $299 which currently helps them pay for insurance. [Kaiser Family Foundation]
  • Tennessee would lose $15.9 billion in federal Medicaid or Children’s Health Insurance Program (CHIP) funding, currently providing lifelines to 1,624,284 Tennesseans. [Urban Institute, Kaiser Family Foundation]

The Affordable Care Act and Medicare: 55 Million Americans are covered by Medicare. The ACA strengthened the Medicare Trust Fund, extending its life by over a decade. In addition, Medicare enrollees have benefited from:

  • Lower costs for prescription drugs: Because the ACA is closing the prescription drug donut hole, more than 11 million Medicare beneficiaries saved more than $23 billion total, an average of more than $2,000 per beneficiary.
  • Free preventive services: The ACA added coverage of an annual wellness visit and eliminated cost-sharing for recommended preventive services such as cancer screenings. In 2015, 26 millionseniors, or 73 percent of all seniors enrolled in Medicare Part B, took advantage of at least one free preventive service.
  • Fewer hospital mistakes: The ACA introduced new incentives for hospitals to avoid preventable patient harms and avoidable readmissions. Hospital readmissions for Medicare beneficiaries dropped 8 percent, which translates into 565,000 times Medicare beneficiaries have avoided an unnecessary return to the hospital since 2010.
  • More coordinated care: The ACA encouraged groups of doctors, hospitals, and other health care providers to come together to provide coordinated high-quality care to the Medicare patients they serve. Accountable Care Organizations now offer 8.9 million Medicare beneficiaries higher quality, more coordinated care.

ABOUT THE ALLIANCE FOR HEALTH SECURITY COALITION
The Alliance for Healthcare Security includes 1199SEIU United Healthcare Workers East, Alliance for Retired Americans, American Medical Student Association, American Medical Women’s Association, Center for Medicare Advocacy, Inc., Community Catalyst, Doctors for America, Families USA, Medicare Rights Center, National Medical Association, National Partnership for Women and Families, National Physicians Alliance, Network for Patient Advocacy, Physicians for a National Health Program, Physicians for Social Responsibility, Service Employees International Union, and the United Spinal Association. More information may be found at CareNotChaos.org.