This week, my mother turns 97 and the Affordable Care Act turns one. I am 70.
If the polls are to be believed, Mom and I are exceptions in our age group because we support the new health reform law. That’s a triumph of fear over fact — and it’s terribly sad.
Women age 65 and older have plenty to worry about already: our families’ health and happiness; the schools and communities our children and grandchildren will inherit; the value of our homes; the security of our retirement savings; and, of course, the health care that we — and those we love — can access and afford.
The federal health law will eliminate many of our worries about cost, quality and continuity of health care. But that truth is being drowned out by fear-mongering talk-radio hosts and lawmakers with political agendas who get in the way of the best interests of their constituents.
How will the measure help? My mother takes four prescription medicines: one to prevent osteoporosis, one to lower cholesterol and two to control blood pressure. She gladly pays her Medicare Part D insurance premiums and her medication co-pays — until June, when she falls into that prescription drug coverage gap called the “doughnut hole.” At that point, her medications start costing her $400 per month.
Mom isn’t alone. Each year, about 16 percent of Medicare beneficiaries reach the doughnut hole. Drugs associated with three conditions — diabetes, Alzheimer’s disease and being female — often tally the costs that land them there.
My mother is lucky. When she hits the doughnut hole, she doesn’t have to take her meds every other day, or choose between medicine and groceries. But many older women aren’t as fortunate.
The health law already has begun plugging the prescription drug coverage gap. Thanks to the overhaul, last year those who fell into the doughnut hole got a $250 rebate, and this year they’ll get 50 percent off brand name drugs once they reach the gap. By 2020, it will close the doughnut hole entirely.
How else is this measure helping older women? By making our coverage more secure. Most older women have chronic conditions such as high blood pressure, diabetes, heart disease or osteoporosis. Many of us have more than one chronic condition. For women approaching 65 who aren’t yet eligible for Medicare, the reforms make it illegal for insurers to deny coverage if these women have pre-existing conditions — a practice that was commonplace, and devastating, before this law was enacted.
How else? By making preventive services affordable. Mom and I faithfully get annual check-ups and other tests when we need them. For me, these include mammograms and cervical cancer screenings. But many older women skip or delay those life-saving steps because they can’t afford to pay part of the cost. Beginning this year, the health law requires Medicare and other insurers to cover those basic preventive services without cost-sharing requirements, such as co-pays, co-insurance and deductibles.
The ACA also helps older women and their families by closing the lifetime dollar limit on private insurance coverage. Years ago, my family watched dear friends suffer when a child became gravely ill. Our friends had to deal not just with the fear and trauma that comes with having a child in peril, but also with insurance coverage limits and then loss — and, as a result, economic instability that changed the trajectory of their lives. Beginning this year, the overhaul bans insurers from imposing lifetime dollar limits on coverage. It’s about time.
And the health law is helping all women by prohibiting insurers from charging women more than men for the same coverage. That gender penalty was a disgrace, and it cost women dearly every year of their lives. Good riddance!
When I was young, there was no Medicare. When Congress established it in 1965, I remember the response. Near-hysteria, it seemed. Fear-mongers called it “socialized medicine” and confidently predicted the end of a functional health care system.
Today, there is near-universal agreement among seniors that it has improved health care quality and access. It has worked, over time, because we gave it a chance and we gave it time.
I’ve been an advocate, and an observer, for decades now. I can honestly say that rarely have I seen messaging as cynical and destructive as that designed to undermine health reform.
So I say to the fear-mongers: Enough! Stop using distortions and scare tactics to target my generation, my peers and my friends.
And I say to my peers: Let’s be more discerning. Let’s separate fact from fiction and set an example with clear-eyed analysis. We saw the hysteria when Medicare was put into place, and today most of us recognize it as a lifeline. Let’s apply those lessons, and help build a health care system that works for us, our children and our grandchildren. That would be a legacy to make us proud. On my mom’s 97th birthday, I had one wish: more time in happiness and good health. For the health law’s first anniversary, my wish is much the same: that Americans grant the time this law needs to prove its worth. Seniors should lead the way.
Judith L. Lichtman is senior advisor and former president of the National Partnership for Women & Families.