Everyone knows of the controversy generated by the new health care reform Affordable Care Act.  Democrats trumpet the new regulations on health insurance companies: ending pre-existing conditions, banning rescissions, abolishing life-time and annual caps, guaranteeing renewability and establishing cost sharing limits.

Republicans decry the cost of the program, how it explodes the national debt and drives the health care system towards socialized medicine. They fail to recognize that Congressional members, their staffs and eight million government workers already enjoy the benefits of guaranteed health care through the Federal Employee Health Benefits Program, heavily subsidized (approximately 70%) by the US taxpayers.

What neither party will admit, the law discriminates against senior citizens. It provides catastrophic coverage to persons younger than 65, but no such benefit for those older than 65. Beginning in 2014, every U.S. citizen younger than 65 will have his or her annual maximum out-of-pocket costs capped at $5,950 for individuals and $11,900 for families. Persons lose that benefit when they become eligible for Medicare. When senior citizens most need protection against catastrophic health care costs, it is rescinded. Studies by Harvard researchers show that 62% of all personal bankruptcies have a medical cause.  From 1991 to 2007, the bankruptcy rate for persons over 65 has more than doubled.

In 2008, the Congressional Budget Office (CBO) performed a study, designated Health Care Option 81, that showed combining Medicare A&B into a single program, with a $525 annual deductible and a 20 percent co-pay for both Medicare A&B, an annual out-of- pocket cost sharing limit of $5,250 could be implemented with a cost savings of $26 billion over 10 years. The one-time $525 deductible would also replace the current Medicare “A” $1,068 deductible for each hospital stay per year.

Why hasn’t Congress taken action on this seemingly great idea? One reason is Congressional members fear a backlash from seniors over the higher deductible amount. However, most seniors would no longer have to purchase expensive Medicare supplemental insurance, which would actually save them significant expense. Another fear is that monthly premiums might increase. But premium increases could be scaled to match a person’s income as is done for Medicare premiums today, to lessen the impact. The real reason may be that many members of Congress are still bitter over the fall-out from the failed Medicare Catastrophic Act of 1988.

Last month, members of the Rocky Mountain Action Coalition (RMAC) talked with the Washington staff of Wyoming Senator Mike Enzi, ranking Republican on the Senate HELP or Health, Education, Labor and Pensions, committee, to discuss this issue. They stated that Senator Enzi supports Medicare catastrophic cost protections, but several large organizations like AARP are heavily lobbying Congress against it. They would stand to lose much of their Medicare supplemental insurance business if a catastrophic limit were implemented.

Senior citizens will continue to have no protection against catastrophic medical costs unless Congress finds the courage to act on this issue. Rep. Dianna DeGette, House Chief Deputy Whip; Reps. Ed Perlmutter and Jared Polis, members of the House Rules Committee and Sen. Mark Udall, member of the Senate Special Committee on Aging, are the Colorado representatives best positioned to address this problem. They can be contacted through their individual websites or through www.rmac-co.org.  All concerned seniors should contact these Congressional representatives immediately.

Rocky Mountain Action Coalition

John Kotson, Chairman

July, 2010