CHAMPAIGN, Ill. Although the effects of the controversial health care reform act will be somewhat muted for many older Americans, it will inevitably have enough of an impact that seniors will discover that there is plenty to like and dislike about the law, a University of Illinois expert on elder law cautions in published research.
Law professor Richard L. Kaplan says the virtues of the Patient Protection and Affordable Care Act of 2010 are a "mixed bag," and how it will affect any one person depends on that person's specific situation.
"You have to expect some negative aspects to any plan that takes $575 billion out of Medicare, a program that affects primarily older people and the disabled," Kaplan said. "That's invariably going to cut some people's benefits."
Kaplan warns that while some of the touted benefits of the law are real, others come with serious caveats. For example, the much-ballyhooed closing of the "doughnut hole" in Medicare Part D is not as generous as it is usually portrayed.
"First of all, the coverage gap is not 'closed' if you think that means complete coverage," Kaplan said. "What the law does is lower a patient's cost obligation to a 25 percent co-payment from 100 percent. That's a big benefit, but it's not the same as saying that people won't have any cost exposure whatsoever.
"Second, the doughnut hole is closing, but in annual steps over a 10-year period," he said.
"For example, the co-payment for generic drugs is 93 percent this year rather than 100 percent last year."
Kaplan, the Peer and Sarah Pedersen Professor of Law at Illinois, adds that there are some provisions of the law that are unalloyed benefits for seniors. For example, the addition of an annual wellness visit makes Medicare more oriented toward preventative care.
"For many people, when they first get onto Medicare, the initial physical examination may be the first time they've seen a physician in
|Contact: Phil Ciciora|
University of Illinois at Urbana-Champaign