WASHINGTON   –  “I voted against the health care bill recently passed in Congress – four times as a matter of fact.  Despite my opposition to the legislation, however, I still feel very strongly that the contents of the bill need to be carefully and factually explained to the millions of Americans affected by its provisions.

Last week, I discussed the major efforts already underway to revise and reform the health care bill.  There are hundreds of ways in which it could be made better and actually slow the rates of increase in health care costs, one of the prime barriers to access in our country.  But this week I would like to take on the components of the bill which will affect Medicare beneficiaries now and in the future.

A great deal of misinformation is floating around about the parts of the bill dealing with Medicare, so let me lay out a few facts in black and white.

The traditional Medicare benefit will not change. 

Medicare Advantage, on the other hand, will change dramatically.  Starting next year, reimbursement rates through the supplemental insurance program will be frozen and then cut in successive years by hundreds of billions.  The cuts will result in a decrease in benefits and limits on care for Medicare Advantage subscribers.

There will be one change to Medicare coverages.  Where previously Medicare paid only for one general check-up when a new beneficiary first entered the program, now Medicare will cover annual wellness visits and increase reimbursements to primary care providers.

Notwithstanding the higher reimbursement rates promised for primary care providers, a 21.3 percent cut is still on the table for Medicare reimbursements across the board.  Finding and keeping a quality primary care provider will get tougher for Medicare patients, especially with 32 million more insured Americans seeking the same doctors for care.  As costs rise in general as a result of the health care law, it is a very good idea for Americans in the Medicare program to establish a strong relationship with their primary physicians right now.  As more doctors limit their Medicare patients, finding good providers who will stick with their patients amid a tougher reimbursement structure will be a major challenge for senior citizens.

The health reform bill also proposes to close the so-called doughnut hole in the Medicare Part D prescription drug program by 2020.  This year, beneficiaries who fall into the doughnut hole (in which they are responsible for 100 percent of their prescription drug costs between $2,700 and $6,154) will get a $250 rebate.  In 2011, Part D beneficiaries will get a 50 percent discount on name-brand drugs.  While this provision is certainly a huge windfall for name-brand pharmaceutical companies, it will also save some beneficiaries on their out-of-pocket drug costs.

Finally, the new law creates an independent advisory board which will recommend future changes to Medicare to prolong the life of the program.  Those recommendations will almost certainly be cuts to the program, so present and future beneficiaries should keep a close eye on this issue along with their federal elected officials.

As I continue to work to lower health care costs and to undo the troubling aspects of this law, Medicare will remain a major focus.  Southern Missouri is home to more Medicare beneficiaries than any other congressional district in the state, a situation complicated by the rural nature of our region.  The strength of Medicare and access to providers has never been a more important issue for all of us.”