It has been a central campaign promise from Mitt Romney: His Medicare overhaul plan would not touch benefits for anyone older than 55.
That may not, however, be the case with the Republican presidential nominee’s other health-care proposals. A growing body of research suggests that his plans to repeal the Affordable Care Act and cut Medicaid funding would have a direct impact on the health care that seniors receive.
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Repealing the health law would mean higher Medicare premiums, the Kaiser Family Foundation found in a recent analysis. Wellness visits and prescription drugs also would cost more. Although under the current law, reductions in doctor payments could create an access issue.
The impact could be greatest for the lowest-income seniors, who qualify for both the Medicare and Medicaid programs, and there could be a significant slowdown in federal funds available for their care.
The health-care law cuts $716 billion in Medicare spending, largely by reducing how much insurers and health-care providers get paid to manage seniors’ care. Since Medicare beneficiaries pay a percentage of the program’s overall budget, lower spending means lower premiums.
“If the Medicare savings are repealed, and the benefit enhancements are repealed, there’s a direct effect on seniors today,” said Tricia Neuman, director of the Kaiser Family Foundation’s Medicare Policy Project.
Health and Human Services estimates that Medicare beneficiaries paid $94 less out-of-pocket for hospital and doctor coverage this year than they would have without the health-care law. That number will rise to $572 in 2021 as the Medicare cuts grow larger.
“An expected slower rate of growth in Medicare spending leads to a slower rate of growth in beneficiary out-of-pocket payments,” the February 2012 research brief concluded.
About 5 percent of seniors would see some premiums increase, as the Affordable Care Act expands an income-related premium for anyone earning more than $85,000.
Overall, though, analysts say that out-of-pocket spending by seniors would increase if the Affordable Care Act is repealed. “On average, spending for seniors would rise because their premiums would rise,” Neuman said.
The Romney campaign says that seniors spending less would also get less: Cutting Medicare’s reimbursement rates for hospitals and doctors could force them to try to do more with fewer resources.
“There’s not enough efficiency they can wring out of the system,” said Oren Cass, domestic policy director for the Romney campaign. “What’s actually going to happen is that seniors are going to see an erosion in the quality of care and the quality of services.”
The Office of the Medicare Actuary noted in May that certain health law cuts to doctor reimbursements could cause payment rates to “become inadequate in the long range.”
Repealing the health law also would have an impact on Medicare’s “doughnut hole,” the gap between Medicare’s regular and catastrophic drug coverage, in which seniors are responsible for footing the bill. The average senior who falls into this space spends $604 on prescription drugs.
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