The Affordable Care Act (ACA) helped make preventive care, including recommended cancer screening, more affordable and accessible for millions of Americans. Using population-based data from the Surveillance, Epidemiology, and End Results (SEER) Program, we estimated the impact of ACA policy changes to facilitate the diagnosis of cancer at an earlier and more treatable stage. We estimated that the ACA resulted in an increase of 8,400 (8 percent) diagnoses of early-stage colorectal cancer among US seniors in the period 2011–13. However, the ACA had no distinguishable effect on the number of diagnoses of early-stage breast cancer over the same time period. It is likely that the ACA initially affected the diagnosis of colorectal cancer more than that of breast cancer because the decrease in out-of-pocket spending was larger for colorectal than for breast cancer screening.
Affordable Care Act Changes To Medicare Led To Increased Diagnoses Of Early-Stage Colorectal Cancer Among SeniorsFebruary 1, 2017
Early death after discharge from emergency departments: analysis of national US insurance claims data | The BMJFebruary 1, 2017
In this national analysis, we found that over 10 000 Medicare beneficiaries each year died within seven days after being discharged from emergency departments, despite mean age of 69 and no obvious life limiting illnesses. For context, these deaths accounted for 1.7% of all non-hospice deaths in the Medicare fee for service population annually
Full Repeal of Obamacare Would Hasten Medicare’s Insolvency | Committee for a Responsible Federal BudgetJanuary 7, 2017
Under current law, CBO projects Medicare’s HI, or Part A, trust fund will exhaust its reserve by 2026. By our estimate, full repeal of the ACA would advance that insolvency date to 2021 and more than triple the program’s 10-year deficit. Repealing the ACA’s coverage and tax provisions but retaining its Medicare cuts would advance its insolvency date to 2024 and increase its deficit by half. And either change would significantly worsen Medicare HI’s long-term financial outlook.
What Are the Implications of Repealing the Affordable Care Act for Medicare Spending and Beneficiaries? | The Henry J. Kaiser Family FoundationDecember 14, 2016
This brief explores the implications for Medicare and beneficiaries of repealing Medicare provisions in the ACA. The Congressional Budget Office (CBO) has estimated that full repeal of the ACA would increase Medicare spending by $802 billion from 2016 to 2025.1 Full repeal would increase spending primarily by restoring higher payments to health care providers and Medicare Advantage plans. The increase in Medicare spending would likely lead to higher Medicare premiums, deductibles, and cost sharing for beneficiaries, and accelerate the insolvency of the Medicare Part A trust fund. Policymakers will confront decisions about the Medicare provisions in the ACA in their efforts to repeal and replace the law.
A growing proportion of Medicare beneficiaries are opting out of the government-run insurance program. They are instead choosing a private plan alternative, one of the Medicare Advantage plans. The strength of this trend defies predictions from the Congressional Budget Office, and nobody can fully explain it.
Here’s another mystery. Traditional Medicare spending growth has slowed, bucking historical trends and expectations. Though there are theories, we don’t fully know what’s causing that either.
The passage of Obamacare is perhaps the most important recent example. By CBO’s 2010 estimates, Obamacare authorized $940 billion in new spending to expand insurance coverage over its first ten years. Congress partly offset these costs with provisions for new revenue like the medical-device tax and the so-called “Cadillac tax” on expensive employer-sponsored plans. To make up the remaining difference, it relied on Medicare changes similar to proposals that had been considered previously in the Senate Finance Committee’s earlier draft of the legislation: changes to physician payments, cuts to Medicare Advantage, and new Hospital Insurance revenues. All told, the actuaries credited Obamacare with $575 billion in net Medicare savings — even as those savings were used to paper over the law’s new spending. These ten-year estimates have changed over time, as the law’s schedule did not provide for full implementation until several years into the initial ten-year budget window.
Five years into Medicare spending cuts that were supposed to devastate private Medicare options for older Americans, enrollment in private insurance plans through Medicare has shot up by more than 50 percent, confounding experts and partisans alike and providing possible lessons for the Affordable Care Act’s insurance exchanges.