Ask Stacy: Will Obama Stop Medicare From Paying for My Cataract Surgery?

I’ve been dealing with consumer questions and complaints for more than 20 years. During that time, I’ve seen the media misinform the public more times than I can count.

In the past this was often done through ignorance, or to line someone’s pockets. These days, however, misinformation is more likely to arise from those with a political ax to grind.

Such is the case with the Affordable Care Act, otherwise known as Obamacare.

Which leads us to this week’s question.

I’ll be signing up for Medicare very soon. Do you know if Medicare will continue to pay for cataract surgery that is recommended by an eye doctor in 2014 and beyond? I heard something about Obama changing this as part of his Obamacare program. Thank you. – Miki

You certainly can’t blame Miki for asking this question. I did a Web search and came up with several sources that would make any reader concerned.

Example: From an editor’s note at Money Morning:

Hip replacements, knee replacements, and cataract surgery will be especially hard to get from Medicare in the months ahead … Which is why you should get some of those procedures done NOW if you can. As President Obama once said to an elderly woman at a town hall meeting: “Maybe you’d be better off not having the surgery and taking a painkiller instead.”

This comment, especially the last sentence, is obviously ridiculous. But like many falsehoods spread online, there’s a kernel of truth behind it.

The Affordable Care Act will reduce payments to doctors and hospitals for the care of Medicare patients. For some who hate the law, this is proof that Medicare patients will soon be getting worse care, or be unable to get some procedures. After all, the logic goes, if you’re trying to treat the same number of people with less money, the result has to be seniors receiving fewer services.

You don’t have to look far to find someone advancing this argument. According to MediaMatters.org, former New York Lt. Gov. Betsy McCaughey said this on Fox News a few weeks ago:

This law [the Affordable Care Act], as written, is designed to vastly expand Medicaid and pay for it by eviscerating Medicare, taking $700 billion out of Medicare and moving it over to fund this expansion of this entitlement. It’s like robbing Grandma to spread the wealth.

McCaughey is one of many arguing that a decline in Medicare reimbursement will result in procedures being eliminated, care being rationed, and health care providers, including hospitals, refusing to take Medicare patients at all.

But that’s likely a gross exaggeration. From FactCheck.org:

As we have written many times, the law does not slash the current Medicare budget by $500 billion. Rather, that’s a $500 billion reduction in the future growth of Medicare over 10 years, or about a 7 percent reduction in growth over the decade. In other words, Medicare spending would continue to rise, just not as much. The law stipulates that guaranteed Medicare benefits won’t be reduced, and it adds some new benefits, such as improved coverage for pharmaceuticals.

In summary, while Miki’s concern is understandable, it’s unfounded. If she needs it, she’ll be able to get cataract surgery under Medicare.

She can read more about the Affordable Care Act and Medicare at this page of Medicare.gov. She might also like to read “Will Obamacare Affect Medicare? Myths and Facts” from U.S. News & World Report.

Because of the sheer volume of misinformation out there about the Affordable Care Act, it’s easy for people like Miki to become confused. So let’s take a step back and see exactly what this law is, and what it isn’t.

What the Affordable Care Act is

The Affordable Care Act is a law designed to make health insurance more available and affordable.

It attempts to accomplish this in five ways: 

  • It expands the Medicaid program so more low-income Americans are covered.
  • It requires insurance companies to cover those with pre-existing conditions, thus allowing more Americans to buy health insurance. 
  • It establishes online marketplaces to promote competition among private insurance companies, hopefully leading to lower prices. (The marketplaces are where people who don’t get affordable insurance through their workplace can buy insurance on their own.)
  • It establishes minimum requirements for health insurance.
  • It requires many of the uninsured to get coverage by using both carrot and stick. The carrot is income-based subsidies for those who buy insurance on the marketplaces. The stick is penalties for those who refuse to buy insurance.

What the Affordable Care Act isn’t

The Affordable Care Act is not a government-run health care plan. By the way, Medicare, which has had relatively few complaints, is a government-run health care plan.

The Affordable Care Act does not provide government health insurance. The health insurance offered on health care exchanges is offered by private companies.

The Affordable Care Act doesn’t ration health care, establish “death panels,” or prevent seniors or anyone else from getting necessary medical procedures. 

The law’s not simple, and it’s not perfect. Whether it will accomplish its objective – to bring more Americans affordable health care – has yet to be seen. So both scrutiny and criticism of this complex law, as well as its execution, are justified.

What’s not justified is frightening senior citizens, or anyone else, with lies designed to do nothing more than advance a political agenda. 

Got a money-related question you’d like answered?

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The questions I’m likeliest to answer are those that will interest other readers. In other words, don’t ask for super-specific advice that applies only to you. And if I don’t get to your question, promise not to hate me. I do my best, but I get a lot more questions than I have time to answer.

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Comments & discussion

We welcome your opinions, but let’s keep it civil. Like many businesses, we reserve the right to refuse service to anyone. In our case, that means those who communicate by name-calling, racism, using words designed to hurt others or generally acting like an uninformed bully. Also, comments that include links to email addresses or commercial websites typically aren't posted. This isn't a place to advertise your business.

  • Camilia Robin

    Could it be though, that Medicare will pay the providers such a low amount that doctors will stop providing the service to Medicare patients?

    • Al Seaver

      Doctors are already refusing to accept Medicare and insurance due to this fiasco of a plan, so the answer to your question is yes.

    • UncleParrothead

      … or require Medicare patients to pay more for the same procedures that are covered today

  • Al Seaver

    How can they say it’s not government run ? If the government is dictating the rules for the insurance companies, it most certainly IS government run. And “healthcare rationing” is the same as “death panels” if you are denied the necessary care to survive due to rationing.

  • Gary

    Wow, Stacy, you’ve bought into this federal over-reach totally. I’d have to guess you are either a democrat or a least a left-leaning independent to believe such non-sense. Although most of the time you give good advice, it sure makes me wonder or question your opinions.

  • ponce

    Couple of things. I haven’t had dental insurance for twenty-five years because it became too expensive. My friend’s daughter and her children do get their dental work paid for, however, because they have a Cadillac “policy”, i.e. Medicaid. Not only that, but my friend gets a mileage reimbursement to take his daughter and grandchildren to the dentist, unless they take a reimbursed cab ride.

    On to Medicare. Had a heart attack thirteen years ago. Every year after that I took a yearly stress test, paid for by my private insurer. Not so last year when I signed up for Medicare. Apparently the good “doctors” in Washington, D.C. don’t feel I need a stress test every year, so now they permit me to have one every two years. Hope my arteries continue to stay free of blockages over the longer duration. This runs counter to the myth of the heartless, “for profit”, insurance companies who give sub-standard care – look no further than Medicare for miserly behavior.

  • Draftdog

    Thank you Mr. Obama, for screwing up one of the only government programs that is really working, and helping low income people. I realize we are the old ones and mostly not Black so not important to you.

  • TeeTime

    I can’t wait for the republican plan to come out. Wait! It’s here already. This is a plan based on the conservative think tank Heritage Foundation’s plan.

    • John Hughes

      The Republican plan: Only the rich get to see doctors. That way they don’t have to wait in line. Just like at amusement parks where they can buy their way to the front.

  • Tricia Campbell

    Wow. You obviously have been too busy drinking the Kool-Aid to follow the news. MILLIONS of people, most of whom were happy with their current healthcare, have now been forced into this program with higher premiums, higher deductibles, and fewer treatment options (i.e., their doctors and/or hospitals are no longer participating). And it IS only going to get worse. According to the government’s own accounting (in the Federal Register back in June or July of 2010), they estimate up to 80% of Americans will lose their current plans.

    I usually like your columns, but now I see that you’re just another partisan hack, defending the indefensible. This plan is neither affordable nor caring, and the best thing we could do is put it on the scrap pile and start over.

  • John Hughes

    This will insight a riot: The Republican plan: Only the rich get to see doctors. That way they don’t have to wait in line. Just like at amusement parks where they can buy their way to the front.