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


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When it comes to the Affordable Care Act, political agendas have led to so much misinformation, it's hard to know what to believe.

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?

You can ask a question simply by hitting “reply” to our email newsletter. If you’re not subscribed, fix that right now by clicking here.

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.

Got any words of wisdom you can offer for this week’s question? Share your knowledge and experiences on our Facebook page.

Stacy Johnson

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