As Volunteer President of the Maine Association of Area Agencies on Aging, John E. Nale, Esq. was invited to be the keynote speaker at Spectrum Generations' Annual Breakfast. John spoke on the Patient Protection and Affordable Care Act, including the added benefits to all seniors and Medicare recipients. John's comments can be seen below.

"Good morning and thank you. My name is John Nale. I currently serve as Volunteer President of the Maine Association of Area Agencies on Aging.
The Older Americans Act of 1965 created the Administration on Aging as the federal level advocate and coordinator of services for the elderly. Our five Area Agencies on Aging were created as the local-state agencies charged with advocating for Maine's seniors.

Our mission is to improve the quality of life and well-being of Maine's 200,000+ seniors, which includes advocating on behalf of all older persons at the Legislative, administrative, and personal levels. With the help of staff and hundreds of volunteers who gave more than 225,000 volunteer hours of service, the five Area Agencies on Aging have, during the last year:
1. Provided consultation, advice and support to more than 75,000 seniors;
2. Responded to over 100,000 contacts regarding Medicare, Social Security, Caregiver Support, and other senior-related matters;
3. Saved elders hundreds of thousands of dollars by making sure they were taking advantage of the government benefits they were entitled to and helping them obtain appropriate prescription drug coverage and enrolling in Medicare Buy-In Programs;
4. Helped thousands of seniors remain at home with support provided through home- and community-based services programs; and
5. Delivered over 1 million Meals on Wheels to more than 7,500 homebound people.

Patient Protection and Affordable Care Act a/k/a Health Care Reform
The bill was signed into law on March 23, 2010. This date also marked the beginning of two very different processes.

The first is the process that federal agencies and state governments began to prepare the regulatory changes necessary to implement the new law.

The second process, because the Act was enacted without a single Republican vote, the Republicans in Congress and other opponents began working on a parallel process to repeal or challenge the legislation in total or in significant respects. As the minority leader, soon to become majority leader of the House, John Baner said and as quoted in our AARP October Bulletin, "Repealing this bill has to be our number one priority." Although repeal of the bill is not realistic while President Obama is in office, those opposed to the bill could slow the process down by holding hearings, issuing subpoenas, and refusing to fund major provisions of the bill. In other words, if they can't repeal it they'll choke and starve it to death.

Also as stated in the AARP October Bulletin were results of a recent poll showing widespread misunderstanding of what the law actually says. The polls found that more than a third of people 65 and older think it would allow a government panel to make decisions about end-of-life care, known as "death panels", and half think that the bill would cut benefits to everyone on Medicare, when in fact the bill does neither.

I'd like to take this opportunity to give an overview of the bill based on studies put out by the Kaiser Family Foundation, the Journal of Health and Biomedical Law, AARP Journals and Fact Sheets, and many other independent sources.

The bill can be broken down into 2 parts:
1. The first part relates to those of us who are under the age of 65 and requires everyone to purchase health insurance either on their own or through a group policy offered by private employers or a government entity employer.
2. The second part relates to those of us who are over the age of 65 and on Medicare.

The first part that relates to those of us under the age of 65 contains the "individual mandate" provisions that require everyone to obtain health insurance coverage and a "guaranteed issue mandate" provision that requires health insurance companies to issue health insurance policies to all individuals regardless of an individual's past, present or future health status. The idea behind the first part being that by requiring everyone to obtain health insurance coverage there will be more money in the "pot" so-to-speak, thereby spreading the cost among more people and thereby bringing the cost of health insurance down for everyone.
Therefore, the primary focus of the first part of the bill is to require everyone to obtain coverage and to require the insurance companies to provide that coverage.

The second part of the bill focuses on those of us who are over the age of 65 and on Medicare.
The focus here is on better care, less profit for the insurance companies and pharmaceutical companies, and reducing waste, fraud, and abuse within the Medicare system.
The rumor that Medicare benefits will be cut by $500 billion is false. The fact of the matter is that the new health care law improves Medicare benefits by spending more wisely, requiring the health insurance companies and pharmaceutical companies to make less profits, and cracking down on waste, fraud and abuse, thereby resulting in $500 billion in savings over the next 10 years and extending the Medicare program financial stability by an additional 12 years.

The law improves Medicare benefits in the following ways:
1. It protects and guarantees the Medicare benefits that are now in place;
2. It improves and expands Medicare benefits by closing the infamous "donut hole" in prescription drug plans and otherwise lowers out-of-pocket prescription drug costs;
3. It adds a free annual wellness visit coupled with an annual wellness plan coupled with free screenings for diabetes, cancer, and other preventive screenings;
4. It improves access to primary care and provides incentives to hospitals and doctors who provide quality care and penalizes providers for preventable errors;
5. It provides financial help to educate our future doctors and nurses; and
6. It improves long-term care services through several programs that make it easier for elders to receive care in their homes as opposed to nursing homes and assisted living facilities.

The law reduces the profits of insurance companies and pharmaceutical companies by telling the Medicare Advantage insurance companies that payments to them will be reduced and that 85% of what is paid to them must be used for patient care.
It tells the pharmaceutical companies that they will make less profit by requiring them to give 50% discounts on name brand drugs and 7% discount on generic drugs.
The law cracks down on waste, fraud and abuse by establishing 20 strike forces made up of hundreds of FBI agents and agents from the U.S. Department of Health and Human Services that will be deployed around the country to reduce Medicare fraud that at present costs the Medicare program $60 billion per year. So the key points to remember about the new health care law, it:
1. Protects guaranteed Medicare benefits;
2. Improves and expands Medicare-covered benefits;
3. Lowers prescription drug costs;
4. Reduces health insurance and pharmaceutical company profits; and
5. Reduces waste, fraud and abuse.

Admittedly, the law as written is not perfect but it is a major step in the right direction. What we need to do now is support changes to the law that will improve it, not repeal it, not choke it and not starve it to death."