Hector Barreto

Words matter.

“If you like your doctor, you will be able to keep your doctor, period. If you like your healthcare plan, you'll be able to keep your healthcare plan, period,” President Obama said during a speech to the American Medical Association in June 2009.

Honoring your commitments is the cornerstone of trust in our leaders. The American people won’t accept illusions or misdirection’s. That’s why its troubling that because of the Affordable Care Act (ACA) or Obamacare, Medicare will be cut by $1.05 trillion, 6.3 million Americans have lost their healthcare coverage since its implementation and millions more stand to lose Medicare Advantage plans they have grown to rely on.

The future of Medicare is a huge concern for America’s seniors — and rightly so.

Washington and ACA have made deep cuts to the program to the tune of $1.05 trillion over the first 10 years. The largest of these cuts came from reducing Medicare Advantage payments to hospitals and other healthcare providers who give our seniors medical care. Worst of all, these cuts do nothing to prevent Medicare from going bankrupt in the estimated next 12 years. This means our grandparents and parents are experiencing cuts now, and our children cannot count on a program they are already paying into.

Over the years, Medicare Advantage has been the pioneer of quality, value and effective healthcare coordination. It includes 14 million seniors that will be affected across the board, and most heavily in states such as Minnesota, Oregon, Arizona, New York, Florida, Ohio, Texas, California and Nevada.

The Affordable Care Act gutting of Medicare Advantage will reduce America’s families and seniors options and variety of plan choices, decrease access to care, cause less access to physicians, as well as an increase in out of pocket expenses for important services, such as disease management for people with chronic conditions, coordination of care, transportation, pharmacy benefits and on-call nurses available by phone.

The Congressional Budget Office reports that the ACA significantly reduces payments to Medicare Advantage by an estimated $156 billion from 2013 to 2022.This means enrollees would have to register in less generous programs and face increased out-of-pocket costs, while on an average fixed income of about $1,230 a month. The math just doesn’t add up, resulting in seniors having to choose between paying the electric bill or their prescription drugs.

Obamacare’s cuts to Medicare Advantage are similarly diminishing access to services, including hospitals, nursing homes, home health agencies and hospice agencies. In fact, the Medicare Trustees project says that lower Medicare payment rates would cause 15 percent of hospitals, skilled nursing facilities, and home health agencies to become unprofitable by 2019. And although the impact to healthcare businesses will be real, the profound impact will be seniors not accessing medical care.

The Affordable Care Act will also cause injury to diabetics, patients with kidney disease and nerve damage, and especially populations with high diabetic incidence such as Hispanics. These metabolic syndromes, including diabetes, disproportionately affect minorities and socioeconomically challenged patients. By choosing to cut reimbursement for these conditions, the Center for Medicare Services is disadvantaging minorities and people of low socioeconomic status without regard for the associated costs.

Lastly, in order “to rein in spending levels,” the Affordable Care Act made additional cuts to physician reimbursement rates under Medicare. This has caused doctors to leave the program due to the ever-increasing government regulations and habitual uncertainty regarding reimbursement, and forced American families to seek out new physicians.

This is the wrong direction for the future of Medicare and the wrong direction for our grandparents, parents and children. Turning the clock back on Medicare Advantage will adversely affect the most vulnerable in our nation. We can and must do better.

Healthcare reform is a necessity in this nation. Americans expect and deserve quality healthcare with choices and control of their care. However, lawmakers in Washington need to come together now to introduce a workable alternative. We need to have the Centers for Medicare and Medicaid Services implement only the cuts mandated by the ACA and eliminate all other proposed cuts to Medicare Advantage funding. It is essential that we demonstrate that effective self-governance is possible with minimal intrusive regulation by requiring Medicare and other funding sources to contract directly with qualified organizations at no less than 95% of current Medicare Advantage payments; creating private managed care organizations that will be risk-bearing entities; removing state boundaries; reforming malpractice and expanding Health Savings Accounts.

Congress must intervene and stop further cuts to both Medicare and the Medicare Advantage Program. The ACA and arbitrary decisions regarding Medicare Advantage Funding by CMS have put the access and quality of care for seniors at extreme risk. Medicare funding has been raided and our seniors will pay the price of lower quality and reduced access healthcare.

Medicare Advantage has a meaningful value to the elderly of this nation. Senior care in America is at risk because of Obamacare. Therefore, real action is necessary with fundamental, structural reforms that will keep our promise to our grandparents and parents.


Hector Barreto

Hector Barreto is the Chairman of The Latino Coalition and the former US Small Business Administrator.