Sebelius Touts Benefits, Savings of ACA Ahead of Third Anniversary

Since its enactment three years ago, the Affordable Care Act has helped Medicare beneficiaries save more than $6.1 billion on their prescription medications because of discounts offered to those who reach the Medicare Part D "doughnut hole," HHS Secretary Kathleen Sebelius announced Thursday, The Hill's "Healthwatch" reports (Viebeck, "Healthwatch," The Hill, 3/21).

Prior to the ACA, Medicare Part D beneficiaries paid 25% of the cost of their drugs until the total bill reached $2,830. Beneficiaries then paid the full cost of drugs until their total out-of-pocket spending reached $4,550, the gap in coverage known as the doughnut hole.

The ACA called for Medicare beneficiaries in 2010 to receive one-time, $250 rebates when they reached the doughnut hole. In 2011, the rebate was replaced by a 50% discount on brand-name drugs. The discount will increase gradually until 2020, when the coverage gap will be closed (California Healthline, 12/5/12).

Sebelius noted that in 2013, the discounts will increase to 53% for brand-name drugs and to 21% for generic medications. "By making prescription drugs more affordable, the [ACA] is improving and promoting the best care for people with Medicare," she said (Viebeck, "Healthwatch," The Hill, 3/21).

During an interview Thursday on MSNBC's "Morning Joe," Sebelius also noted that the ACA is helping consumers get a "better bang for their buck" because the law is helping to decelerate premium rate increases and ensuring that insurers are spending those dollars on consumers' health benefits, Politico reports.

Sebelius said, "We have seen far fewer double-digit increases in the last three years than in the previous decade," adding, "And more insurance commissioners … are really reviewing those rates carefully [and] are rejecting the double-digit increases."

For example, California's insurance commissioner is challenging premium rate hikes of more than 20%, which insurers have blamed on a health insurance fee that is scheduled to take effect in 2014, Politico reports (Robillard, Politico, 3/21).

Sebelius also cited several key ACA provisions that are scheduled to take effect in 2014 that will help further increase savings. She acknowledged that "there's still some misunderstanding" about the law and touted the benefits of the ACA's insurance exchanges.

"For the first time ever, people who are uninsured because of cost, and a lot of people who are buying insurance on their own and a lot of small-business owners will finally be part of insurance plans that have to compete side by side" (Baker, "Healthwatch," The Hill, 3/21).