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This week President Obama signed into law H.R. 3590, the Patient Protection and Affordability Care Act.  This is the first of two important pieces of legislation passed by the House of Representatives on Sunday, March 21, that will provide access to health insurance for virtually all Americans. 

The second bill passed by the House, the Health Care and Education Affordability Reconciliation Act of 2010, H.R. 4872, is a reconciliation measure that makes important changes to the new health care reform law as well as changes to federal student loan provisions. Once this bill is passed in the same form by the Senate and the House, it, too, will go to President Obama for his signature.  The Senate passed the reconciliation measure with minor changes today, March 25, by a vote of 56-43. The legislation will now return to the House to be voted on again.  Steny Hoyer (D. MD.), House Majority Leader, has stated that he expects the House to vote on the bill again later today.

Regardless of the procedural technicalities, it is important to remember that health care reform legislation is now law.

In the coming weeks the Center will provide detailed analysis of many of the provisions that affect Medicare beneficiaries and low-income individuals.  We want to remind you of some of the important changes:

The Patient Protection and Affordability Care Act advances the goal of protecting the existence of Medicare.  It strengthens Medicare's guaranteed benefits and extends the life of the Part A Trust Fund by 9 years.  Because the law produces savings from Medicare, some are concerned that benefits will be cut and the program weakened.   The opposite is true. Not a single guaranteed benefit in Medicare is cut and, in fact, benefits are improved. Reducing payments to private Medicare Advantage plans means beneficiaries and taxpayers will no longer be subsidizing those plans at the expense of traditional Medicare, which is used by 75 percent of beneficiaries. 

Provisions of the law will slow the growth of Medicare premiums and out-of-pocket costs, improve beneficiaries' access to preventive benefits by eliminating cost-sharing for them and start to close the gap in prescription drug coverage known as the donut hole.  Medicare beneficiaries who reach the donut hole in 2010 will receive a $250 rebate.  Medicare will begin covering an annual physical in 2011. The law also strengthens provisions that prevent discrimination in benefit structures by Medicare Advantage plans, changes the way that Part D benchmark plans are calculated, and changes the time period for enrolling in Part C and Part D plans.

Moreover, the law promotes delivery system reforms to encourage high quality, coordinated health care.  These changes are particularly important for beneficiaries who have chronic conditions – as do nearly all Medicare beneficiaries. 

Other provisions will improve access to long-term supports and services and expand Medicaid coverage to, among others, people with disabilities who must still wait two years to be eligible for Medicare.   One provision eliminates cost-sharing for prescriptions drugs for people who are eligible for both Medicare and Medicaid, who need a skilled level of care, but who reside in the community under a state waiver program.

Enactment of the Patient Protection and Affordable Care Act is an important step in protecting Medicare for older people and people with disabilities, and toward ensuring that the rest of America has the same guaranteed right to health care as enjoyed by Medicare beneficiaries for the past 45 years.