Impact of health care reform on medicare and dual medicare-medicaid beneficiaries

Abstract

The Affordable Care Act (ACA) HR 4972 (Public Law 111-148 and 111-152) contains a broad sweeping set of health care reforms that will move our country toward universal insurance coverage, change how Medicare and Medicaid pay for services, and infuse a new focus on wellness and care coordination into our previously reactive health care system. Each of these reforms will have important implications for patients with cancer, both those who have been diagnosed as well as those who have yet to be diagnosed. This article provides a brief overview of how some of the key changes included in the ACA will affect Medicare patients and those dually eligible for the Medicaid program. We focus on Medicare in particular because individuals 65 years or older make up only 12% of the U.S. population, but account for more than half of all cancer patients. The ACA will also have important impacts for cancer patients without health insurance-nearly 10% of all cancer patients-as we move toward universal coverage that does not discriminate against individuals with pre-existing conditions. Changes in the ACA that will affect access to and payment for cancer care among Medicare and dually eligible patients are outlined in this article.