Puerto Rico Medicare beneficiaries save $110M under ‘Affordable Care Act’

Written by  //  September 24, 2012  //  Government  //  No comments

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Resident Commissioner Pedro Pierluisi

Since its enactment by the federal government in 2010, the Affordable Care Act has already saved more than 45,000 Medicare beneficiaries in Puerto Rico a total of $111.4 million on the cost of prescription drugs, Resident Commissioner Pedro Pierluisi said Sunday.

According to a report released by the U.S. Department of Health and Human Services  in July 2012, the ACA had — at that point in time — saved Puerto Rico Medicare beneficiaries a total of $97.2 million.

“In just the last two months, the total amount that Puerto Rico Medicare beneficiaries have saved on prescription drugs has increased by about $15 million, and now totals $111,427,280. In addition, according to a report released this week by HHS, the average person with original, fee-for-service Medicare will save a total of $5,000 from 2010 to 2022 as a result of the ACA. Medicare beneficiaries with high prescription drug costs will save much more — about $18,000 — over the same time period,” said Pierluisi.

“These savings are extraordinarily impressive, and they are only possible because of the health care reform bill spearheaded by President Obama,” he added.

Since the ACA was enacted, more than 5.5 million seniors and people with disabilities nationwide, including in Puerto Rico, have saved nearly $4.5 billion on prescription drugs as a result of the legislation.

Beneficiaries in the Medicare prescription drug coverage gap known as the “donut hole” have saved an average of $641 in the first eight months of 2012 alone. This includes $195 million in savings on prescriptions for diabetes, over $140 million on drugs to lower cholesterol and blood pressure, and $75 million on cancer drugs so far this year.

In 2010, Medicare beneficiaries who hit the coverage gap or “donut hole” in the Medicare prescription drug benefit received a one-time $250 rebate. In 2011, Medicare beneficiaries began receiving a 50 percent discount on covered brand name drugs and coverage for 7 percent of the cost of generic drugs in the coverage gap.

This year, Part D covers 14 percent of the cost of generic drugs in the coverage gap.  Coverage for both brand name and generic drugs in the gap will continue to increase over time until 2020, when the coverage gap will be closed.

In addition, Pierluisi noted that, during the first eight months of 2012, more than 19 million people with original Medicare received at least one preventive service at no cost to them. And in 2011, an estimated 32.5 million people with original Medicare or Medicare Advantage received one or more preventive benefits free of charge. Prior to 2011, individuals with Medicare had to pay cost sharing for many preventive health services.

Under the Affordable Care Act, many preventive services are offered free of charge to beneficiaries, with no deductible or co-pay.

“The goal — and the priority — is that every individual in Puerto Rico be able to obtain preventive care, so they can stay healthy and treat any medical problems early on,” Pierluisi said. “Prior to the ACA, it was more difficult for individuals to receive the preventive care they need and deserve, because these services were more expensive. Now that this landmark legislation has been enacted, many important preventive services are offered free-of-charge or at low cost to Medicare beneficiaries.”

“Over the last four years, I have fought tirelessly to seek parity for Puerto Rico under federal health programs like Medicare and Medicaid, and we have achieved huge gains. Island residents can already feel the difference, with better services being provided at a lower cost,” Pierluisi added. “I will continue to defend the Affordable Care Act, and the benefits it has delivered to Puerto Rico, in the United States Congress.”

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