Dismantling the ACA Would Harm Medicare and Medicare Beneficiaries | Highlight on Preventive Services

The Supreme Court will review the constitutionality of the Affordable Care Act (ACA) this term in California v. Texas, with oral argument scheduled for November 10, 2020. This ongoing litigation challenges the ACA’s individual mandate, but raises questions about the entire law’s survival, and could result in dismantling the entire ACA.

While the ACA’s changes to the individual insurance market and its expansion of Medicaid have been the focus of much media coverage, the law has affected every part of the health care system, including Medicare. The ACA is woven into Medicare, including over 165 provisions that help beneficiaries and strengthen the program’s financial well-being. Striking down the ACA would have disastrous ramifications for Medicare beneficiaries and the U.S. health care system as a whole. In a series of CMA Alerts leading up to the Supreme Court oral argument, the Center will highlight some of the harms undoing the ACA would bring to Medicare and Medicare beneficiaries.

The ACA eliminated Medicare beneficiary cost-sharing (e.g., copayments or coinsurance amounts) for many life-saving preventive services. Because of this, 62 million people have access to free preventive services. Some of these screening services include bone mass measurement for those with osteoporosis, depression screening, diabetes screening, heart disease screening, obesity screening and counseling, and free annual wellness visits. The annual wellness visit differs from the Welcome to Medicare visit in that it can takes place yearly, instead of just once upon entering the program. The annual wellness visit can include many preventive services that Medicare previously did not cover. If the Supreme Court strikes down the ACA, then these important life-saving screening services would no longer be available for free for Medicare beneficiaries.

The Center for Medicare Advocacy strongly opposes dismantling the ACA.  On May 13, 2020 the Center joined AARP and Justice in Aging in submitting an amicus brief in support of California and the other states defending the law. The amicus brief highlights the ACA’s key protections for older adults and the devastating consequences that would ensue if the law is nullified.

Additional Resources:

• Kaiser Family Foundation Analysis (updated September 2020): https://www.kff.org/health-reform/issue-brief/potential-impact-of-california-v-texas-decision-on-key-provisions-of-the-affordable-care-act/#medicare
• Medicare Rights Center and National Council on Aging Infographic (2019): https://d2mkcg26uvg1cz.cloudfront.net/wp-content/uploads/Medicare-covered-preventive-services.pdf
• Center explanation of ACA’s expansion of Medicare coverage of preventive benefits (September 2010): https://medicareadvocacy.org/affordable-care-act-expands-medicare-coverage-for-prevention-and-wellness/
• Center statement concerning the fate of the ACA in light of Supreme Court nomination hearings (October 2020): https://medicareadvocacy.org/supreme-court-nomination-could-have-devastating-consequences-for-the-affordable-care-act-and-medicare/