FYI, Eric
________________________________
From: Medicare Watch <medicarewatch@xxxxxxxxxxxxxxxxxx>
Sent: Thursday, June 17, 2021 5:34 PM
To: ericprussell@xxxxxxxxxxx <ericprussell@xxxxxxxxxxx>
Subject: Supreme Court Dismisses Latest Challenge to the Affordable Care Act
Today, the U.S. Supreme Court once again upheld the Affordable Care Act (ACA)
as the law of the land.
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Developed by the Medicare Rights
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Medicare Watch is a weekly newsletter providing Medicare news and policy
developments, as well as useful Medicare reminders.
June 17, 2021 | Volume 12, Issue 24
Supreme Court Dismisses Latest Challenge to the Affordable Care Act
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<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fmedicarerights.us15.list-manage.com%2Ftrack%2Fclick%3Fu%3D1621f54a596f3717c22815356%26id%3D22b60a0343%26e%3Dda4d728a95&data=04%7C01%7C%7C7e1d00e600514409687808d931d7a399%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637595624503219997%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=5qATpeLdcDofmiTAPucvKJDA4SEe1fwU%2F4NzbNv6J9g%3D&reserved=0>
Today, the U.S. Supreme Court once again upheld the Affordable Care
Act<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fmedicarerights.us15.list-manage.com%2Ftrack%2Fclick%3Fu%3D1621f54a596f3717c22815356%26id%3D1c8137c93c%26e%3Dda4d728a95&data=04%7C01%7C%7C7e1d00e600514409687808d931d7a399%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637595624503219997%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=RX6cDSvIjQuxsWb0D8D6HBBsiAzSLwb4IriciDKmg1E%3D&reserved=0>
(ACA) as the law of the land, determining that the plaintiffs in California v.
Texas<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fmedicarerights.us15.list-manage.com%2Ftrack%2Fclick%3Fu%3D1621f54a596f3717c22815356%26id%3D6221974f63%26e%3Dda4d728a95&data=04%7C01%7C%7C7e1d00e600514409687808d931d7a399%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637595624503229989%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=mG2uQs03R%2FIGYWduFqMWEbcKcjQrRhcPvPQOqz6o0os%3D&reserved=0>
lacked standing to sue. Lack of standing means that the plaintiffs could not
show that they were harmed by the law they were challenging, which bars any
ability to sue in federal court.
From the beginning, many experts and observers dismissed the lawsuit as
frivolous<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fmedicarerights.us15.list-manage.com%2Ftrack%2Fclick%3Fu%3D1621f54a596f3717c22815356%26id%3D06fa13d629%26e%3Dda4d728a95&data=04%7C01%7C%7C7e1d00e600514409687808d931d7a399%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637595624503239981%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=j8mQxcjR0%2BKhbYMVsrjj4ZCiLyMIiHA0BSgbOu37llY%3D&reserved=0>
and inconsistent with settled
law<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fmedicarerights.us15.list-manage.com%2Ftrack%2Fclick%3Fu%3D1621f54a596f3717c22815356%26id%3Da55542598d%26e%3Dda4d728a95&data=04%7C01%7C%7C7e1d00e600514409687808d931d7a399%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637595624503239981%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=dXOyg6gYeeU05A9dhAqr%2FgBtBbrgXXt5nhHn6IS%2B6t4%3D&reserved=0>.
Despite this widely held belief, the case progressed through federal
court<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fmedicarerights.us15.list-manage.com%2Ftrack%2Fclick%3Fu%3D1621f54a596f3717c22815356%26id%3D325bffbcdd%26e%3Dda4d728a95&data=04%7C01%7C%7C7e1d00e600514409687808d931d7a399%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637595624503249975%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=%2BX5zKm8GFO60KSeJZRNC%2BKf7WS0Rdkrp8omCEJuu1Ew%3D&reserved=0>,
and the Trump administration, instead of defending the law, wholly embraced
the poor legal
reasoning<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fmedicarerights.us15.list-manage.com%2Ftrack%2Fclick%3Fu%3D1621f54a596f3717c22815356%26id%3D08a02dd991%26e%3Dda4d728a95&data=04%7C01%7C%7C7e1d00e600514409687808d931d7a399%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637595624503249975%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=ymuvNNGI75z7vSHs0Txac3%2FmqA0%2FSg%2ByPBLtNOn5bbs%3D&reserved=0>
and attacked the law in court.
Read
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AARP Report Highlights Increase in Retail Prices for Brand Name Prescription
Drugs
[https://mcusercontent.com/1621f54a596f3717c22815356/images/2c78d174-7207-44ae-b69d-b61838762251.png]
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An updated
report<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fmedicarerights.us15.list-manage.com%2Ftrack%2Fclick%3Fu%3D1621f54a596f3717c22815356%26id%3D938388fb53%26e%3Dda4d728a95&data=04%7C01%7C%7C7e1d00e600514409687808d931d7a399%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637595624503269962%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=QTY7Y8QW2hAQ98BAQkgLZyHXnOKCpaI4HfJzlc%2FEY14%3D&reserved=0>
from the AARP Public Policy Institute shows the growth in retail prices for
many brand name prescription drugs continues to significantly outpace general
inflation, contributing to problems with prescription drug affordability for
people with Medicare.
From 2019 to 2020, retail prices for 260 brand name drugs widely used by older
adults grew by 2.9%, more than twice the country’s general inflation rate
(1.3%). Over the last 16 years, the entire period during which AARP has been
publishing this report series, brand name drug prices have routinely increased
much faster than general inflation.
These price changes have meaningful consequences for people with Medicare. In
2020, the typical cost of a brand name medication was $6,600. With older adults
taking an average 4.7 prescription drugs every month, this translates to an
annual retail cost of more than $31,000—higher than the median annual income
for a Medicare beneficiary ($29,650).
Read
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Spotlight
In Case You Missed It
Medicare Minute: Original Medicare and Medicare Advantage
Appeals<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fmedicarerights.us15.list-manage.com%2Ftrack%2Fclick%3Fu%3D1621f54a596f3717c22815356%26id%3D3470de3f35%26e%3Dda4d728a95&data=04%7C01%7C%7C7e1d00e600514409687808d931d7a399%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637595624503279959%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=WtezRP7p8BRyK%2Blh7xMi28BvjwUJuUxRQaVgYT0wZwQ%3D&reserved=0>
Recording Available Now
If Original Medicare or your Medicare Advantage Plan denies coverage for a
health care item or service you receive, you have the right to appeal the
decision. In this Medicare Minute, you'll learn about how to read appeal
notices and begin an appeal with Original Medicare or your Medicare Advantage
Plan.
Visit Medicare
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to access the recording of today's presentation as well as an archive of all
the presentations given so far this year.
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Medicare Reminder
If you have Extra
Help<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fmedicarerights.us15.list-manage.com%2Ftrack%2Fclick%3Fu%3D1621f54a596f3717c22815356%26id%3D2055c7828e%26e%3Dda4d728a95&data=04%7C01%7C%7C7e1d00e600514409687808d931d7a399%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637595624503289954%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=0UNKvFDfg5siC9dlbE9lMemqC7bGViYTL39AOTijhfY%3D&reserved=0>,
throughout the year you will pay either the Extra Help copayment or your
plan’s copay for your prescription drugs. You always pay the lower cost between
the two. Note that plan copays for prescriptions may change during the year,
meaning at times the price for your prescription drugs may differ.
Example: Mr. S has full Extra Help and a monthly income above $1,094, so his
Extra Help copays are $3.70 for generics and $9.20 for brand-name drugs.
However, his plan copay for his generics is $1.35. Mr. S will therefore pay the
plan copay of $1.35 because it is cheaper than the Extra Help copay of $3.70.
If Mr. S had full Extra Help and a monthly income below $1,094, his copays
would be $1.30 for generics and $4.00 for brand-name drugs, making his generic
Extra Help copay less costly than the plan copay of $1.35. This means that Mr.
S would pay the Extra Help copay throughout the year. If Mr. S had partial
Extra Help, he would pay a 15% coinsurance for his prescription drugs or his
plan’s standard copay.
Your out-of-pocket costs also change when you reach catastrophic
coverage<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fmedicarerights.us15.list-manage.com%2Ftrack%2Fclick%3Fu%3D1621f54a596f3717c22815356%26id%3D634182c641%26e%3Dda4d728a95&data=04%7C01%7C%7C7e1d00e600514409687808d931d7a399%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637595624503299948%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=EKxaAUAxwwjMLBh4LhVbBm3HVuZ%2BdOaY7Bajmlt25T8%3D&reserved=0>
($6,550 out of pocket in 2021). Those with full Extra Help who reach
catastrophic coverage generally will pay nothing for covered drugs for the
remainder of the calendar year. Those with partial Extra Help will pay $3.70
for generic drugs and $9.20 for brand-name drugs for the remainder of the
calendar year.
Visit Medicare Interactive to learn more about the Extra Help
program.<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fmedicarerights.us15.list-manage.com%2Ftrack%2Fclick%3Fu%3D1621f54a596f3717c22815356%26id%3D4b69ea1da3%26e%3Dda4d728a95&data=04%7C01%7C%7C7e1d00e600514409687808d931d7a399%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637595624503299948%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=GvoMc7JfMz3xmNd9Wz9pawNfhvDhM2Mqw3B%2BNwIJahQ%3D&reserved=0>
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