By Robert Hasty, D.O., FACOI, Associate Professor and Vice Chair of Internal Medicine
Program Director, Palmetto General Hospital Internal Medicine Residency Program
them.
4
For the purposes of this discussion, I have included some of the
key provisions of the law with a discussion related to each provision.
Closure of the Donut Hole and Discount on
Prescription Drugs for Seniors
On December 8, 2003, President George W. Bush signed the
Medicare Prescription Drug and Modernization Act of 2003, which
created Medicare Part D and provided an entitlement benefit for
prescription drugs for Medicare recipients. This entitlement drew sig-
nificant criticism due to its complexity. One aspect of this was once
beneficiaries paid their premium, they would receive coverage for
prescription drugs up to a threshold and then would be uncovered
until the beneficiary reached a much higher threshold of prescription
drug expense where coverage would resume. This gap in recipients’
coverage is commonly referred to as the
donut hole
.
While maintain-
ing prescription drug coverage to these beneficiaries at all levels
of utilization, the Affordable Care Act will completely phase out the
donut hole by the year 2020.
5
n March 23, 2010, President Barack Obama signed the Patient
Protection and Affordable Care Act.
1
This is arguably the most
important health care legislation in recent years and is perhaps as
monumental as Medicare in terms of its ability to change the delivery of
health care in the United States.
The Affordable Care Act has developed into one of the most
controversial political topics in recent history. The pundits often refer
to it as
Obamacare
in a nod to the significant role President Obama
had in its development. In the ensuing years, the Affordable Care
Act has become a polarizing topic with Republicans criticizing it
while Democrats typically defend its merits. During this controversy,
the legality of the law was challenged all the way to the Supreme
Court, and on June 28, 2012, the highest court of the United States
upheld the law. Regardless of individual opinions, it appears it will
remain the law of the land.
2,3
Few Americans understand many of the provisions of the law, per-
haps, with the exception of the mandatory requirement. In fact, only 39
percent of Americans report they understand how it is going to impact
20
COM Outlook . Fall 2012
The Patient Protection
and Affordable Care Act:
What You Need to K
now!
O
