Here’s an interesting piece explaining how the Affordable Care Act reduces the growth of Medicare spending over time. According to this essay, it’s a straightforward case of rationing.
What will this mean? Seniors will be the least (financially) desirable patients as they attempt to find doctors who will see them and institutions that will admit them. Harvard health economist Joe Newhouse predicts they may have to seek care at community health centers and safety net hospitals. The Medicare Office of the Actuary predicts that in a few short years hospitals will begin closing and the elderly and the disabled will have increasing difficulty obtaining access to care.
Note: since some of these estimates were made, the administration has delayed cuts in payments to Medicare Advantage plans and there has been a slowing of overall health care spending – some of which may be permanent. Ideally, we should have an annual updating of the numbers provided here. But the changes in the estimates would be changes of degree, not of kind.