In 2003, President Bush expanded Medicare, by subsidizing prescription drug costs under Part D.

There are further changes to Medicare and Medicaid in the Affordable Care Act. There were expansions in the number of preventative health care services offered for free (such as colorectal screening), and by closing gaps in prior coverage (HHS, 2012). Berenson (2010) notes that the ACA pays for this expanded coverage by decreasing Medicare spending by reducing payments to private plans under Medicare Advantage and reduced payments for many providers. There are fears that this will cause many providers to either refuse Medicare patients or that the quality of care will be lowered. There are also changes to the structure of Medicare, the end result being more government intervention on the cost side of the program, in an attempt to use the program's bargaining power with health care providers to lower its costs. It is possible...
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