What Do the Election Results Mean for Seniors?

Now that the votes are counted and President Obama has a second term, what does it mean for seniors? While President Obama's re-election means Medicare and Medicaid as we know them will likely be preserved at least for the next four years, many challenges are still ahead.
One of the biggest outcomes of the election is that the Affordable Care Act (ACA – a.k.a. "Obamacare"), which candidate Mitt Romney had promised to repeal, will almost certainly remain as law and be fully implemented. The law is already beginning to close the gap in Medicare’s prescription drug coverage known as the "doughnut hole," as well as providing free preventative care for Medicare recipients. The ACA also included a number of provisions aimed at improving long-term care and helping recipients remain in their homes rather than be forced into nursing homes, and these will continue to be carried out.
There may be some issues ahead, however. Before the end of the year, Congress will try to avoid going over the "fiscal cliff," which is what will happen if it fails to act on continuing at least some of the Bush-era tax cuts and fails to prevent automatic spending cuts that it agreed to as part of last year's deficit reduction deal. Many economists believe that the combination of the two could send the fragile economy back into recession. Lawmakers are now trying to agree on a "grand bargian," alternative spending and revenue measures that will will help reduce the deficit while not damaging the economy.
Although Medicare and Medicaid will likely maintain their current structures, cuts may be made during these negotiations or later. The President still has to deal with a Republican majority in the House of Representatives, many of whom want to cut spending and entitlement programs.
President Obama reportedly offered to increase the Medicare age to 67 in last year’s budget negotiations with Republicans. In addition, many are worried that the President may be inclined to cut Social Security benefits as well during fiscal cliff negotiations, according to a recent policy update from the National Academy of Elder Law Attorneys. During the first debate, the President said his position on Social Security did not differ markedly from Governor Romney's. Romney supported raising the retirement age and privatizing Social Security benefits.
“There is going to be the fight of our lifetime to maintain Social Security, Medicare and Medicaid,” says Eric Kingson, a professor of social work at Syracuse University quoted in a Huffington Post article titled "Obama's Second Term and Older Americans."
According to a Reuters article, congressional Republicans are also expected to ask for concessions from the ACA, including delaying and scaling back the planned expansion of Medicaid. In addition, state lawmakers, many of whom are Republican, will decide how the ACA is carried out. Thirty states have Republican governors, some of whom have said that they will opt out of the Medicaid expansion provided for in the ACA. But President Obama's re-election may boost the prospects for expansion. According to Kaiser Health News, his win may prod reluctant states to move forward with the expansion.
The National Consumer Voice for Quality Long-Term Care warns that "hard budgetary decisions made by the President along with Congress could potentially cause some long-term care consumers to face higher care costs or a decline in access to services." The National Coalition on Health Care, a group of consumer groups, unions, and employers, has released a plan to control spending without cutting Medicare or Medicaid. More proposals and compromises are likely to be considered in the coming months.