Posts filed under ‘Fiscal Responsibility’
Quick!
Stop paying anything more to Medicare Advantage plans than to traditional Medicare. Listen to the GAO and stop all bonus payments to private Medicare plans. Start negotiating what Medicare pays for prescription drugs. Then recalculate Medicare’s fiscal solvency and begin serious discussions about Medicare’s future.
Constant calls for changing Medicare into a Voucher system will simply increase privatization of Medicare. Once again we’ll give taxpayer dollars to the insurance industry, increase costs to older people, disabled people, and their familes – and do nothing to address the needs of tomorrow.
Change the conversation. Insist on real solutions.
Let Health Care Reform Work!
Hello, Supreme Court:
Since the Affordable Care Act became law in 2010, significant progress has been made to enhance access to health care for all Americans. The health care reform law is strengtheing Medicare, helping families, and saving taxpayers money. This progress touches the lives of millions of Americans — of all ages, from every state, and every walk of life. That’s why the Constitution authorizes the FEDERAL government to implement this kind of law for the general welfare.
The Affrodable Care Act will help millions more Americans if it is fully implemented.
Let it work!
Protecting Medicare and the Middle Class: Themes From The State of the Union
As described in his State of the Union address, the President’s blueprint for a lasting economy is both necessary and commendable. An essential part of that blueprint is ensuring all Americans have access to high-quality, affordable health care. As the President stated, we need to ensure that Medicare “remain[s] a guarantee of security” for older Americans and individuals with disabilities. When private insurance let older people down in the 1960s, Americans embraced the President’s theme of “shared responsibility” to care for our most vulnerable citizens by creating Medicare. While the economic security of the middle class has declined for decades, Medicare has dramatically enhanced the economic and health security of hundreds of millions of older Americans and people with disabilities.
And yet, the future of Medicare hangs in the balance as members of Congress discuss ways to privatize Medicare and diminish the security it provides for middle class families.
“We applaud the President’s commitment to continuing Medicare as a community program that families can rely on,” states Judith Stein, founder and executive director of the Center for Medicare Advocacy. “Medicare is an American success story. It has served American families and adapted with the times for more than four decades. It has provided a critical economic lifeline for families” she continued. “We can not afford to risk the security of the next generation by giving Medicare away to private insurance companies.”
The Center for Medicare Advocacy also echoes the President’s call to uphold the consumer protections and health coverage in the Affordable Care Act. “The Affordable Care Act greatly enhanced Medicare,” says David Lipschutz, policy attorney at the Center for Medicare Advocacy. “Since it was signed into law, millions of older and disabled Americans with Medicare have received more help in paying for their prescription drugs, putting money back into their pockets. Among other things, the Affordable Care Act has also added no-cost preventive benefits for people with Medicare and extended the solvency of the program.”
Medicare is a tried and true American value that provides high-quality, cost efficient health care for our grandparents, parents, neighbors and friends. “Pretending to protect Medicare by shifting costs from the federal government back to older people and their families would negate Medicare’s original purpose: to protect older people and their families from illness and financial ruin due to health care costs,” said Judith Stein. “We thank the President for defending Medicare’s guarantee of security and resisting calls for a private voucher system that would further endanger the middle class and destroy the national treasure we’ve known as Medicare.”
Perhaps Someone IS Listening
The NY Times editorial of 12/18/2011, “Working with Medicare,” picks up on some ideas the Center has been espousing for years:
- Negotiate drug prices for Medicare beneficiaries.
- Let the Affordable Care Act do its job.
- Be careful regarding private plans, premium support and too much cost-shifting to beneficiaries.
- The REAL solution to Medicare costs lies in addressing health care costs in general.
CMA in the New York Times: Don’t Privatize Medicare
http://www.nytimes.com/2011/12/10/opinion/medicare-and-private-health-insurance.html
Medicare “Reform” – Beware the Wolf in Sheep’s Clothing
This week, Rep. Paul Ryan (R-WI) and Sen. Ron Wyden (D-OR) outlined yet another effort to privatize Medicare; a twist on Rep. Ryan’s voucher plan from earlier this year.
The new proposal would supposedly “preserve” the traditional Medicare program, but force it to compete with private plans. Similar to the earlier Ryan voucher plan, which the Congressional Budget Office estimated would cost Medicare beneficiaries twice as much as traditional Medicare, this one is based on the flawed assumption that private plans will save Medicare money through competition and innovation. The belief that privatization will drive down costs is not based in fact.
On the contrary, private plans have not saved Medicare money, and often cost more than traditional Medicare. In fact, traditional Medicare — not private plans — has been the leader in innovations to keep health costs down and increase quality.
Under the latest Ryan privatization plan, beneficiaries would have a voucher to purchase a health plan (including traditional Medicare), and there would be a cap on the overall amount of Medicare spending per beneficiary. If a plan (including traditional Medicare) cost more than the voucher amount, then the beneficiary would have to pay the difference between the actual price and the voucher.
If traditional Medicare is forced to compete with private, for-profit plans, as Ryan proposes, private plans will work to minimize their spending, and woo the least costly beneficiaries. If beneficiaries that are more expensive to treat remain in traditional Medicare, it will be at a built-in competitive disadvantage, and might well become unsustainable.
The math is pretty simple. If beneficiaries pay more for health care, the federal government will save money. That’s where these federal savings come from. But this approach won’t do anything to reduce overall health care spending, which is the real problem. Instead, it will likely lead to reduction in benefits and increase cost-sharing for Medicare beneficiaries. Don’t be fooled into thinking this proposal protects and preserves Medicare – it eliminates a unified program.
Traditional Medicare has changed dramatically since its inception in 1965. It has been a cost-effective health care insurance model leading to innovation, access to care and economic security. But Medicare has been complicated and made more expensive by adding layers of private options. Further, as Medicare becomes more and more fragmented and traditional Medicare loses enrollment, it loses its bargaining power over health care costs and its ability to create innovations in the broader health system.
Untethered from the overspending and complexities that have been foisted on Medicare by private plans and non-negotiable drug prices, it could once again be a model, for affordable health insurance. Traditional Medicare needs to be strengthened with fewer, not more private options.
CMA Responds to the NY Times: Don’t Privatize Medicare!
Dec. 4, 2011
The New York Times
620 Eighth Avenue
New York, NY 10018
To the Editor:
Your December 4, 2011 editorial (”What About Premium Support?” ) about changing Medicare into a voucher system wisely states many of the problems with public subsidies of private health insurance for Medicare beneficiaries. All such experiments have cost more and provided less value to those in need of coverage.
I have been an advocate for Medicare beneficiaries for almost 35 years. I’ve seen numerous forays into privatizing Medicare. Clinton-era plans, Medicare Plus Choice, Medicare Advantage: none of them have provided better coverage more cost-effectively than the traditional Medicare program.
I don’t recommend a private plan to my mother. That should be a good test for anyone championing premium support.
Additionally, ever-increasing private options have made Medicare too complex, especially given the very limited number of advocates available to help beneficiaries understand, choose and navigate the system.
Call it what you will, ”premium support” is the latest jingle for privatizing Medicare. It’s not a new or creative idea, and it will only add more costs and confusion. What we need is an objective look at what’s needed to encourage participation and cost efficiencies in traditional Medicare, not further adventures in privatization.
JUDITH STEIN
Executive Director
Center for Medicare Advocacy
A Modest Medicare Proposal (As Suggested by a Reader)
Instead of raising the age of eligibility for Medicare, why don’t we just use Part D as a model and create a new Eligibility Donut Hole?
People ages 65 – 69 can keep their eligibility. But, between ages 70 and 85: Into the new Donut Hole. Eligibility for Medicare would end during this time – after all it’s these older people that start getting sick, so it’s the perfect time to stop paying for their health care. The new Donut Hole would save the government a ton of money!
Those who do make it through the Eligibility Donut Hole without Medicare, would once again become eligible at age 86. At that point most people only need “comfort measures” and their conditions usually won’t improve, so Medicare wouldn’t pay for their care anyway!
If the goal is to save money, a new Medicare Eligibiity Donut Hole is the way to go.
Six Solutions for Medicare Solvency and Reducing the Deficit
As lawmakers debate the future of Medicare as part of broader efforts to address the federal deficit, proposals have emerged that would have severe repercussions for beneficiaries and their families.[1] Sound solutions that would protect Medicare coverage while reducing costs to taxpayers have not been seriously addressed. The six solutions we propose would accomplish both of these goals.
These solutions, unlike many current proposals, do not shift costs to beneficiaries or completely restructure the Medicare program. They promote choice and competition while shoring up the solvency of Medicare. Adopting these solutions would be a responsible step in reducing our deficit the right way.
1. Negotiate Drug Prices with Pharmaceutical Companies
The Medicare prescription drug law passed in 2003 prohibits the Secretary of Health and Human Services from negotiating prices with pharmaceutical companies. These companies gained 47 million customers when Medicare began covering prescription drugs, but they did not have to adjust their prices in return. Requiring the Secretary to negotiate drug prices for Medicare would save taxpayers billions of dollars – potentially over $200 billion over ten years.[2] Taxpayers currently pay nearly 70% more for drugs in the Medicare program than through the Veteran’s Administration, which has direct negotiating power.[3] Savings realized from reducing Medicare drug cuts could be used to improve benefits for beneficiaries and reduce the deficit.
2. Stop Paying Private Medicare Plans Anything More Than Traditional Medicare
According to the Medicare Payment Advisory Commission (MedPAC), Medicare pays, on average, 10% more for beneficiaries enrolled in private insurance (Medicare Advantage or MA plans) than for comparable beneficiaries enrolled in traditional Medicare.[4] Despite these extra payments, beneficiaries in private plans who are in poor health, or who have chronic conditions, often have more limitations on coverage than they would under traditional Medicare.[5]
A large portion of the overpayments made to private plans actually goes to insurers rather than to benefit Medicare beneficiaries.[6] Although the Affordable Care Act (ACA) changed the payment formula for Medicare Advantage plans, some plans will continue to be paid as much as 115% of the average traditional Medicare payment rate for their county when the new rates are fully implemented. MedPAC estimates that by 2017Medicare Advantage payment benchmarks will average 101% of traditional Medicare. ACA also provides additional payments for plans that receive high quality ratings, increasing the likelihood that some MA plans will continue to be paid more than under traditional Medicare. Reducing private MA payments to 100% of traditional Medicare, as MedPAC proposed before the enactment of ACA, will increase the solvency of the Medicare program and curb costs for taxpayers. Private plans simply should not receive higher pay than traditional Medicare.
3. Include a Drug Benefit in Traditional Medicare
Offering a drug benefit in traditional Medicare would give beneficiaries a choice they do not now have, encourage people to stay in traditional Medicare, and save money for taxpayers. It would also provide an alternative to unchecked private plans that leave many with unexpected high out-of-pocket costs. A drug benefit in traditional Medicare would protect beneficiaries against expensive and sometimes abusive marketing practices. Further, traditional Medicare’s lower administrative costs could free up money for quality care, would result in lower drug prices for beneficiaries, and save taxpayers over $20 billion a year.[7]
4. Extend Medicaid Drug Rebates to Medicare Beneficiaries Who Are Dually Eligible or Part D Low-Income Subsidy Participants
Dual eligibles (people eligible for both Medicare and Medicaid) comprise one-fourth of all Medicare drug users, and are among the most costly beneficiaries. Because Medicare, rather than Medicaid, covers most of their drugs and because Medicare cannot negotiate drug prices, their drugs are not eligible for the same rebates as they would be under the traditional Medicaid program. Extending these rebates for dually eligible people as well as for those who qualify for the Part D Low-Income Subsidy – the poorest Medicare beneficiaries – would save approximately $135 billion over ten years.[8]
5. Lower the Age of Medicare Eligibility
People between 55 and 65 who are not disabled are currently unable to enroll in Medicare. Lowering the age of eligibility to enroll this healthier population in the Medicare program would add revenue from people who will likely need less care and fewer services than older and disabled enrollees.
6. Let the Affordable Care Act Do Its Job
The Affordable Care Act includes many measures to control costs as well as models for reform that will increase the solvency of the Medicare program and lower the deficit while protecting Medicare’s guaranteed benefits. The Congressional Budget Office estimates that repealing or defunding ACA would add $230 billion to the deficit while ignoring the real issue of rising overall health care costs, which contribute heavily to the growing national debt. ACA includes strong measures to allow CMS to combat fraud, waste, and abuse that will bring down costs, as well as a variety of pilot and demonstration projects that aim to bring better care and quality to beneficiaries.[9] The bipartisan Bowles-Simpson Deficit Commission recommended that these projects be implemented as quickly as possible.[10] Allowing ACA to do its job will create a foundation on which to build by improving care and holding down costs for taxpayers.
Conclusion
“Protecting Medicare” by shifting costs from the federal government to beneficiaries and their families – whether through a voucher program or spending caps or other draconian measures – is a perversion of Medicare’s original intent: to protect older people and their families from illness and financial ruin due to health care costs. The Center for Medicare Advocacy’s Six Solutions promote the financial welfare of Medicare and the country, without doing so at the expense of older and disabled people.
[1]See previous Alerts from the Center, “Why Medicaid Matters to Medicare Beneficiaries and Their Families”, “What Happens to Current Nursing Home Residents if House Budget Resolution Becomes Law?”
[2]National Committee to Preserve Social Security and Medicare, available at http://www.ncpssm.org/pdf/price_negotiation_part_d.pdf
[3]Center for Economic and Policy Research, “Negotiating Prices with Drug Companies Could Save Medicare $30 Billion”, March 2007, available at http://www.cepr.net/index.php/press-releases/press-releases/negotiating-prices-with-drug-companies-could-save-medicare-30-billion.
[4]MedPAC, Report to the Congress, March 2011, Chapter 12 (March 2011), available at http://www.medpac.gov/documents/Mar11_EntireReport.pdf.
[5] Neuman P. Medicare Advantage: Key Issues and Implications for Beneficiaries. Testimony before the House Committee on the Budget, United States House of Representatives, June 28, 2007, available at http://www.allhealth.org/briefingmaterials/NeumanTestimony-830.pdf,
[6] Medicare Payment Advisory Commission. March 2009 Report to Congress, Chapter 3: The Medicare Advantage Program. P. 251-253, available at http://www.medpac.gov/chapters/Mar09_Ch03.pdf.
[7]Senator Dick Durbin, available at http://durbin.senate.gov/public/index.cfm/pressreleases?ID=555cc1e8-cc54-4ead-9d85-d5e6275b3789.
[8]Office of Management and Buget Congressional Budget Office, Living Within Our Means (September, 2011); Letter to Honorable Charles Rangel, available at http://www.cbo.gov/ftpdocs/104xx/doc10464/hr3200.pdf
[9]See previous Alert from the Center, “Combating Fraud, Waste, and Abuse in Health Care.”
[10]The National Commission on Fiscal Responsibility and Reform, “The Moment of Truth,” December 2010.
Raising the Medicare Eligibility Age Will Actually INCREASE Costs
Policymakers and pundits continue to propose Medicare changes that would have severe repercussions for beneficiaries and their families. These proposals will continue to make news as deficit discussions heat up. Too often, however, they are based on false information, which is repeated as fact by the media, pundits and policymakers. We aim to correct public misinformation about Medicare.
Medicare Works. For 46 years it has opened doors to necessary care for hundreds of millions of older and disabled people, and enhanced economic security for beneficiaries and their families. Informed Americans need to know the truth about the program and the people it serves.
Did you know?
According to the Center on Budget and Policy Priorities (www.cbpp.org) that “Raising Medicare’s eligibility age from 65 to 67, which the new Joint Select Committee will likely consider this fall as a deficit-reduction measure, would not only fail to constrain health care costs across the economy; it would increase them.
While this proposal would save the federal government money, it would do so by shifting costs to most of the 65- and 66-year-olds who would lose Medicare coverage, to employers that provide health coverage for their retirees, to Medicare beneficiaries, to younger people who buy insurance through the new health insurance exchanges, and to states.
View the full report at: http://www.cbpp.org/cms/index.cfm?fa=view&id=3564 or http://www.cbpp.org/files/8-23-11health.pdf 7pp.
CMA Health Policy Blog 