Posts filed under ‘Medicare’
Medicaid Matters!
Medicare has received most of the headlines regarding proposals from Congress and the Administration to reduce the federal deficit and raise the federal debt ceiling. Proposals to restructure Medicaid have been receiving less attention than those about Medicare. But Medicaid, which serves nearly 60 million Americans − older people, people with disabilities, pregnant women, children and their families – may be in greater jeopardy than Medicare. The good news is that more than 50% of all Americans either have received services through Medicaid or have a friend or family member who has, so most Americans know something about Medicaid and its importance to them, their families and friends.
Medicare and Medicaid – Inextricably Intertwined
Nearly nine million low-income Medicare beneficiaries depend on Medicaid to help them pay Medicare’s significant premiums and cost-sharing and to pay for services erroneously denied or excluded from Medicare coverage, including nursing home care and community-based long-term supports and services. These beneficiaries are generally poorer and sicker than the general Medicare population. They comprise 21% of Medicare enrollees, and use 36% of Medicare dollars. They comprise 15% of Medicaid enrollees and use 40% of Medicaid dollars. Medicaid is critical to the health and well-being of these individuals and their families.
For these beneficiaries, Medicaid is necessary to cover:
- Medicare’s Out-of-Pocket Costs –Medicaid pays for all of Medicare’s cost-sharing for about four million Medicare beneficiaries and pays the Part B premium for more than eight million beneficiaries.
- Long-Term Care Supports and Services – More than 10 million people in the U.S. have long-term care needs and more than 80% of those people live in the community. Medicare pays for only about one-quarter of spending for long-term care. When family resources are exhausted or in need of additional support, Medicaid steps in.
- Nursing Facility Services –Medicaid pays some costs for 70% of all nursing home residents, most of whom are also eligible for Medicare.
- Home and Community-Based Services – Increasingly, Medicaid is paying for long-term care supports and services in the community in addition to paying for care in nursing facilities.
Real People Depend on Medicaid to Pay for Services Not Covered by Medicare or to Provide Coverage When Medicare is Denied
The Center for Medicare Advocacy represents thousands of dually eligible people who need help paying their Medicare cost-sharing or who have been denied Medicare coverage. These older and disabled people would go without necessary health care if they did not have Medicaid to help pay their Medicare out-of-pocket costs or to rely on when Medicare denies coverage – often erroneously.
Although our clients may eventually win coverage on appeal, the vast majority of dually eligible people lack representation, and do not appeal Medicare denials. They depend on Medicaid to pay for necessary health care. The ability to fall back on Medicaid when Medicare coverage is denied, or is no longer available, or does not cover the needed health service, is also a blessing for families. Without Medicaid, families of these older and disabled people would have to find the resources themselves to pay for their loved-ones’ care, see them go without the care they need, or try to provide it themselves.
Medicaid matters. Protect it – for the health of all Americans.
Sen. Lieberman: Wrong Way on Medicare
We’re sorry – Connecticut’s Senior Senator has once again entered the Medicare “reform” debate with the wrong perspective. Instead of looking to insure more people while lowering costs, Senator Lieberman, and his colleague Sen. Coburn, unveiled a plan on June 28th that is misdirected – reducing the number of people covered by Medicare, and foregoing major opportunities to bring down costs.
The Lieberman-Coburn proposal would raise the age of eligibility for Medicare, raise the cost of Medicare for beneficiaries, limit the ability to purchase supplemental insurance to fill Medicare’s gaps, and continue billions of dollars of wasteful overpayments to pharmaceutical companies and private Medicare plans.
Listen carefully folks, this is not the right direction for Medicare!
Read more of Judith Stein’s comments on the plan nobody is going to like in the CT Mirror at http://www.ctmirror.org/story/13101/liebermancoburn
Lower Medicare Age
Lawmakers continue to talk about the future of Medicare as they address the federal deficit, and many of the proposals that have emerged would have horrible repercussions for Medicare beneficiaries and their families. Just last week, Connecticut’s Senator Joe Lieberman suggested raising the eligibility age for Medicare; an unsound idea that would hurt the actuarial balance of the Medicare risk pool. Raising the eligibility age would increase the proportion of older, sicker people in Medicare, while younger, healthier people – and their largely unused premiums – would be excluded. That’s the exact wrong direction, and we at the Center had to respond.
Follow the links below to see our letters in the New York Times and the Washington Post.
http://www.nytimes.com/2011/06/16/opinion/l16krugman.html?_r=2&partner=rssnyt&emc=rss
New York Says No
New York voted for Medicare yesterday. In a traditionally Republican district, Democrat Kathy Hochul won a special election for an open Congressional seat. The major issue in the campaign was the budget recently passed by Republicans in the House of Representatives that eliminates Medicare as a defined benefit program. Candidate Hochul opposed this change, recognizing it for what it is – an end to Medicare. Voters agreed with her.
The New York vote reminds us that Americans value Medicare. They understand that the Republican Budget won’t save Medicare; it will replace it with individual vouchers toward the cost of purchasing private insurance.
Under the Republican plan, beginning in 2022, people who become eligible for Medicare would instead receive a voucher, worth about $8,000. No one knows what private plans would be available for purchase, what geographic regions would be included, or what health services and providers would be covered. We do know that Medicare guarantees certain coverages, and it has worked to bring quality health care to older and disabled people for 46 years. When Medicare was enacted in 1965, half of all Americans 65 or older had no insurance. Private insurance did not want to cover them. Now, because of Medicare, 95% of people 65+ are covered.
Yesterday, Joe Courtney, the Congressman who represents the district of the Center’s home office also said yes to Medicare and no to vouchers. ( VIDEO: Courtney decries GOP plan to end Medicare as we know it.)
Fortunately, when Kathy Hochul takes her seat in Congress to represent New York, Congressman Courtney will have another ally in efforts to preserve Medicare.
Truth: Why I Love Paul Krugman
From Paul Krugman in today’s New York Time, May 13, 2011
This has to be one of the funniest political stories of recent weeks: On Tuesday, 42 freshmen Republican members of Congress sent a letter urging President Obama to stop Democrats from engaging in “Mediscare” tactics — that is, to stop saying that the Republican budget plan released early last month, which would end Medicare as we know it, is a plan to end Medicare as we know it.
Now, you may recall that the people who signed that letter got their current jobs largely by engaging in “Mediscare” tactics of their own. And bear in mind that what Democrats are saying now is entirely true, while what Republicans were saying last year was completely false. Death panels!
Well, it’s time, said the signatories, to “wipe the slate clean.” How very convenient — and how very pathetic.
Anyway, the truth is that older Americans really should fear Republican budget ideas — and not just because of that plan to dismantle Medicare. Given the realities of the federal budget, a party insisting that tax increases of any kind are off the table — as John Boehner, the speaker of the House, says they are — is, necessarily, a party demanding savage cuts in programs that serve older Americans. …
Between an aging population and rising health costs, then, preserving anything like the programs for seniors we now have will require a significant increase in spending on these programs as a percentage of G.D.P. And unless we offset that rise with drastic cuts in defense spending — which Republicans, needless to say, oppose — this means a substantial rise in overall spending, which we can afford only if taxes rise.
So when people like Mr. Boehner reject out of hand any increase in taxes, they are, in effect, declaring that they won’t preserve programs benefiting older Americans in anything like their current form. It’s just a matter of arithmetic.
Which brings me back to those Republican freshmen. Last year, older voters, who split their vote almost evenly between the parties in 2008, swung overwhelmingly to the G.O.P., as Republicans posed successfully as defenders of Medicare. Now Democrats are pointing out that the G.O.P., far from defending Medicare, is actually trying to dismantle the program. So you can see why those Republican freshmen are nervous.
But the Democrats aren’t engaging in scare tactics, they’re simply telling the truth. Policy details aside, the G.O.P.’s rigid anti-tax position also makes it, necessarily, the enemy of the senior-oriented programs that account for much of federal spending. And that’s something voters ought to know.
A version of this op-ed appeared in print on May 13, 2011, on page A27 of the New York edition with the headline: Seniors, Guns And Money.
Save Medicare by Ending It?
Save Medicare by Ending It? Reduce the Current Deficit with a Plan for 2022?
Really?
The Budget introduced by Rep. Ryan and passed by Republicans in the House of Representatives would eliminate Medicare as of 2022. Instead of guaranteeing coverage for specific health care, like Medicare does, the Ryan Budget would provide a voucher to each eligible person to buy private insurance. The voucher would be worth a flat dollar amount. There is no guarantee that someone would be able to buy insurance for that amount or that if insurance is available, the insurance would cover and pay for the same services as Medicare.
A voucher system is nothing like Medicare. You can’t save Medicare by eliminating it. And you can’t solve today’s deficit problems with a plan that begins in 2022.
This time, we’re not buying it!*
_______________________
* See, Kaiser Health Tracking Poll, http://www.kff.org (April 27, 2011)
President Obama Supports Medicare
Thank you, President Obama, for proposals that strengthen Medicare. We are so pleased, and relieved, to have a leader in the White House who’s drawn a line, refusing to pretend the elimination of Medicare and Medicaid are necessary to protect America’s future. Instead, he’s called for real, shared responsibility and is continuing efforts to provide affordable health care for all.
The President’s framework for fiscal responsibility protects the integrity of Medicare and Medicaid by building upon the progress made in the Affordable Care Act to cut overall health care costs. His proposals strengthen both programs while achieving savings by addressing Medicare physician payment reforms; reducing overpayments; improving care for those who are eligible for both Medicare and Medicaid; and focusing on wasteful spending and cost growth.
The President was explicit about his vision for Medicare and Medicaid when he said:
…”let me be absolutely clear: I will preserve these health care programs as a promise we make to each other in this society. I will not allow Medicare to become a voucher program that leaves seniors at the mercy of the insurance industry, with a shrinking benefit to pay for rising costs. I will not tell families with children who have disabilities that they have to fend for themselves. We will reform these programs, but we will not abandon the fundamental commitment this country has kept for generations.”
The Center for Medicare Advocacy applauds the President for his work to preserve Medicare, Medicaid and the well-being of American families who are already struggling in today’s economy. We thank the President for recognizing that fiscal responsibility for the federal government does not mean eliminating programs like Medicare and Medicaid that work to provide access to health care for vulnerable populations. Nor does it mean saving federal dollars by shifting costs to states, families and taxpayers.
What a breath of fresh air!
Rationing Medicare & Health Care?
The budget released on April 5th by the House of Representatives purports to benefit Main Street Americans.
Once again we’re hearing proposals to “reform” Medicare and to cut the federal deficit. These plans are not about reform or even dedicated to deficit reduction. They are about a long held desire to do away with Medicare, shifting costs to American families who are already struggling.
Newt Gingrich said in the 1990s that he might not be able to eliminate Medicare, but he could watch it wither on the vine. This time, the House of Representatives’ Republican budget actually does eliminate Medicare, replacing it with vouchers to purchase private insurance.
This proposal is reckless and extreme. As with Medicare Advantage and Medicare Part D, it will cost beneficiaries and taxpayers more than the traditional Medicare program. With a capped annual voucher to purchase insurance, Medicare beneficiaries will pay more out-of-pocket, get less coverage, and have less access to health care.
Sounds like rationing to us.
What’s The Benefit of De-Funding Health Care Reform?
The House of Representatives will vote today on an amendment to the 2011 Continuing Budget Resolution that would prevent all spending to implement the Affordable Care Act, the health reform law enacted almost one year ago. “This amendment is not in the interest of Medicare, the current fiscal crisis, or families,” says Judith Stein, executive director of the Center for Medicare Advocacy. “Defunding health care reform would endanger children who have pre-existing conditions, deprive uninsured young adults from coverage under their parents’ plans, limit Medicare coverage for preventive services, and end important consumer protections for Americans of all ages.” The amendment to defund health care reform would also eliminate tax credits to small business for providing health coverage to their employees, and would increase the deficit by over $200 billion over the next 10 years.
The Center for Medicare Advocacy has already seen how health reform has improved the lives of millions of people. For example:
• Our clients who are Medicare beneficiaries no longer have to pay cost-sharing for preventive services, and they are now eligible for an annual wellness visit.
• Those with high prescription drug costs will pay less out of pocket for their medicine when they enter the prescription drug donut hole or coverage gap.
• Fewer older people with both Medicare and Medicaid had to change their prescription drug plan in order to be in $0-premium Medicare drug plan.
• Four of our own Center staff members have young adult children who are now covered by the Center’s health plan; without the coverage they would be uninsured.
If the House votes to defund implementation of health reform, all of these people, and millions like them throughout the country, will lose the protections they have already received.
“This amendment is driven by ideology, not serious concern for the welfare of Americans, Medicare, small business, or the American economy,” continues Ms. Stein. We urge Congress not to move backwards by depriving Americans of increased access to fair, affordable health care. Implementation of the Affordable Care Act should be fully funded and should go forward so that, by 2014, all Americans have health insurance, regardless of their age, income, or health status.
CMA Health Policy Blog 