Posts filed under ‘Ryan Plan’

Tax Cuts and Cuts to Medicare & the Social Compact

Center for Medicare Advocacy Executive Director Judith Stein was recently featured in the New York Times explaining how the devastating tax bills will lead to devastating cuts to Medicare and the social compact we all rely on.

Re “Republicans Are Coming for Your Benefits,” by Paul Krugman (column, Dec. 5):

Make no mistake: The tax cuts for corporations and wealthy people that Congress is determined to pass will lead to major cuts to health and economic security for the rest of us.

The Congressional Budget Office anticipates that Medicare alone will be cut by $25 billion in 2018, and the bills also set up future cuts to Medicare, Medicaid and Social Security. The tax legislation would also increase taxes for millions of households with yearly incomes below $200,000.

American families will be expected to pay the price for the trillions added to the federal deficit. Indeed, Senator Marco Rubio said recently that passage of the tax bill “will mean instituting structural changes to Social Security and Medicare.”

Speaker Paul D. Ryan said Congress will have to cut so-called entitlement programs. That’s code for Medicare, Medicaid and Social Security.

Most people and families won’t benefit from these tax cuts. Yet most will be harmed by the spending cuts needed to pay for them. Instead of gutting the social compact Americans rely on, Congress should work to pass true tax reform that helps all Americans and invests in a better future for everyone.

December 12, 2017 at 4:02 pm Leave a comment

Tax Cut Bill Just Got Worse. Health Care at Risk.

Congress’ rushed effort to push through a massive tax cut for corporations and the wealthy presents a clear and present danger to health coverage, other vital programs, and families throughout the country. After adding $1.5 trillion to the federal debt, policymakers will use the higher debt – created by the tax cuts – to argue that deep cuts to Medicare, Medicaid, Social Security and other bedrock programs are necessary.

Amazingly, the tax cut bill just got even worse. After failing repeatedly to repeal the Affordable Care Act (ACA), the Senate is now seeking to repeal the ACA’s individual mandate to purchase insurance coverage in order to help pay for tax cuts. They know this will devastate the ACA.

According to the Congressional Budget Office (CBO), without this provision far fewer people – particularly younger and healthier people – will buy health insurance, which will lead to 13 million people without coverage, and higher premiums for millions more.

To add insult to injury, the CBO also stated that, in addition to the longer-term threats the tax cut poses to Medicare, the cut would also immediately threaten the program. Indeed, CBO projects that the enormous cost of the tax bill would prompt immediate, automatic and ongoing spending cuts to Medicare – $25 billion in 2018 alone.

It’s time to stop this fast-track process to starve the federal budget and pay for massive tax cuts by undercutting the health and economic security of millions of American families.

November 15, 2017 at 10:46 pm Leave a comment

Time to Renew, Not Repeal or Retreat!

Last week, an older adult wrote the Center for Medicare Advocacy:

“I will be on the streets at 66 years old without Medicare and Medicaid.  It’s as simple as that.  My money has all gone raising 3 granddaughters after their mother died.  There are millions of stories like mine everywhere.  We must help the least of us that had bad luck or are sick etc.” J.D., Medicare Beneficiary, Michigan

This week, on its first day, Congress passed a Resolution that begins the process to repeal the Affordable Care Act (ACA). Repealing ACA threatens access to health coverage and Medicaid for 20 million people. It would also reduce Medicare prescription drug coverage, reduce Medicare preventive benefits, and decrease the long-term solvency of the Medicare program.

ACA, Medicare and Medicaid are intertwined. Repealing the Affordable Care Act would also harm Medicare and Medicaid. It would harm the people, like Mrs. D, who raised her own family and is now raising her grandchildren.

Policy-makers need to know how their decisions impact real people. If you know someone who has benefited from the Affordable Care Act, Medicare and/or Medicaid –  Tell Your Story!

January 4, 2017 at 11:26 pm Leave a comment

Medicare Is Withering on the Vine

In 1995 Newt Gingrich predicted that privatization efforts would lead Medicare to wither on the vine. He said it was unwise to get rid of Medicare right away, but envisioned a time when it would no longer exist because beneficiaries would move to private insurance plans.

Well … that’s what’s happening.  Not just by happenstance, but rather according to a determined, strategic plan. The plan has included the following:

  1. Government subsidies to private plans, renamed “Medicare Advantage,” ranging from 14% –  2% above traditional Medicare per-beneficiary costs;
  2. Additional benefits added to private Medicare Advantage, benefits that weren’t added, and aren’t allowed, in  traditional Medicare;
  3. Part D prescription drug coverage wrapped into Medicare Advantage, but not into traditional Medicare;
  4. Increases in traditional Medicare Part B premiums, especially for the middle class;
  5. Limits on access to Medigap insurance to supplement traditional Medicare and on benefits for those who can obtain a Medigap policy.

It didn’t take a crystal ball.  It took a vision, planning and persistence.

The Center for Medicare Advocacy also has vision, planning and persistence. We do all we can to keep Medicare focused on the needs of older and disabled people, not the insurance industry. We speak out with expertise and with  the stories of real people.

With your support, we’ll keep insisting that Medicare is fully present for the families that rely on it – now and in the future. We’re ready to keep Medicare from withering on the vine.

Will you help?

November 28, 2016 at 4:48 pm Leave a comment

Truth: Obamacare Helps Medicare – Pass It On

Speaker Paul Ryan is already in the news saying that because of “Obamacare” Medicare is going broke (Fox News, 11/13/2016). As a consequence, he says, he intends to bring back his plan to privatize Medicare and change it into a voucher system. Under his plan, individuals would be given a set amount to help pay premiums for insurance on the open market. This tired idea is not necessary and not best for Medicare beneficiaries or taxpayers – all of whom would pay more and get less under the Ryan plan. It would  “save” Medicare in name only.

The truth is Obamacare is good for Medicare and Medicare beneficiaries. It added about 10 years to the solvency of the Medicare trust fund, preventive benefits with no co-pays, and reduced prescription drug prices for beneficiaries. Surely Mr. Ryan knows this.

The truth matters.  Pass it on.

For more information see the Washington Post article that gives Ryan’s statement “4 Pinnochios,” their fact-checker’s worst rating for accuracy.

November 14, 2016 at 5:04 pm Leave a comment

Medicare Has Already Been Privatized. And That’s Not Good News.

As Drew Altman of Kaiser Family Foundation wrote in the Wall Street Journal (4/15/2016):
“To some degree many changes long sought by conservatives are already happening incrementally: More than half of Medicaid beneficiaries are in private managed-care plans. Almost one-third of Medicare beneficiaries are enrolled in private Medicare Advantage Plans this year, rather than the traditional program, and the share is projected to grow to more than 40% by 2026. The same is true of private health insurance. Conservatives complain about the ACA, but their preferred vision of health insurance–with high deductibles and lots of “skin in the game” plans–is dominating in the marketplace. The trend is reinforced by many of the policies being sold in the ACA’s insurance marketplaces.”

April 18, 2016 at 1:40 pm Leave a comment

2015 Marks the 50th Anniversary of Medicare – Help Ensure its Future

Since 1965, Medicare has opened doors to health care and increased economic security for hundreds of millions of older people, people with disabilities, and their families.

2015 will also usher in a new Congress. Many of its leaders and members will likely champion plans to further privatize Medicare. These proposals will likely surface despite increasing reports that Medicare costs and the federal deficit are declining, and that traditional Medicare costs less than private Medicare. Once again we will likely hear about plans to transform Medicare to “Premium Support” (a voucher towards the purchase of private insurance). We will probably read about proposals to increase the age of Medicare eligibility, decrease the value of Supplemental Medicare Insurance (Medigap), redesign Medicare to make it “simpler” (but less useful for most beneficiaries). We urge you to listen carefully for these and other such plans. And respond!

Since 1986, the Center for Medicare Advocacy has been on the front lines, advocating for people who depend on Medicare and for a comprehensive Medicare program for future generations. As we mark Medicare’s 50th anniversary, help us ensure its promise to advance access to healthcare. Help us explain what’s true and what’s not, where real savings exist, and when the true interests of beneficiaries are at stake. Help us ensure a real Medicare program lasts for another 50 years.

Be part of our Medicare Truth Squad. Ask us if you have questions. Spread the word – on Twitter, Facebook – in conversations! The future of a comprehensive Medicare program may depend on it.

December 30, 2014 at 6:56 pm Leave a comment

Trustees Report: Medicare IS Solvent

The Medicare trustees reported good news for Medicare today. The Trustees’ annual report finds the life of the Medicare Trust Fund has been extended another four years since their 2013 report, and an additional 13 years from their last projection before the Affordable Care Act passed. The annual report[1] confirms that Medicare continues to provide cost-effective health insurance for more than 50 million older and disabled beneficiaries – and that the Affordable Care Act strengthened Medicare.

Medicare provides health insurance and access to needed care for most Americans age 65 or older and those with significant disabilities. The 2014 Trustees Report confirms that Medicare is working well and will be in fine shape for the foreseeable future. The Trustees conclude benefits are expected to be payable in full until 2030, four more years than they projected in May 2013.

“The Medicare Trustees’ favorable forecast is attributable to slowing health care costs, the recovering economy and the implementation of the Affordable Care Act. The Trustees Report answers skeptics and demonstrates that Medicare is healthy. It continues to be an efficient, cost-effective program that Americans can count on for future generations. It should be protected as one of our great success stories.” said Judith Stein, executive director of the Center for Medicare Advocacy.

The positive outlook for the Medicare Trust Fund is certainly good news. There are opportunities to further improve Medicare’s well-being without reducing benefits or cutting services. Congress could secure the program’s future even more by reducing wasteful overpayments to private Medicare Advantage plans, and by obtaining the best rates possible for prescription drugs.

[1] Read the full report at http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ReportsTrustFunds/index.html.

July 28, 2014 at 10:55 pm Leave a comment

The Ryan Budget: Déjà Vu All Over Again (Again)

On April 1st Representative Paul Ryan rolled out yet another “Path to Prosperity,” as he annually calls his budget.  Unfortunately, the budget is a repeat of past year plans and is not a path to prosperity for most Americans – or for Medicare.

Once again, Rep. Ryan’s budget proposes a private approach to Medicare:

For future retirees, the budget supports an approach known as ‘premium support.’ Starting in 2024, seniors (those who first become eligible by turning 65 on or after January 1, 2024) would be given a choice of private plans competing alongside the traditional fee-for-service Medicare program.

Rep. Ryan has proposed “premium support” for future Medicare participants many times in the past.  While his budget assures us that “this is not a voucher program,” it is, once again, a proposal to pay a certain amount towards private insurance for Medicare beneficiaries. Ironically, Mr. Ryan states such insurance plans “would be available in a newly created Medicare Exchange.” This is ironic because the proposal is remarkably similar to the Affordable Care Act marketplace that is so maligned by Mr. Ryan and his colleagues.

Rep. Ryan suggests that changing Medicare to premium support is needed because

the government has been … a clumsy, ineffective steward of value. Controlling costs in an open-ended fee-for-service system has proved impossible to do without limiting access or sacrificing quality.

In fact, over the last few years traditional Medicare per-capita cost growth has declined, leading the way to parallel reductions in the rise of overall healthcare costs.

The unnecessary costs for the government, taxpayers, and all Medicare beneficiaries that need controlling are the hundreds of billions of dollars in excess payments to private Medicare Advantage plans under Medicare Part C and private pharmaceutical companies under Medicare Part D.  These unnecessary private industry payments are the real threat to Medicare’s future.  If Mr. Ryan’s goal is really to save money and preserve a strong Medicare program, he would look to these cost overruns for savings. He certainly would not propose further privatizing Medicare.

However, the latest Path to Prosperity does again seek to privatize Medicare. At the same time it would reduce Medicare’s value to older people and people with disabilities by:

  • Increasing the age of eligibility to 67.
  • Charging more for Medigap coverage.
  • Combining Parts A and B cost-sharing, thereby increasing costs for most beneficiaries.
  • Increasing premiums for more beneficiaries.

Regrettably, the Ryan plan may provide a continued path to prosperity for private insurance and pharmaceutical companies, but it is a dead end for Medicare, older people and people with disabilities.

April 3, 2014 at 8:26 pm 1 comment

Back to You, Cong. Ryan

In yesterday’s Wall Street Journal, Cong. Paul Ryan weighs in yet again on “entitlement” reform. Suddenly the debate in DC is changing from demolishing Health Care Reform to the traditional Republican targets: Medicare and Social Security.

Here are Mr. Ryan’s suggestions:
• “Reform Medigap plans to encourage efficiency and reduce costs.”
What does this mean? Whose costs would be reduced and where would we find the alleged efficiency? Since we’ve heard this refrain before we know the answer: This proposal would cost older and disabled beneficiaries more. It would require them to pay more for Medicare Part B if they want “first dollar” coverage from a Medigap plan. The efficiency mentioned is based on the assumption that people will forego this kind of Medigap coverage as a result of the increased cost and then forego unnecessary health care that they would obtain if they had full Medigap coverage.
This is suggestion is based on so many false premises it’s hard to know where to begin. Importantly, Medigap policies only make payment for health care that Medicare has already determined meets coverage criteria and is medically necessary and reasonable. Medigap insurance is there to cover some of the Medicare cost-sharing for this necessary care. Without the Medigap coverage the “efficiencies” and savings Mr. Ryan lists would come as a result of older and disabled people foregoing care that is by definition necessary and reasonable.
• Combine Medicare Parts A and B so the program is less confusing.

We are all for making Medicare less confusing. The Medicare Part C and D systems, added to Medicare in 2003, dramatically increased the complexity of the program and decreased the ability of people to understand and use Medicare. But Mr. Ryan does not suggest reducing reliance on the expensive and redundant Parts C and D. He suggests combining Parts A and B. Again, we have heard these proposals before. In the guise of adding simplicity, they increase costs to the older and disabled people who rely on Medicare. While reducing costs for inpatient hospital care, especially for longer stays, the proposals to combine Parts A and B increase beneficiary costs for those services that people need far more frequently: doctors’ care and other outpatient and community-based health services.

If negotiations are returning to the ceaseless discussions about so-called entitlement reform, (which always makes me wonder who’s entitled and what do we mean by reform), we should be serious. The standard should be what’s best for older and disabled beneficiaries and the budget – regardless of the interests of insurance and pharmaceutical industries.

Anyone who truly wants to simplify Medicare and reduce costs, both worthy goals, should bring these suggestions to the table:
Combine Parts B and D. Do away with the expensive costs associated with running a Medicare prescription drug program only through private plans – or at least give people the choice of getting drug coverage through Part B, in the traditional Medicare program.
• Prohibit Medicare from paying any more for the medications it covers than Medicaid pays. The Congressional Budget Office reports this would save at least $140 billion over ten years.
• Reduce the dependence on private Medicare Part C plans.
These private plans are more expensive to taxpayers and provide less value for beneficiaries.

Case in point: Out of the blue, Connecticut residents learned today that one of the largest Medicare Advantage plans, United Healthcare, is dropping 2250 physicians from its network. This means a lot fewer providers will be available for thousands of older and disabled people – as a result of one non-appealable decision made in the best interest of private profit, not Medicare beneficiaries. Medicare Part C adds complexity and costs and should be scaled back accordingly. Beneficiaries should be encouraged to stay in traditional Medicare, which includes all physicians who participate in the program nationwide and is less expensive for taxpayers.

If Mr. Ryan and his colleagues really want to save money and reform Medicare and Social Security, while maintaining their core missions, it can be done. Let’s talk seriously – if there’s the will, there’s a way.

October 10, 2013 at 2:05 pm Leave a comment

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