Medicare

via Amy Lotven and John Wilkerson of Inside Health Policy:

Pelosi: Drug Pricing May Pay For Health Care Pieces Of Infrastructure Bill

House Speaker Nancy Pelosi (D-CA) said everything is on the table for the next legislative package that is expected to focus on infrastructure improvements and include health care provisions like a permanent increase to the Affordable Care Act tax credits — and she said the package likely will be paid for by tackling prescription drug prices.

...Pelosi said including House Democrats’ drug pricing bill, H.R.3, would pay for $500 billion of the cost of the infrastructure bill, part of which could be used to boost ACA tax credits and make ACA coverage more affordable. The savings also could also be used for other health-related efforts, she said. For example, House Energy & Commerce Chair Frank Pallone (D-NJ) has been working with Rep. Jim Clyburn (D-SC) to expand community health centers and to improve broadband services, which would support telehealth.

 

Not much to add to this. Via RawStory:

At a town hall meeting on Fox News Thursday, President Donald Trump acknowledged that his administration intends to cut Social Security and Medicare.

“We — when these trade deals kick in, you know this economy is the best economy we’ve ever had. It’s nothing to what it’s going to be when the trade deals kick in,” said Trump.

“But if you don’t cut something in entitlements, you’ll never really deal with that,” said the questioner.

“We’ll be cutting, but we’re also going to have growth like you’ve never had before,” said Trump.

Ah. Just what you want in the middle of a reelection campaign and a deadly pandemic outbreak.

video clip originally captured by Pod Save America.

Oh yeah...there's also this:

Four days ago, from Trump Administration Centers for Medicare & Medicaid Administrator, Seema Verma:

No, the Trump administration is not cutting Medicaid. https://t.co/bk5uMMKof4

— Administrator Seema Verma (@SeemaCMS) February 6, 2020

(sigh) Honestly not sure why I'm bothering posting this. Anyone who doesn't understand that the only promises Trump keeps are the racist, xenophobic, homophobic, misogynistic, antisemitic and corrupt ones by this point is either a complete idiot or willfully ignorant:

The Trump administration wants to slash billions of dollars in federal support from Medicaid, food stamps and other safety net programs for the poor, while largely sparing the Medicare program that benefits seniors.

On the one hand, this isn't nearly as big of a technical disaster as the HealthCare.Gov launch was in 2013, I admit.

On the other hand, only 8 million people enrolled in ACA exchange plans in the first 2013-2014 Open Enrollment Period, whereas nearly 60 million are enrolled in Medicare.

via the House Energy & Commerce Committee via email:

Bipartisan House Leaders Raise Medicare Plan Finder Concerns

  • Committee Leaders Urge CMS to Open Special Enrollment Period for Beneficiaries Who Used Plan Finder to Make Enrollment Decisions

Washington, D.C. – Bipartisan House health leaders sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma expressing concerns over reports that the Medicare Plan Finder was confusing, generated incorrect results, and inadvertently led beneficiaries to select plans with lower premiums but higher overall costs.

Believe me, I was certain that I had finally gotten this year's Medical Loss Ratio (MLR) rebate project out of my system. I really was.

However, there was one other MLR-related issue which I've wondered about for years: The ACA requires that carriers who sell policies in the Individual and Small Group markets spend at least 80% of the premium revenue on actual medical claims (limiting them to a 20% gross margin), and 85% on the Large Group market (limiting them to 15% gross).

That accounts for around 165 million people, give or take...roughly 50% of the total U.S. population...but what about the other private (or at least semi-private) insurance markets? I'm referring, of course, to privately-administered Medicare and Medicaid plans...aka Medicare Advantage and Managed Care Organizations (MCOs).

A couple of weeks ago I wrote an extensive piece laying out what seemed, at first glance, to be a bona fide state-level Public Option bill quietly working its way through the Washington State legislature:

Democrats in Olympia push through governor’s 'green' agenda and public healthcare coverage bills

...Another key item on the governor’s agenda is the so-called “public option” socialized health care coverage measure, SB 5526. This bill would create subsidized state-funded public health plans managed by regulated insurance companies. It would require the State Insurance Commissioner and the Health Care Authority to set up the socialized plans by 2021.

,,,These plans would be available through the state’s health care exchange to all residents, but the state would pay subsidies to individuals with incomes of up to five times the poverty level. Premiums would be limited to no more than ten percent of adjusted gross income, and payments to doctors and other health care providers would be restricted to Medicare-level limits.

No, it won't go anywhere with the House held by Democrats, but even so:

President Trump is releasing a $4.7 trillion budget plan Monday that stands as a sharp challenge to Congress and the Democrats trying to unseat him, the first act in a multi-front struggle that could consume Washington for the next 18 months.

The budget proposal dramatically raises the possibility of another government shutdown in October, and Trump used to the budget to notify Congress he is seeking an additional $8.6 billion to build sections of a wall along the U. S.-Mexico border.

Here we go again...

Trump’s “Budget for a Better America” also includes dozens of spending cuts and policy overhauls that frame the early stages of the debate for the 2020 election. For example, Trump for the first time calls for cutting $845 billion from Medicare, the popular health care program for the elderly that in the past he had largely said he would protect.

For as much as I write about healthcare policy, I actually don't write about Medicare itself all that often...at least not Medicare as it's defined today.

However, given all the excitement and confusion about what Medicare is and isn't, here's a handy reminder. Just moments ago the Centers for Medicare & Medicaid published information about 2019 Meciare Parts A & B premiums and deductibles:

CMS announces 2019 Medicare Parts A & B premiums and deductibles

Today, the Centers for Medicare & Medicaid Services (CMS) announced the 2019 premiums, deductibles, and coinsurance amounts for Medicare Parts A and B.

There was a bit of confusion on Twitter this morning (shocker!) over a Modern Healthcare story which reported on a new physician payment policy from the Centers for Medicare & Medicaid (CMS) for Medicare enrollees.

At first it looked like CMS was planning on allowing doctors to "balance bill" Medicare patients. Balance billing is already a controversial issue with private insurance; it's the practice of a doctor/hospital charging the patient directly for the difference between what the doctor wants to be paid and what the insurance company agrees to pay them.

Reagan Bush

 

Whenever the discussion of what the next Big Move for healthcare policy should be comes up in Democratic/progressive circles, the incredibly difficult path which had to be paved to get the Affordable Care Act passed in 2009-2010 is often brought up as an example of how difficult it is to make even minor changes, much less major ones.

That gets a bit repetitive after awhile, however, so here's another excellent case study from 20 years earlier: The Medicare Catastrophic Coverage Act of 1988.

Thanks to Amy Lotven for this trip down memory lane via the New York Times:

Retreat in Congress; The Catastrophic-Care Debacle - A special report.; How the New Medicare Law Fell on Hard Times in a Hurry

With the benefit of hindsight, legislators and policy makers in both parties now agree that the seeds of disaster for the Medicare Catastrophic Coverage Act were sown well before it became law barely a year ago.

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