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Medicare News
Medicare, Medicaid Veterans Health Care in
Washington Political Spotlight
Republicans want to cut Medicare, Medicaid;
Democrats want to expand VA health care, key report says traditional
Medicare more efficient than Medicare Advantage
 March 12, 2008 Republicans have introduced their
budget proposal for fiscal 2009, which calls for cuts to the critical
senior citizen programs of Medicare and Medicaid, but that was just the
hottest political move in Washington impacting health care for seniors
and veterans. A committee hearing heard a key report saying traditional
Medicare is a more efficient way of delivering benefits than Medicare
Advantage plans, which supports Democratic efforts to end government
subsidies to the MA plans. The comptroller general criticized the
government in an interview for not acting to secure the financial future
of the entitlement programs. KaiserNetwork.org also reports Democrats
trying to expand the veterans health care system.
Republicans Unveil
Budget Plan That Includes Cuts to Medicare, Medicaid, as House Prepares
To Debate Legislation
Republicans have unveiled a fiscal year 2009 budget
plan that includes cuts to Medicare and Medicaid in response to the
Democrats' $3 trillion budget proposal (H.
Con. Res. 312) that would increase funding for many domestic
programs, the
AP/Houston Chronicle reports. According to the AP/Chronicle, the
"rival budget plans display the difficult trade-offs facing the next
president, who must weigh tax cuts that expire at the end of 2010 with
popular spending programs like education, highway construction and
Medicare."
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Related Stories |
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Health Care
Spending to Double to $4.3 Trillion by 2017; Boomers Drive Medicare
Increased use to double prescription drug spending as
prices go down, generics grow
Feb. 26, 2008
Kohl Wants Action from Medicare Advantage Plans on
Marketing Reform
'Weve heard pledges and promises from this group
before,' he says to recent statement by insurance trade group
March 10, 2008
Medicare Advantage Plans Higher Than Traditional
Medicare for Some Seniors
Medicare Advantage plans to cost Medicare extra $54
billion from 2009 to 2012, GAO reports
Feb. 29, 2008
LA Times Says Employers Moving Retirees to Medicare
Advantage; Driving Up Cost for Other Seniors
Senate Kent Conrad (D-N.D.) called the program "a
runaway train
Feb. 12, 2008
Finance Committee Moves from Stimulus Plan to
Medicare Advantage Problems
Sen. Baucus says, There are too many problems and
abuses.
Feb. 8, 2008
Cost of Entitlement Programs Driven by Skyrocketing
Health Care Costs, Aging Population
Since 1960 health care costs have grown 2.7
percentage points faster per year than the economy as a whole
Feb. 4, 2008
Health Care Providers to Bear Brunt of Medicare Cost
Over-Runs in Future
Administration adds budget feature automatically reducing
payments when costs exceed 45% of funding
Feb. 4, 2008
Senior
Citizen Entitlement Programs Take $208 Billion Hit in Bush Budget
President lays out $3.1 trillion budget and again
says Congress must solve financial future of Medicare, Medicaid, Social
Security
Feb. 4, 2008
Read the latest
news
>
Medicare
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Medicare Drug Program
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Today's
Senior Headlines |
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The Republicans' plan would retain income tax rate
cuts proposed by President Bush and approved by Congress, as well as tax
breaks for married couples, people with children, on investments and
people inheriting large estates. The plan would be paid for through
significant cuts to Medicare, Medicaid and other programs. The House and
Senate are expected to vote on the budget resolution this week.
The budget resolution "sets the stage" for
follow-up legislation on taxes and benefit programs such as Medicare and
for the 12 appropriations bills, according to the AP/Chronicle. However,
unless such legislation is passed, "the budget debate has little real
effect and is mostly about making statements about party priorities,"
the AP/Chronicle reports. According to the AP/Chronicle, in election
years, "Congress invariably leaves alone difficult budget issues such as
the unsustainable growth in benefit programs such as Medicare" and
focuses on appropriation bills, but even action on those bills could be
delayed because of "hard feelings" between Democrats and Republicans
(Taylor, AP/Houston Chronicle, 3/12).
In related news, House Speaker Nancy Pelosi
(D-Calif.) on Tuesday during a speech to the
National League of Cities' Congressional Conference said that House
Democrats will look to include more funding for domestic programs,
including health care, than Bush has requested (Hess, CongressDaily,
3/12).
MedPAC Chair Says
Medicare More Efficient in Delivering Benefits Than Medicare Advantage
Plans
Medicare Payment Advisory Commission Chair Glenn Hackbarth in a
Tuesday hearing of the House Ways and Means
Health Subcommittee said traditional Medicare is a more efficient
way of delivering benefits to beneficiaries than Medicare Advantage
plans, CongressDaily reports (Johnson, CongressDaily, 3/12).
Hackbarth told the panel that compared with
beneficiaries in the traditional program, Medicare spends about $10
billion more annually on beneficiaries enrolled in MA plans, but there
is little evidence of added benefit to justify the extra spending.
MedPAC predicts MA plan payments this year will be 113% of anticipated
fee-for-service spending and 117% of payments to private fee-for-service
plans (Carey,
CQ HealthBeat, 3/12).
MedPAC has recommended eliminating the extra
payment MA plans receive, a proposal supported by many Democrats but
"ardently opposed" by the Bush administration and most Republicans,
according to CongressDaily.
Hackbarth "took particular aim" at fee-for-service
MA plans, which submit bids to the administration at more than 8% higher
than the traditional Medicare rate and in some states receive payments
as much as 20% higher than Medicare, CongressDaily reports. Hackbarth
said, "When Medicare pays a lot more for private fee-for-service in
Texas or in Michigan, a lot of that money is going to higher
administrative costs. ... It's going to insurance companies"
(CongressDaily, 3/12).
Lawmaker Comments
Subcommittee Chair Pete Stark (D-Calif.) said that
he agreed with the MedPAC recommendations and that he would try to
implement them.
Senate Finance Committee Chair Max Baucus (D-Mont.) and other
Democrats have proposed cuts to MA plan payments as part of Medicare
legislation this spring, CQ HealthBeat reports.
Subcommittee ranking member Dave Camp (R-Mich.)
said such cuts would result in 22 states not having any MA plan
beneficiaries, adding that beneficiaries remaining in MA plans "would
see their benefits slashed and out-of-pocket costs increase."
However,
Camp said, "I want to be clear that I'm not suggesting we shouldn't look
at savings opportunities in the Medicare Advantage arena, including
adjusting benchmarks to recognize true market forces" (CQ HealthBeat,
3/12).
Rep. Sam Johnson (R-Texas) asked whether Hackbarth
thought the government was a better insurer than the private industry.
Hackbarth disagreed with Johnson's statement, noting that some MA plans
cost less than traditional plans and deliver higher quality care. "The
problem with this payment system is we're rewarding inefficient private
plans," Hackbarth said (CongressDaily, 3/12).
Comptroller General
Walker Criticizes Congress for Failure To Address Financial Problems for
Entitlement Programs
Comptroller General David Walker on Monday "chided"
Congress for "ignoring the long-term financial crisis" for entitlement
programs such as Medicare and Medicaid, CongressDaily reports. In an
interview with
National Journal Group writers and editors, Walker, who will leave
his post next week, said that Congress is "doing nothing about the $53
trillion hole" in funds for entitlement programs during the 21st
century.
Walker recommended that the next president appoint
a bipartisan commission to develop a proposal to address the issue and
submit the plan to Congress. In addition, Walker recommended a
"mandatory reconsideration trigger" for a reduction in Medicare spending
in the event that spending for the program increases at a higher rate.
Under current law, the president must propose
legislation to revise Medicare when trustees estimate for two
consecutive years that general fund revenue would finance more than 45%
of total program costs within seven years.
The law does not require a
reduction in Medicare spending. Walker said, "We write a blank check for
(health care)," adding, "There is no other country in the world dumb
enough to do that" (Kivlan, CongressDaily, 3/12).
Democrats Call for
Gradual Expansion of VA Health System
Some Democratic lawmakers support a policy shift
that would gradually allow middle- and higher-income veterans into the
Department of Veterans Affairs health care system, CQ Today reports.
Since 2003, so-called "Priority 8 veterans" -
veterans who were not disabled during their service and who have incomes
greater than $27,790 - cannot enroll in the VA health system. The income
threshold is higher for veterans with dependents and for those living in
areas with a high cost of living.
The policy was put in place by then-VA Secretary
Anthony Principi in an effort to reduce waiting lists and costs.
Democratic lawmakers called for the enrollment of Priority 8 veterans in
their "views and estimates" of President Bush's fiscal year 2009 budget
request, but "it appears that some lawmakers have moderated their
views," according to CQ Today.
Senate Veterans' Affairs Committee Chair Daniel Akaka (D-Hawaii)
this week is circulating a letter that calls for changes to the income
threshold but does not call for admitting Priority 8 veterans into the
health system. According to the letter, which will be sent to VA
Secretary James Peake, enrolling some Priority 8 veterans in the VA
system could generate additional revenue for VA because many
middle-income veterans have private insurance. In addition, Priority 8
veterans would have to contribute copayments for VA care.
During a Feb. 13 hearing, Peake was "noncommittal"
about increasing the threshold, according to CQ Today. He said the VA's
priority "is appropriately for those with service-connected
disabilities, those with special needs, and those who really have a
significant economic need." The threshold can be altered by Congress or
VA. According to VA, if all new Priority 8 veterans were allowed to
enroll in the VA health care system, it would cost $3.1 billion in the
first year, $16.9 billion over five years and $39.3 billion over 10
years.
House Appropriations
Subcommittee on Military Construction, Veterans Affairs and Related
Agencies Chair Chet Edwards (D-Texas) last week proposed a plan that
would expand VA eligibility and allow some Priority 8 veterans into the
system but would not completely lift the ban on Priority 8 enrollment.
He said, "My assumption would be, if, overnight, we opened the doors of
our VA hospitals to all the Priority 8 veterans, you could end up having
such a dramatic increase in demand that you end up compromising quality,
increasing waiting lines for doctors' appointments for millions of
veterans, including those presently using the system" (Yoest, CQ Today,
3/11).
Shalala
Former
HHS Secretary Donna Shalala on Monday said Bush is making progress
in improving veterans' care at
Walter Reed Army Medical Center, but Congress has stalled on other
recommendations, the
Raleigh News & Observer reports (Price, Raleigh News & Observer,
3/11). Bush in March 2007 named former Sen. Bob Dole (R-Kan.), a
disabled veteran of World War II, and
University of Miami President Shalala as co-chairs of a nine-member
presidential commission charged with making recommendations to improve
military and veterans' health care.
Bush formed the group after the
Washington Post published a two-part series that examined problems with
the conditions at Walter Reed and the process by which injured veterans
seek disability compensation (Kaiser
Daily Health Policy Report, 7/26/07).
Shalala, in a speech at
North Carolina University, said most of the commission's
recommendations could be implemented through executive order, and about
10% require congressional approval. However, the election year is
distracting Congress from acting on the recommendations, Shalala said
(Raleigh News & Observer, 3/11).
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