May 23, 2013
The Obama Medicare Agenda: Why Seniors Will Fare Worse
Abstract
/Today's seniors are facing higher Medicare costs. Over the next five
years, current law, as amended by the Patient Protection and Affordable
Care Act, already guarantees higher out-of-pocket costs for seniors.
Beyond the current law, President Obama's latest budget proposal would
increase seniors' costs even more. Many seniors will experience a
reduction in their Medicare Advantage benefits or even a loss of their
existing plan. Medicare “as we know it” is already a thing of the
past'the only way to preserve the Medicare benefit for current and
future retirees is through structural reform. /
Today's seniors are facing higher Medicare costs. Over the next five
years, current law, as amended by the Patient Protection and Affordable
Care Act (PPACA, also known as Obamacare), already guarantees higher
out-of-pocket costs for today's seniors. Beyond the current law, the
President's latest budget proposal would increase seniors' costs even
more. So, notwithstanding “progressive” politicians' rhetorical promise
to “keep Medicare as we know it,” the Obama Administration is formally
committed to increasing seniors' out-of pocket costs, while the
President and his allies in Congress have already enacted major Medicare
payment reductions that threaten their access to care. Beyond the
payment reductions to hospitals, skilled nursing facilities, and home
health care agencies, many seniors will also experience a reduction in
their Medicare Advantage benefits or even a loss of their existing plan.
*Obamacare Radis Medicare to Pay for Other New Programs
~/media/images/reports/2013/05/bg2801/bgobamamedicareseniorsfareworsechart1825.ashx>*
*Status Quo Hikes *
The 2012 Medicare trustees report says that between 2012 and 2017,
seniors' standard Medicare Part B monthly premiums will jump from $99.90
to $128.20, while their Part B deductibles will rise from $140 to
$180.[1] <#_ftn1> Seniors' Medicare hospital deductible will increase
from $1,156 to $1,336, while their /daily /hospital co-insurance will
climb from $289 to $334. For seniors who remain in the hospital beyond
90 days (lifetime reserve days), the per diem co-insurance costs are
estimated to reach $668 by 2017.[2] <#_ftn2>
*Obamacare: Impact on Access to Care.* Obamacare mandates $716 billion
in Medicare payment reductions over the next 10 years.[3] <#_ftn3>
However, contrary to the way they are often portrayed, these cuts are
not aimed at specific instances of “waste, fraud, and abuse.” Rather,
they are across-the-board changes in Medicare payment formulas for
hospitals, nursing homes, home health agencies, hospice agencies, and
Medicare Advantage plans.
Notwithstanding the tiresome rhetoric that Medicare payment reductions
affect /only /providers and /not /beneficiaries, funding cuts for
Medicare services directly affect those who depend on those services. If
these major reductions are implemented by Congress over the coming
decade, seniors' ability to access Medicare services will surely be
compromised. In fact, the Medicare Trustees said that “[a]bsent other
changes, the lower Medicare payment rates would result in negative total
facility margins for an estimated 15 percent of hospitals, skilled
nursing facilities, and home health agencies by 2019, and this
percentage would reach roughly 25 percent in 2030 and 40 percent by
2050.”[4] <#_ftn4>
Seniors Face Severe Access Programs Because of Obamacare Cuts
This means that seniors would have an increasingly difficult time
accessing care. As the Trustees explain,
Medicare's payments for health services would fall increasingly
below providers' costs. Providers could not sustain continuing
negative margins and would have to withdraw from serving Medicare
beneficiaries or (if total facility margins remained positive) shift
substantial portions of Medicare costs to their non-Medicare,
non-Medicaid payers. Under such circumstances, lawmakers would
probably override the productivity adjustments, much as they have
done to prevent reductions in physician payment rates.[5] <#_ftn5>
Moreover, these “savings” are not even reserved to enhance the solvency
of the financially troubled Medicare program. Instead, the “savings” are
used to finance new spending for non-Medicare coverage expansions in
Obamacare.[6] <#_ftn6> Despite the simple fact that the same dollar
cannot be spent twice, the Obama Administration simultaneously claims
credit for extending the life of the Medicare trust fund, financing
expanded health insurance coverage outside Medicare, and reducing the
federal deficit.
*Higher Medicare Taxes. *The PPACA will also increase Medicare taxes.
The law raises the standard Medicare payroll tax, which funds the
hospital insurance (HI) trust fund, on high-income earners (individuals
with an annual income of $200,000 and couples with an annual income of
$250,000) from 2.9 percent to 3.8 percent and also extends the 3.8
percent Medicare tax to investment income. Together, this is the largest
tax increase in Obamacare, costing taxpayers almost $318 billion between
2013 and 2022.[7] <#_ftn7>
Once again, however, the new Medicare payroll tax revenue is
double-counted: It is paying for new spending, while also extending the
life of the trust fund.[8] <#_ftn8> As for the new Medicare tax on
investment income, Medicare trustee Charles Blahous explains that
“[t]hough termed an ‘Unearned Income Medicare Contribution' (UIMC) under
the law, this revenue would not come from Medicare's traditional
contribution base and it would /not /be allocated to a Medicare Trust
Fund.”[9] <#_ftn9> (Emphasis added.)
*Obamacare: Impact on Seniors' Medicare Advantage Coverage.* Currently,
27 percent of all Medicare beneficiaries are enrolled in Medicare
Advantage (MA) plans. MA plans are attractive to beneficiaries because
they offer more comprehensive coverage than traditional Medicare. Most
notably, unlike traditional Medicare, MA plans cap out-of-pocket costs,
which eliminates the need for beneficiaries to pay extra and purchase
separate supplemental insurance, and these plans also routinely offer
drug coverage. Further, since 2007, between 85 percent and 94 percent of
participating seniors have had the option of enrolling in these private
plans while paying /no premium/ other than the standard Medicare Part B
premium.[10] <#_ftn10>
The PPACA reduces payments in the MA program by $156 billion between
2013 and 2022. When the law was enacted in 2010, the Medicare
actuary projected the impact of these cuts: “We estimate that in 2017,
when the MA provisions will be fully phased in, enrollment in MA plans
will be lower by about 50 percent (from its projected level of 14.8
million under the prior law to 7.4 million under the new law).”[11]
<#_ftn11>
According to the Medicare actuary, then, an estimated 7 million seniors
will leave Medicare Advantage over the next four years, but that means
that they will have to re-enroll in the less generous traditional
Medicare program.[12] <#_ftn12> Not only will these seniors face the
loss of their existing comprehensive health plan, they will somehow have
to fill big gaps in their Medicare benefits'which would mean substantial
increases in their out-of-pocket costs. To compensate for gaps in
traditional Medicare coverage, nearly all seniors enrolled in
traditional Medicare purchase separate drug coverage and supplemental
health insurance coverage, which are projected to cost on average $42 a
month and $230 a month, respectively, in 2017.[13] <#_ftn13>
An analysis by health care economists Robert Book and James Capretta
shows, “By 2017, Medicare beneficiaries who would have enrolled in
Medicare Advantage under prior law will lose an average of $1,841 due to
the MA changes alone and $3,714 when the effects of the entire bill,
including the FFS [fee-for-service] cuts, are considered.”[14] <#_ftn14>
But those seniors who remain in MA will also face increased
out-of-pocket costs because of other features of the President's health
care law. Obamacare imposes a special “fee” (a tax) on all health
insurance plans beginning in 2014, including MA plans. Of course, as
with all taxes on firms in any market, the costs of the tax increases
are routinely passed on to consumers in the form of higher prices or, in
the case of insurance, higher premiums. In this particular case, Oliver
Wyman, a leading benefits consulting firm, has estimated, “In the
Medicare market, the premium tax would increase the expected cost of MA
coverage per enrollee by $3,604 over the ten-year period.”[15] <#_ftn15>
*Obama's FY 2014 Budget: Higher Seniors' Premiums.* In his fiscal year
(FY) 2014 budget proposal, President Obama has proposed additional
Medicare changes that would also increase costs for seniors.[16] <#_ftn16>
For Medicare Parts B and D, the President's budget plan would expand
“means testing” in the Medicare program for upper-income seniors,
resulting over time in a total of 25 percent of all Medicare
beneficiaries paying an income-adjusted premium. Under current law,
there are four income-adjusted brackets; seniors in these income
brackets pay progressively higher premiums, ranging from 35 percent to
80 percent of total Medicare program costs. In his latest budget
proposal, President Obama expands the number of brackets from four to
nine, requiring seniors to pay from 40 percent to 90 percent of total
Medicare premium costs. For the lowest bracket, an individual with an
income of $85,000 to $92,333 who is enrolled in Part B and Part D would
have a combined premium increase of about $401.76 in 2017, compared to
what he would pay under current law. For an individual with an annual
income between $178,000 and $196,000, his combined premium increase
would be an estimated $1,615 in 2017 (at 85.5 percent of total costs).
Reduction of taxpayer subsidies for high-income Medicare recipients is
sound policy. There is indeed a large and growing bipartisan consensus
among a variety of analysts on the need to expand the scope of Medicare
“means testing.” While it makes sense to gradually reduce taxpayer
subsidies for an expanded pool of upper-income seniors, it is not
necessary to require one out of every four Medicare beneficiaries to pay
more than the standard Medicare premiums.[17] <#_ftn17>
*Obama's Budget: New Fees *
President Obama's FY 2014 budget would also impose new fees on baby
boomers joining Medicare beginning in 2017. His 2014 budget proposal
introduces a $25 increase in the Part B deductible for new beneficiaries
in 2017, 2019, and 2021, a $75 total increase by 2021, plus a $100
co-payment for home health services in certain cases.
Traditional Medicare incurs excessive costs resulting from
“first-dollar” coverage by Medigap and other supplemental insurance.
This first-dollar coverage increases utilization of medical services and
drives up Medicare costs for seniors and taxpayers alike.
President Obama is right to address the need to curb the first-dollar
coverage that drives up Medicare costs. His solution, however, is hardly
the best available option. The President proposes a premium surcharge'a
kind of “premium tax”'for new beneficiaries who choose a Medigap plan
with first-dollar or near-first-dollar coverage. This approach would
affect a majority of new beneficiaries in Medigap.[18] <#_ftn18> The
surcharge would be equivalent to 15 percent of the average Medigap
premium, adding an estimated $413.60 a year to these seniors' premium
costs.[19] <#_ftn19> While there is general agreement that supplemental
coverage drives up overall Medicare costs, a much better approach would
be to restructure Medicare's cost-sharing arrangements, instead of
imposing yet another federal “tax” on seniors.[20] <#_ftn20>
*Obamacare and Obama's Budget: New Prescription Drug Costs *
The Obama Administration's proposed new out-of-pocket costs will be
coupled with a general increase in premiums for beneficiaries enrolled
in Medicare Part D, the Medicare drug program.
The PPACA designates an estimated $48 billion to reduce out-of-pocket
costs for Medicare beneficiaries, particularly those who find themselves
faced with a gap in coverage for their drug costs, commonly referred to
as the “donut hole.” The President's policy is to close this Medicare
Part D donut hole.[21] <#_ftn21> Under the law, the donut hole is slated
to close by 2020.
While out-of-pocket costs for Medicare Part D will be reduced, the
changes enacted under the new health law will only come at a higher
premium price for seniors. According to the Congressional Budget
Office's 2010 estimate, “enacting those changes would lead to an average
increase in premiums for Part D beneficiaries of about 4 percent in
2011, rising to about 9 percent in 2019.”[22] <#_ftn22>
These Medicare prescription drug premium increases must be understood in
terms of how the Part D donut hole actually affects today's seniors.
While the average premiums of /all/ Part D beneficiaries will increase,
of all 48.6 million Medicare enrollees in 2011, only 3.6 million
actually fell into the donut hole.[23] <#_ftn23> Moreover, approximately
11 million enrollees receive low-income subsidies for drug coverage,
including coverage in the donut hole. Today, most private health plans
already provide additional coverage for beneficiaries who might find
themselves in the donut hole. For 2012, 52 percent of all plans provide
generic or some generic and some brand-name drug coverage in the donut
hole.[24] <#_ftn24>
The President's FY 2014 budget proposal would close the Part D coverage
gap for brand-name drugs in 2015, five years sooner than under current
law. For the small minority of seniors who fall into the donut hole
annually, that would be a welcome development; but most seniors should
also realize that while assisting the small number of seniors who fall
into it, the President's proposal makes the drug benefit more expensive
and thus will result in a general increase in seniors' Part D premiums.
*A Backdoor Tax on Seniors. *Today in Medicare Part D, private plans and
drug manufacturers negotiate a discounted price; it is a market price.
The government is not involved at all in these negotiations. The result:
Market efficiencies have been dramatically successful in controlling
Medicare drug costs and stabilizing the growth in seniors' premiums.
The President's recent budget proposal, however, would require drug
companies to pay the government the difference between the privately
negotiated Medicare price and the price (the “rebate”) the government
sets for the sale of drugs in the Medicaid program for low-income
Medicare beneficiaries. These seniors today receive subsidies, and they
account for about 30 percent of all Medicare Part D enrollees.
The President's proposed Medicare “rebate” would act as a tax on the
drug companies doing business with the federal government, but it would
also function as a price control on Medicare drugs. In other words, the
new rebate policy would distort the Part D market by fixing artificially
low prices for one group of beneficiaries, and creating powerful
incentives for the companies to try to make up the revenue losses by
charging higher prices in other sectors of the Medicare market. This
means that most seniors would experience increased premiums. Analysts
with the American Action Forum estimate that a Medicaid-style rebate for
Part D would increase beneficiary premiums by anywhere between 20
percent and 40 percent.[25] <#_ftn25>
*Out of Options *
President Obama's latest budgetary scheme is not a serious prescription
for long-term Medicare reform. While it tweaks Medicare's administrative
payment systems, it simply retains the current structure and provides
for more cost shifting to seniors.
The President's budget is another indication that the Administration and
its allies on Capitol Hill are running out of consequential options.
They have already cut Medicare Part A and Medicare Advantage
provider-reimbursement rates to levels that even government actuaries
have stated, in print, to be unrealistic. They have instituted a new
Medicare tax on the “unearned” income of upper-income Americans (such as
investment income) that will not even be exclusively used to enhance the
solvency of Medicare. The vaunted Medicare “savings” from Medicare
provider payment reductions and other changes enacted through the PPACA
will also finance health insurance coverage mandated by Obamacare.[26]
<#_ftn26>
America needs a sound Medicare policy. The Obama Administration's agenda
for increased costs for Medicare beneficiaries, plus the latest budget
tweaks to administrative payments, will not reverse the troubled
program's unsustainable course.[27] <#_ftn27>
Americans differ on Medicare reform. They may disagree on the right
future for Medicare. But one thing is certain: Under the Obama agenda,
seniors will pay more'much more'and they will pay this steep price in
many different ways, including a loss of access to care resulting from
demoralized doctors and other medical professionals cutting back on
Medicare practice or, in some cases dropping out of Medicare practice
altogether. Doctors and other medical professionals are facing a bleak
future of continued reimbursement reductions and the higher
administrative costs of complying with an even larger set of
increasingly complex rules and reporting requirements.
The bottom line: Medicare “as we know it” is already a thing of the past
and the only way to preserve Medicare for current and future retirees is
through major, market-based structural reform.[28] <#_ftn28>
*/'/Robert E. Moffit, PhD,*/is Senior Fellow, and /*Alyene Senger*/ is
Research Assistant, in the Center for Health Policy Studies at The
Heritage Foundation./
Show references in this report <#>
[1] <#_ftnref1> Centers for Medicare and Medicaid Services, /2012 Annual
Report of the Boards of Trustees of the Federal Hospital Insurance and
Federal Supplementary Medical Insurance Trust Funds/, April 23, 2012,
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ReportsTrustFunds/Downloads/TR2012.pdf
(accessed
April 15, 2013). There is a “hold harmless” provision that applies to
Part B premium increases. As the Trustees' report explains, “Part B
premiums may also vary from standard rate because a ‘hold-harmless'
provision can lower the premium rate for individuals who have their
premiums deducted from their Social Security benefits. On an individual
basis, this provision limits the dollar increase in the Part B premium
to the dollar increase in the individual's Social Security benefit. As a
result, the person affected pays a lower Part B premium, and the net
amount of the individual's Social Security benefit does not decrease
despite the greater increase in the premium.”
[2] <#_ftnref2> Ibid.
[3] <#_ftnref3> Douglas W. Elmendorf, Director, Congressional Budget
Office, letter to Speaker John Boehner, U.S. House of Representatives,
July 24, 2012,
http://www.cbo.gov/sites/default/files/cbofiles/attachments/43471-hr6079.pdf
(accessed
May 15, 2013).
[4] <#_ftnref4> Centers for Medicare and Medicaid Services, /2012 Annual
Report of the Boards of Trustees of the Federal Hospital Insurance and
Federal Supplementary Medical Insurance Trust Funds/, April 23, 2012, p.
217.
[5] <#_ftnref5> Ibid.
[6] <#_ftnref6> Douglas W. Elmendorf, Director, Congressional Budget
Office, letter to the Honorable Jeff Sessions (R–AL), U.S. Senate,
January 22, 2010. The letter states, “The reductions in projected Part A
outlays and increases in projected HI revenues resulting from PPACA
would significantly raise balances in the HI trust fund and might
suggest that significant additional resources…had been set aside to pay
for future Medicare benefits. However, only the additional savings by
the government as a whole truly increase the government's ability to pay
for future Medicare benefits or other programs, and those would be a
much smaller.… Unified budget accounting shows that the majority of the
HI trust fund savings under PPACA would be used to pay for other
spending and therefore would not enhance the ability of the government
to pay for future Medicare benefits.”
[7] <#_ftnref7> Elmendorf, letter to Speaker Boehner.
[8] <#_ftnref8> Elmendorf, letter to Senator Sessions.
[9] <#_ftnref9> Charles Blahous, “The Fiscal Consequences of the
Affordable Care Act,” Mercatus Center at George Mason University, April
10, 2012, p.
49, http://mercatus.org/sites/default/files/The-Fiscal-Consequences-of-the-Affordable-Care-Act_1.pdf
(accessed May 16, 2013).
[10] <#_ftnref10> Medicare Payment Advisory Commission, “A Data Book:
Health Care Spending and the Medicare Program,” June 2012, p.
159, http://www.medpac.gov/documents/Jun12DataBookEntireReport.pdf
(accessed May 15, 2013).
[11] <#_ftnref11> Centers for Medicare and Medicaid Services, “Estimated
Financial Effects of the ‘Patient Protection and Affordable Care Act,'”
as amended,” April 22, 2010, p. 11,
http://www.cms.gov/Research-Statistics-Data-and-Systems/Research/ActuarialStudies/downloads/PPACA_2010-04-22.pdf
(accessed
May 15, 2013).
[12] <#_ftnref12> We should note here that the Congressional Budget
Office (CBO) released a May 2013 Medicare baseline that estimates an
increase in Medicare Advantage enrollment over the next decade, a
projection directly at odds with the decline the Medicare actuary
predicts. The CBO, however, offered no explanation for its latest
adjustment to estimated MA enrollment or its revision of previous
projections.
[13] <#_ftnref13> Centers for Medicare and Medicaid Services, /2012
Annual Report of the Boards of Trustees of the Federal Hospital
Insurance and Federal Supplementary Medical Insurance Trust Funds/,
April 23, 2012, p. 229, and calculations based on Department of Health
and Human Services, “Variation and Trends in Medigap Premiums,” December
2011, http://aspe.hhs.gov/health/reports/2011/medigappremiums/index.pdf
(accessed May 15, 2013). For Medigap plans, the average annual premium
increase from 2001 to 2010 was 3.8 percent, and average premiums in 2010
were $177. If premiums continued to increase at 3.8 percent a year, the
average Medigap premium would be $229.80 in 2017.
[14] <#_ftnref14> Robert A. Book and James C. Capretta, “Reductions in
Medicare Advantage Payments: The Impact on Seniors by Region,” Heritage
Foundation /Backgrounder/ No. 2464, September 14, 2010,
http://www.heritage.org/research/reports/2010/09/reductions-in-medicare-advantage-payments-the-impact-on-seniors-by-region.
[15] <#_ftnref15> Chris Carlson, “Annual Tax on Insurers Allocated by
State,” Oliver Wyman, November 2012, p. 7.
[16] <#_ftnref16> Office of Management and Budget, /Budget of the United
States Government: Fiscal Year 2014/,
http://www.whitehouse.gov/sites/default/files/omb/budget/fy2014/assets/budget.pdf
(accessed
May 15, 2013).
[17] <#_ftnref17> Under the Heritage Foundation proposal, for example,
the current Medicare policy of reducing taxpayer subsidies for
high-income seniors' Medicare coverage would be continued and expanded.
Reductions in taxpayer subsidies would be phased down gradually, and
phased out entirely for the wealthiest 3 percent of Medicare recipients.
But the Heritage subsidy reduction proposal would affect less than 10
percent of the entire Medicare population. See Stuart M. Butler, Alison
Acosta Fraser, and William W. Beach, eds., /Saving the American Dream:
The Heritage Plan to Fix the Debt, Cut Spending, and Restore
Prosperity/, The Heritage Foundation, 2011, p. 20,
http://savingthedream.org/.
[18] <#_ftnref18> Department of Health and Human Services, “Variation
and Trends in Medigap Premiums.” Together, Medigap plans C and F enroll
57.7 percent of all Medigap enrollees.
[19] <#_ftnref19> Calculation based on data from Department of Health
and Human Services, “Variation and Trends in Medigap Premiums.” The
average annual premium increase from 2001 to 2010 was 3.8 percent and
average premiums in 2010 were $177. If premiums continued to increase at
3.8 percent a year, the average Medigap premium would be $229.80 in
2017. Therefore, a 15 percent surcharge would equal $34.47 a month and
$413.64 a year in 2017.
[20] <#_ftnref20> For a discussion of this issue, see Robert E. Moffit
and Alyene Senger, “Medicare's Outdated Structure'and the Urgent Need
for Reform,” Heritage Foundation /Backgrounder/ No. 2777, March 22,
2013, p. 3,
http://www.heritage.org/research/reports/2013/03/medicares-outdated-structureand-the-urgent-need-for-reform;
Robert E. Moffit, “The First Stage of Medicare Reform: Fixing the
Current Program,” Heritage Foundation /Backgrounder/ No. 2611, October
17, 2011,
http://www.heritage.org/research/reports/2011/10/the-first-stage-of-medicare-reform-fixing-the-current-program;
and Robert E. Moffit and Drew Gonshorowski, “Double Coverage: How It
Drives Up Medicare Patient and Taxpayer Costs,” Heritage Foundation
/Backgrounder/, forthcoming.
[21] <#_ftnref21> The “donut hole” is the congressionally created gap in
Medicare drug coverage in which beneficiaries must pay 100 percent of
the total costs up to a specific “catastrophic” threshold ($4,750 in
2013). When that dollar threshold is reached, the insurance resumes
payment. The oddity of this benefit design has no parallel in the
private market.
[22] <#_ftnref22> Congressional Budget Office, “Comparison of Projected
Medicare Part D Premiums Under Current Law and Under Reconciliation
Legislation Combined with H.R. 3590 as Passed by the Senate,” March 19,
2010, http://cbo.gov/sites/default/files/cbofiles/ftpdocs/113xx/doc11379/comparison.pdf
(accessed October 24, 2012).
[23] <#_ftnref23> Kaiser Family Foundation, “The Medicare Prescription
Drug Benefit,” October 2012, p.
1, http://www.kff.org/medicare/upload/7044-13.pdf (accessed November 1,
2012).
[24] <#_ftnref24> Medicare Payment Advisory Commission, “A Data Book:
Health Care Spending and the Medicare Program,” p. 163.
[25] <#_ftnref25> Doug Holtz-Eakin and Michael Ramlet, “Cost Shifting
Debt Reduction to America's Seniors: Medicare Part D Rebates Would
Dramatically Increase Drug Premiums,” American Action Forum, July 21,
2011, http://americanactionforum.org/sites/default/files/AAF_Part%20D%20Financial%20Impact%202%20.pdf
(accessed May 15, 2013).
[26] <#_ftnref26> Elmendorf, letter to Speaker Boehner, and Elmendorf,
letter to Senator Sessions.
[27] <#_ftnref27> Alyene Senger and John Fleming, “Medicare at Risk:
Visualizing the Need for Reform,” Heritage Foundation chart series,
March 2013,
http://www.heritage.org/research/projects/medicare-at-risk-visualizing-the-need-for-reform#.UYGA7qLUep0.
[28] <#_ftnref28> For a further discussion on premium support, see
Robert E. Moffit, “The Second Stage of Medicare Reform: Moving to a
Premium Support Program,” Heritage Foundation /Backgrounder/ No. 2626,
November 28, 2011,
http://www.heritage.org/research/reports/2011/11/the-second-stage-of-medicare-reform-moving-to-a-premium-support-program.
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READ OUR LATEST REPORT ON Health Care
Medicare's SGR: Fixing It the Right Way, Not in a Lame Duck Session
Read More
Key Points
1. 1 Through the enactment of the Patient Protection and Affordable
Care Act (PPACA), the Obama Administration and its allies in
Congress have already committed to increasing seniors'out-of-pocket
costs, while implementing steps that are sure to significantly
reduce their access to care.
2. 2 The President's latest budget proposal doubles down on this flawed
approach. It does not substantially reform the financially desperate
Medicare program; it simply shifts costs to seniors. While these
increased costs are substantial to beneficiaries, they are mere
tweaks to an enormous and troubled Medicare program.
3. 3 Medicare "as we know it" has already been drastically changed by
the PPACA, and the only way to preserve the Medicare benefit for
current and future retirees is through structural reform.
Key Points
* Through the enactment of the Patient Protection and Affordable Care
Act (PPACA), the Obama Administration and its allies in Congress
have already committed to increasing seniors'out-of-pocket costs,
while implementing steps that are sure to significantly reduce their
access to care.
* The President's latest budget proposal doubles down on this flawed
approach. It does not substantially reform the financially desperate
Medicare program; it simply shifts costs to seniors. While these
increased costs are substantial to beneficiaries, they are mere
tweaks to an enormous and troubled Medicare program.
* Medicare "as we know it" has already been drastically changed by the
PPACA, and the only way to preserve the Medicare benefit for current
and future retirees is through structural reform.
This report discusses:
* Health Care Reform
* Medicare
* Obamacare
Why Obamacare is Wrong for America
About the Author
[Robert Moffit]
Robert E. Moffit, Ph.D. Senior Fellow