Social Security, Medicare & Medicaid Work for America

This week, in honor of Medicare’s birthday, Strengthen Social Security, a coalition of 300 national and state organizations, announced the release of a new series of reports, Social Security, Medicare & Medicaid Work for America. The reports show the clear value and benefits these programs provide in each state, as well as the raw numbers and demographics of people whose lives have literally been saved by America’s social safety net. (Current)

LA Times: Medicare patients happier than those with private coverage

Elderly Americans on Medicare are substantially happier with their insurance coverage than their younger counterparts who rely on commercial insurance, according to a new national survey.

Only 8% of Medicare beneficiaries 65 or over rated their coverage “fair” or “poor,” the nonprofit Commonwealth Fund found.

By comparison, 20% of those with employer-based coverage gave their insurance plan low marks. And 33% of people who bought insurance on their own reported unhappiness with their coverage.

“There are a lot of myths out there,” said Commonwealth Fund president Karen Davis, lead author of the report published in the journal Health Affairs. “It is important to remember how well Medicare performs.”

What the Health Care Ruling Means for Medicare:

  • A number of preventive services, including mammograms, bone scans and depression and diabetes screenings, no longer involve deductibles and co-pays under the Affordable Care Act.
  • The gradual closing of the dread “doughnut hole” gap in Part D drug coverage by 2020 will proceed, bolstered by discounts that have already lowered drug costs.
  • The Court’s action preserves several initiatives advancing efforts to support elderly and disabled people in their homes, rather than in nursing homes.
  • Starting in 2014, the Affordable Care Act will help husbands and wives hold onto more of their assets if a spouse must spend down to qualify for Medicaid.
  • Provisions that strengthen efforts to cut Medicare abuse and fraud will survive as well. 
The Bottom Line: Great news for seniors on Medicare.

The Hill: Medical specialists push back on initiative from healthcare law

Medical specialists are urging regulators to slow implementation of an initiative funded by the 2010 healthcare law that aims to streamline care for some low-income elderly and disabled patients.

In a letter, the Alliance of Speciality Medicine asked the Centers for Medicare and Medicaid Services (CMS) for a one-year delay on the grounds that the current “direction and speed” of the project’s implementation would jeopardize payments to medical professionals as well as the care of so-called dual eligibles — people enrolled in both Medicare and Medicaid.

“While the goal of the program is to eliminate duplication of services for these patients,” the group wrote, “we are deeply concerned about unintended consequences.”

The average cost of care for a dual eligible is five times more than that of a regular Medicare beneficiary, according to the Kaiser Family Foundation. The CMS program would give 15 states up to $1 million to create pilot programs aimed at increasing the efficiency of that care.

The alliance’s letter expressed “significant concern” that the demonstrations would trigger “unsustainable cuts in provider payment rates.”

San Francisco Chronicle: Future of Medicare & Why You Should Be Worried

What Would Happen if the Medicare Program was Terminated?
If the Medicare program was terminated, the financial situations of high risk groups such as the elderly and the disabled would significantly worsen. Seniors and disabled citizens would be forced to find health coverage elsewhere, and that may not be possible due to pre-existing condition clauses that are in place with many major insurance carriers. Additionally, premium costs could sky rocket because many insurance programs charge based on age-banding rules.

Expect Even Higher out of Pocket Costs
The death of Medicare would mean an increase in the financial burden on senior citizens and the disabled. Medical costs would skyrocket for these groups and there is no guarantee that they will be able to find a health insurance carrier to cover them without a waiting period. Even though the deductible for Medicare is high, the medical services that it covers are even higher. If the recipient is able to find an insurance carrier willing to cover them without a waiting period, they can expect to have their mouth drop in shock when they see the premium costs. An unfortunate truth is that individual coverage for senior citizens and disabled patients is nothing short of outrageous. In order to offset these high costs, a bit of financial planning is in order.

Why the Younger Generations Should Worry
Although retirement may seem like a long way off, it takes a lifetime to save up for a hearty retirement fund. If Medicare ceased to exist, you may need to save up even more money for your future retirement. In order to save up enough money for retirement, you would need to take full advantage of your 401(k), pension plans and retirement savings plans in order to optimize your retirement savings. The safety nets that older generations have come to depend on may not be around when you need them most.

Source: sfgate.com

The Kansas City Star: Q&A about possible changes to Medicare

Medicare will remain untouched at least until next year?

No. The 2010 health care law made some potentially important money-saving changes to the program. It saves $500 billion in Medicare spending over 10 years, in part by cutting rates to private Medicare Advantage plans and reducing payments to hospitals and other medical providers.

It also requires higher-income seniors to pay more for their care. In addition, the law created a yet-to-be-constituted panel of experts, called the Independent Payment Advisory Board, to cap federal spending on Medicare at no more than the growth rate of the gross domestic product plus 1 percent.

After November’s elections, lawmakers will seek agreement on ways to cut the deficit once again, including through targeted proposals to lower Medicare spending. If they’re unsuccessful, automatic spending cuts of 2 percent are slated to start taking effect next year, all from payments to hospitals and other care providers.

Is there anything that Democrats and Republicans agree on?

Paul Ryan (R-WI) and Obama have proposed capping the growth of Medicare to the annual increase in the gross domestic product plus 0.5 percent. Members of both parties talk about increasing the eligibility age of Medicare from 65 to 67 and requiring higher-income beneficiaries to pay more.

Where do the presidential candidates stand on Medicare?

Romney’s plan is similar to the one the House approved last week, which he and competitor Newt Gingrich have endorsed. Rick Santorum, another GOP competitor, also supports Ryan’s ideas, but has said he’d prefer eliminating the traditional, government-run program and requiring beneficiaries to choose from plans offered by private insurers. Candidate Ron Paul, a Republican congressman from Texas, would maintain Medicare for current seniors but would wean younger people away from the insurance program in favor of free-market approaches.

Obama takes a somewhat different tack: His health care law retains Medicare’s benefit structure but authorizes some efforts to try restraining spending by moving to a reimbursement system that rewards providers based on patient outcomes, rather than on volume.

Source: kansascity.com