We all know that Republicans have taken a sledgehammer to Medicaid, cutting $1 trillion over the next the years. Republicans also have not extended the premium subsidies for people with low incomes in the ACA state health insurance exchanges, leaving millions of people unable to afford the premiums and uninsured in 2026. There’s far less attention on the Republicans’ stealth attack on Medicare, which Robert Kuttner highlights in The American Prospect.
Pushing back against Republicans, Democrats in Congress say they will allow the government to shut down when funding ends on September 30, unless Republicans add money to Medicaid and extend the premium subsidies for people in the state health care exchanges. Democrats also want assurances that Trump will spend congressionally appropriated funds for the National Institutes of Health and other medical research.
Without additional government funding for Medicaid and the ACA health plans, most Americans will pay higher health care costs. Hospitals, specialists and other health care providers will charge patients more to help make up for their losses.
Medicare is destined to face $500 billion in cuts over the next decade. The Republicans’ tax law triggers these cuts because it increases deficits. The administration is attacking Medicare in other ways. The Centers for Medicare and Medicaid Services plans to test a program in six states–Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington–that requires providers to get prior authorization for a set of services in traditional Medicare. The government plans to reimburse the corporate middlemen overseeing prior authorizations a percentage of the money they save, creating a powerful incentive for them to deny care.
Though traditional Medicare has never required treating physicians and other providers to get prior authorization before delivering treatments, traditional Medicare remains far more cost-effective than Medicare Advantage and other corporate health insurance. Traditional Medicare leaves out the middlemen that drive up costs.
Some Democratic Senators are urging CMS to halt the pilot program until it gets proper review and comment from interested parties. CMS appears to have circumvented the notice and comment period required before launching the pilot.
Here’s more from Just Care:
- Medicare agency to test prior authorization in traditional Medicare
- Oncologists report excessive deaths from prior authorization
- Prior authorization in Medicare Advantage harms patients, sometimes severely
- Louisiana: Medicare Advantage denials harm patients, while gouging taxpayers
- Proposed new prior authorization rules unlikely to improve access to care for people in Medicare Advantage
