JustCare

Tag: Paul Ryan

  • HHS proposals would drive up Medicare costs

    HHS proposals would drive up Medicare costs

    A recent StatPlus story reports that the Trump administration is considering proposals that could drive up Medicare costs significantly for 58 million older adults and people with disabilities. The U.S. Department of Health and Human Services is looking at ways to move more people into Medicare Advantage plans. It is planning a series of pilot programs, and it has asked doctors and hospitals to weigh in on what they would like to see.

    Republican policymakers have long wanted to put a cap on federal Medicare spending. One easy way to do so is to limit per person Medicare payments. But, traditional Medicare does not permit such caps since it must pay for all medically reasonable and necessary services. Medicare Advantage plans, however, allow an easy mechanism for fixed payments.

    To keep people from flocking back into traditional Medicare and to encourage enrollment in Medicare Advantage, HHS wants to increase out-of-pocking costs in traditional Medicare. And, it can do so by making it easier for doctors to enter into private contracts with patients through which patients are liable for the full cost of their care or by lifting the cap on doctors’ charges–the balance billing limits.

    HHS plans to rely on the Centers for Medicare and Medicaid Innovation to develop these pilot programs. CMMI pilots do not require legislative approval. And CMMI has about $1 billion annually to spend on pilots that lower Medicare spending if they also improve quality. The ideas being put forward, however, are in line with many of Congressman Paul Ryan’s proposals for gutting Medicare, with no evidence that they improve quality.

    HHS is also looking to promote the conservative notion of “premium support.” Through premium support, the government would be able cap per person spending on traditional Medicare, by only giving people a fixed amount to help pay their premiums. Higher out-of-pocket spending on premiums, coinsurance and deductibles would mean more costs for people with Medicare. Premium support could be designed to make private Medicare Advantage plans seem a much better deal than traditional Medicare, particularly for people in good health.

    The problem is that premium support would hurt everyone with Medicare. Anyone joining a Medicare Advantage plan to save money could need costly care at any time, driving up their out-of-pocket costs tremendously. And, again, how would premium support promote quality?

    To be clear, MedPAC, the Medicare Payment Advisory Commission, has found year after year that Medicare Advantage plans are less cost-effective than traditional Medicare.  But, they do provide a route for Congress to easily slash spending on Medicare.

    If you believe that Congress should improve and expand Medicare, not cut it, please sign this petition.

    Here’s more from Just Care:

  • Republican Medicaid reform proposals devastating

    Republican Medicaid reform proposals devastating

    As a pediatrician, I prioritize the importance of Medicaid in child health. But as an American I am proud of how Medicaid also cares for 27 million adults with struggling incomes, 6 million older adults, 10 million Americans with disabilities, in addition to 33 million children. With nearly 1 in 3 Americans covered by Medicaid and Medicare, we all know and love people who rely on these programs for their health care. But, the Republican Medicaid reform proposals, which thankfully appear to be dead for now, would be devastating to the program.

    Health care providers are hardly thrilled about lower reimbursement from Medicaid, but American taxpayers should recognize that Medicaid is doing a better job than the private insurance industry at providing cost-effective health care. Prior to states opting for Medicaid expansion under the Affordable Care Act, Medicaid spending growth per enrollee was 3.1 percent, compared to the private insurance industry’s 4.6 percent. In 2013, as states began expanding their Medicaid programs, the Congressional Budget Office revised estimates of projected federal Medicaid spending, and determined the federal government would be spending $385 billion less on Medicaid between 2011 and 2020. Talk about getting bang for your taxpayer buck.

    Despite this track record of high performance and low costs, Congressional Republicans would like nothing more than to destroy and overhaul Medicaid through proposals like block grants and per capita caps. The majority of the American people did not vote for Trump, and they gave zero mandate to his regime or members of Congress to wreck health care.

    However, Trump’s Secretary of Health and Human Services (HHS) Tom Price, Speaker of the House Paul Ryan, and their allies in Congress have plotted against patients before on caps and block grants for Medicaid, which starts by slashing over $1 trillion dollars over 10 years from the program, reducing it by a third of its current size. Then, the federal government would set arbitrary, fixed limits on how much it will contribute to each state’s Medicaid program. There will be no flexibility for any state in the event of economic downfall, epidemics, natural disasters, or other unforeseen challenges. The dominos fall from there, hurting the health care of millions of patients and families.

    Because per capita caps and block grants drastically reduce a state’s financial resources for Medicaid patients, Americans can expect to see 14 million patients kicked out of the program with nowhere else to go for coverage. For those patients who manage to qualify for capped or block-granted Medicaid, the severe budget restrictions will limit already limited benefits. That means my patients with disabilities will have fewer visits with physical therapists. The rising cost of long-term care services will be passed to older Americans because capped or block-granted Medicaid cannot cover as much.

    Currently, patients and families covered by Medicaid are not facing exorbitant out-of-pocket costs for health care and prescriptions. That peace of mind will end with caps and block grants, as more states demand “more skin in the game” from patients who are already struggling with poor economic and health conditions. In the game of caps and block grants, average Americans are the losers.

    Your local hospitals and clinics depend on Medicaid funds in order to serve your community, and that funding needs to be flexible when new health challenges come up from natural disasters, opioid addiction, or diseases like Zika. The per capita caps and block grants envisioned by Ryan and Price are so restrictive that state governments will not receive additional federal Medicaid funds when those unexpected public health challenges arise. Natural disasters and the opioid epidemic are already burdensome for local economies. Capped or block-granted Medicaid will worsen the impact for everyone.

    Doctors, patients, and families need to send a clear message to the Trump regime, our Congress, Secretary Tom Price, and Speaker Paul Ryan: We are standing up for our fellow Americans on Medicaid. We absolutely reject block grants and per capita caps. Medicaid is proving its fiscal responsibility by providing health care on a lean budget to over 70 million Americans. People we love are on Medicaid and they are happy with their care. Where we can make upgrades that improve the health of our fellow Americans, we should. However, the majority of Americans did not vote for their health care to be wrecked by per capita caps or block grants for Medicaid. This cannot happen on our watch.

     

    Here’s more from Just Care:

  • Trump HHS pick is fierce opponent of Medicare and ACA

    Trump HHS pick is fierce opponent of Medicare and ACA

    President-elect Trump‘s choice of Tom Price to head the Department of Health and Human Services (HHS) sends a strong signal that the Trump Administration will be allied with Speaker Paul Ryan in repealing the Affordable Care Act. Price also is a fierce opponent of Medicare. He supports gutting both Medicare and Medicaid and rationing health care based on people’s ability to pay for it.

    As a Congressman and Chair of the House Budget Committee, Price has made his views on health care known. He authored a bill that turns over much control over health insurance to the industry, with the Orwellian name, Empowering Patients First Act. He supports health insurance regulations that allow insurers to charge older people significantly more than they may today and to sell policies that offer less than adequate coverage. And, he is opposed to subsidies to help people with low incomes afford their health care.

    If Price has his druthers, Congress would privatize Medicare and Medicaid, turning them over entirely to private insurance companies. Like Ryan, he wants to eliminate their guaranteed benefits and leave older adults, people with disabilities and people with low-incomes at the mercy of insurers, with inadequate coverage, in the health care marketplace.

    Just recently, Price’s Budget Committee released a plan that would have Congress automatically cut Medicare, Medicaid and Social Security substantially to pay for tax cuts mainly for the wealthiest Americans, which president-elect Trump and Congressional Republicans support. The Center for American Progress reports that under his plan, over ten years, Social Security would be cut $1.7 trillion, Medicare would be cut $1.1 trillion, and Medicaid would be cut by nearly $700,000 billion.

    And, even without Congressional action affecting our health care system, as head of HHS, Price will have tremendous power to drive changes in Medicare, Medicaid and health insurance in America. As head of HHS, Price will determine how laws are interpreted. He can choose for HHS to limit its oversight of health insurers or to stop spending money on enforcement or to revise provider payment policies.

    There’s no candy-coating what will happen if Ryan and Price get their way in Congress. Here’s what we should expect:

    • The ACA will be repealed, Medicare will no longer guarantee basic health care coverage, and Medicaid will likely be turned over to the states in the form of federal block grants.
    • Hospitals and doctors will ratchet up their charges.
    • Drug companies will increase drug prices.
    • Insurance companies will compete for business by keeping their premiums as low as possible for the young and healthy and denying coverage or charging high deductibles and out-of-pocket costs when people need care; people with costly conditions will be forced to pay exorbitant premiums as well as high deductibles and copays for coverage or forego care.
    • Insurers will restrict their coverage as much as possible and give people only a limited choice of doctors and hospitals. There may not be a guaranteed package of Medicare benefits.
    • Government will provide little oversight of the health care industry and/or will not hold insurers accountable for failing to deliver good quality care.

    The American Medical Association, AMA, and American Hospital Association, AHA, are both supporting Tom Price. They likely see deregulation of the health care industry as a way for doctors and hospitals  to charge higher rates and operate with less accountability. However, deregulation of the health insurance industry will ultimately bite doctors and hospitals in the back.

    If Price’s views prevail and Congress kills Medicare and Medicaid, insurers are more than likely to use their leverage to form narrow networks, keeping their enrollees from using costly specialists and specialty hospitals. Alternatively, insurers will raise out-of-pocket costs for specialty care so high that patients won’t be able to afford them, and doctors and hospitals will be left holding the bag.

    If you oppose deregulation of our health insurance system and an end to Medicare’s guaranteed benefits, please sign this petition and visit your Senators to make your views known.

    Here’s more from Just Care:

  • One million “hands off Medicare” petitions delivered to Congress

    One million “hands off Medicare” petitions delivered to Congress

    On Wednesday, Social Security Works, Just Care, and several other organizations delivered more than one million petitions to Congress demanding that it and president-elect Trump keep their hands off Medicare. At the press conference, on behalf of the Democrats in Congress, Senator Chuck Schumer promised to fight “tooth and nail” to protect Medicare, with Senator Bernie Sanders and Congresswoman Nancy Pelosi by his side.

    Donald Trump pledged not to touch Medicare, Medicaid or Social Security during his presidential campaign. And, Bernie Sanders reminded everyone of that. “He said ‘I am not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid,’” […] “Mr. Trump, we are going to hold you accountable.”

    President-elect Trump’s campaign website makes clear that he supports House Speaker Paul Ryan’s agenda. It used to include this language: “I’m not going to cut Medicare or Medicaid.” It now promises to “modernize Medicare,” a euphemism for cutting Medicare, turning Medicare over to private insurance companies, capping government support for the program, and shifting more costs onto older adults and people with disabilities.

    If you believe the government should keep its hands off of Medicare, please sign this petition.

    Watch these highlights from the petition delivery on Capitol Hill:

    Here’s more from Just Care: