The Senate is now considering the House reconciliation bill, and it’s still anyone’s guess whether the more than $700 billion in Medicaid cuts will remain in the bill. These drastic Medicaid cuts are not enough to offset the cost of extending tax breaks to ultra-wealthy Americans, which is also in the bill. Some Republican Senators were considering eliminating waste and fraud in Medicare Advantage as a way to reduce federal spending, reported John Wilkerson for StatNews. Sadly, that’s no longer on the table, reports xxx for Politico.
Eliminating the overpayments to Medicare Advantage insurers would be a huge win for people with Medicare, the Medicare Trust Fund, and taxpayers writ large. The Congressional Budget Office projects that the overpayments will cost $1 trillion over the next ten years. Ending the overpayments would add $520 billion back into the Medicare Trust Fund and reduce Medicare premiums by more than $200 billion, according to the Committee for a Responsible Federal Budget.
As the House bill stands, it would trigger $500 billion in Medicare provider cuts, which President Trump has said he opposes. Cutting Medicare provider payments would be a dangerous move politically, as older adults vote. Therefore, some Republicans were focused on eliminating waste and fraud in Medicare.
Senator Lisa Murkowski of Alaska advocated for keeping insurers from gaming the payment system. They make their enrollees appear sicker than they are, adding diagnoses codes to their medical charts and then charge the government more than what’s appropriate to provide Medicare benefits to their enrollees. Senators Roger Marshall of Kansas, Susan Collins of Maine and Ron Johnson of Wisconsin were also talking about ending the insurers’ ability to add diagnoses codes to enrollees’ medical records, without providing them with any additional care associated with those codes.
In Ron Johnson’s view: “We can’t afford to waste money, we can’t afford fraud, we can’t afford abuse of taxpayer dollars. So we got to look at those things.” President Trump appears open to any cuts targeted on waste, fraud and abuse.
Senators Cassidy and Merkley have a bipartisan bill to prevent some of this “upcoding.” The Congressional Budget Office says their bill would save $124 billion; others say it could save up to $275 billion over ten years. But, including provisions from that bill or any other provisions that take money from Medicare Advantage, even if it’s pure waste are no longer in the cards, reports Politico.
Senator Kevin Cramer of North Dakota, who had suggested they include cuts to Medicare Advantage waste in the reconciliation bill last week, now says it is not likely to be included in the final bill. In his view, “There aren’t many of us courageous enough to talk about it.” The insurers are claiming, as they always do, that it would be a cut to benefits. While they can argue whatever they please, cutting waste should not lead to benefits cuts.
It’s still not at all clear what the Republicans will agree on. But, ending waste in Medicare Advantage seems to be off the table. Senator Josh Hawley of Missouri argues that it would be a mistake for them to touch Medicare in any way, reports Bloomberg News.
Here’s more from Just Care:
- Government can easily cut $500 billion in Medicare Advantage waste
- Cassidy and Merkley unite to eliminate waste in Medicare Advantage
- House reconciliation bill would push millions off Medicaid
- Five things to think about when choosing between traditional Medicare and a Medicare Advantage plan
- Medicare Advantage inappropriate denials of care abound
