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Celebrating 35 years of making Medicare more accessible, affordable, and equitable!

Julie Carter

Senior Federal Policy Associate

Once Again, Medicaid Work Requirements are Found Impermissible

Yesterday, a federal judge blocked efforts by two states to impose onerous paperwork and employment requirements on Medicaid recipients as a condition of maintaining coverage. For the second time, the judge found that Kentucky’s plan was not permissible under the Medicaid statute, and that similar rules in Arkansas — that have already led to thousands of Arkansans losing coverage — could not stand. The rulings are a set back for the Trump Administration, which has sought to reshape the Medicaid program by allowing states to implement such restrictions.

Electronic Health Records Can Be Useful for Patients, but Concerns Remain

Electronic Health Records (EHRs) allow providers and hospitals to input information about a patient’s health, diagnoses, and treatments into a computer system. These records can, when used correctly, help physicians keep track of patient histories and preferences and improve quality of care. They also give patients more access to their own data, increasing their ability to seek second opinions, better understand their health issues, and make corrections where needed. The use of EHRs has exploded in recent years, with 9% of hospitals using them in 2008 and 96% today.

Lack of Dental Coverage has Real Costs and Consequences for People with Medicare

This week, the nonpartisan Kaiser Family Foundation (KFF) released an issue brief examining the issue of oral health for people on Medicare. It describes the consequences of foregoing dental care, current sources of dental coverage, use of dental services, and related out-of-pocket spending.

Despite the evidence that oral health is related to physical health, Original Medicare does not cover most dental care needs. While some Medicare Advantage plans may offer dental benefits, this coverage is often limited, and its availability can vary considerably across plans. As a result, many people with Medicare often lack adequate oral health coverage, which exposes them to serious health complications and high out-of-pocket spending.

Why Do People Leave Medicare Advantage for Original Medicare?

This week, researchers released an analysis of patterns in Medicare showing that people with high needs—like significant chronic illness—and people with both Medicare and Medicaid coverage choose to leave their Medicare Advantage (MA) plans more often than people without similar health issues or Medicaid coverage. The researchers sought to discover why these patterns exist and what the implications might be for MA going forward.

Many Older Adults with Medicare Not Getting the Long-Term Help They Need

A new study by the Commonwealth Fund examines the use of long-term services and supports (LTSS) among Medicare beneficiaries age 65 and older, and finds that the Medicare program is falling behind in offering the supports many older adults need. Currently, Medicare does not broadly cover most types of LTSS that could help older adults and people with disabilities remain in their homes and communities as they age. While Medicare Advantage does cover some limited LTSS, this coverage is spotty, and does not apply to the approximately two-thirds of Medicare beneficiaries who rely on Original Medicare.

CMS Announces New Model to Reduce Unnecessary Emergency Department Use

Today, the Centers for Medicare & Medicaid Services (CMS)—the agency that oversees the Medicare program—announced a new model within traditional Medicare that could help people with Medicare avoid unnecessary trips to the Emergency Department. This new model would allow emergency transportation services to take individuals to their primary care doctor or urgent care, or to deliver treatment in place, when the person does not need to be seen in an emergency room.

Cardiovascular Preventive Medicine Saving Lives and Saving Medicare Money

Though it’s well known that preventive care can improve health and save lives, establishing that preventive care can also save money has been more difficult. Until now, researchers have consistently found that preventive services do not end up saving money in the long term, but a new study shows that cardiovascular treatment seems to be the exception.

CMS Completes Rollout of New Medicare Cards Ahead of Schedule

Last week, the Centers for Medicare & Medicaid Services (CMS)—the agency that oversees the Medicare program—announced that they finished the rollout of new Medicare cards to 61 million people with Medicare ahead of the original deadline of April, 2019. This means that all people with Medicare should now have Medicare cards that include a random Medicare Beneficiary Identifier (MBI) instead of a number based on their Social Security number.

Medicaid Changes Likely in 2019

As 2019 gets underway, the Medicaid program continues to be in the spotlight. This week, the Kaiser Family Foundation (KFF) released an issue brief that highlights some of the major program changes that states, the Administration, and Congress may pursue in 2019.

Over 66 million people receive their health coverage through Medicaid, including older adults, people with disabilities, children, low-income parents, and other adults. Any changes to the program, therefore, have the potential to affect millions of families.

Administrative Proposal to Lower Medicare Drug Prices Shows Promise but Risks Remain

In November, the Centers for Medicare & Medicaid Services (CMS)—the agency that oversees the Medicare program—announced new proposals that could potentially lower prices for some of the drugs covered by Medicare Part B but could threaten access to medications for people with Medicare. CMS invited comment on their proposals and, last month, Medicare Rights responded.

Health care affordability is a top issue on our national helpline each year, and the high cost of prescription drug coverage is one major component of this. Most of the medications people with Medicare take are covered under Part D. Part B only accounts for a small percentage of Medicare-covered drugs, but they are some of the most expensive. It is clear that Part B medications can drive significant out-of-pocket costs for people with Medicare with life-altering conditions like cancer, end-stage renal disease, or rheumatoid arthritis.

CELEBRATING

YEARS

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