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Medicare Watch

Medicare Watch articles are featured in a weekly newsletter that helps readers stay up-to-date on Medicare policy and advocacy developments, and learn about changes in Medicare benefits and rules.

As Federal Deficits Increase, so Do Threats to Medicare

Last week, the Medicare Rights Center explained how the House majority’s budget plan for 2019 would fundamentally restructure Medicare and Medicaid, slashing more than $2.1 trillion from the programs over 10 years. Though this approach is not unexpected—as lawmakers promised to use deficits created by last year’s tax bill as an excuse to pursue such cuts—it is extremely troubling.

Read More »

As Expected, House Budget Plan Targets Medicare and Medicaid

This week, House Republicans unveiled a 2019 budget proposal that would balance the federal budget in nine years—largely by significantly cutting and fundamentally restructuring Medicare and Medicaid. This approach is not unexpected. Lawmakers were clear that after passing a costly tax bill that drives up deficits, they would use these higher deficits to justify cuts to programs like Medicare. In the House budget resolution, they are keeping that promise: the budget would end Medicare and Medicaid as we know them.

Read More »

New ACA Repeal Framework Resurrects Damaging Ideas from 2017

This week, the Health Policy Consensus Group—a consortium of think tanks and former and current lawmakers—put forward a new plan to repeal the Affordable Care Act (ACA) that would end Medicaid expansion and eliminate the ACA’s robust consumer protections for individuals with preexisting conditions, adults over 50, and women. If this sounds familiar, it should. Last year saw several plans to end the ACA’s Medicaid funding and consumer protections, often couched in language promising states more “flexibility.” These proposals would have caused millions of Americans to lose access to critical services, pay more for care, or even lose health coverage entirely.

Read More »

Tax Changes, Demographics, and Costs Trigger Changes in Medicare’s Financial Future

In its annual report to Congress, the Board of Trustees for Medicare said the program’s hospital insurance trust fund (Part A) could lack funds to pay full benefits by 2026—three years earlier than projected in last year’s report. Despite this finding, the Medicare program itself remains strong and sustainable. The trustees report identifies several factors that impact the balance of program funds.

Read More »

Surprise Administrative Decision Puts Millions at Risk of Losing Health Coverage

Last week, the Department of Justice (DOJ) asked a federal court in Texas to end the Affordable Care Act’s (ACA) protections for people with pre-existing conditions. The underlying legal challenge was filed earlier this year by 20 state attorneys general, who argue that without the individual mandate—which was eliminated in December’s Tax Cuts and Jobs Act—the entire is ACA unconstitutional. In an unexpected move, the DOJ declined to defend the ACA in this case, and instead asked the court to invalidate only the law’s provisions that prevent insurers from denying coverage or charging higher rates based on health status.

Read More »

Medicare Rights Opposes Potential New Medicare Model that Puts Beneficiaries at Risk

Last week, the Medicare Rights Center submitted comments to the Center for Medicare & Medicaid Innovation (CMMI) in response to a request for information on a potential new Medicare model. CMMI—an offshoot of the Centers for Medicare & Medicaid Services (CMS), which is the agency that oversees the Medicare program—was created to develop and test new ideas in health care delivery. Most of these ideas involve different ways of paying providers such as doctors or hospitals.

In this request for information, CMMI asked interested parties to provide input on ways to design and test a model for Direct Provider Contracting (DPC). In a DPC model, a beneficiary could choose to join a primary care or specialty provider’s practice and potentially gain certain benefits such as reduced cost sharing or increased services that Medicare does not generally pay for. While this idea may be intriguing, CMMI did not provide any detail on how such a model would work, which leaves some dangerous options on the table.

Read More »

Shifting Drugs from Part B to Part D May Create Winners and Losers

This week, Avalere Health, a Washington DC-based consulting firm that specializes in strategy, policy, and data analysis, released a study on the impact of moving the coverage of some drugs from Medicare Part B to Part D. While most drugs are covered under the Part D prescription drug program, Part B, the part of the Medicare program that covers outpatient medical services like office visits, covers a few. The drugs covered by Part B are usually ones that beneficiaries would not give to themselves. For example, if a provider administers the drug during an office visit, Part B instead of Part D, might cover that drug.

Earlier this month, the Trump Administration announced it would consider transitioning certain Part B drugs into Part D as part of a larger strategy to lower drug prices and out-of-pocket costs. This makes it essential to understand what effects the switch could have on people with Medicare.

Read More »

Beneficiary Advocates Urge Centers for Medicare & Medicaid Services to Correct Inaccuracies in Medicare & You Handbook for 2019

This week, the Medicare Rights Center, the Center for Medicare Advocacy, and Justice in Aging sent a joint letter to Seema Verma, Administrator of the Centers for Medicare & Medicaid Services (CMS), on May 15, 2018, objecting to serious inaccuracies in the draft Medicare & You Handbook for 2019, and urging CMS to rectify the errors prior to disseminating the Medicare & You Handbook.

Read More »

As Federal Deficits Increase, so Do Threats to Medicare

Last week, the Medicare Rights Center explained how the House majority’s budget plan for 2019 would fundamentally restructure Medicare and Medicaid, slashing more than $2.1 trillion from the programs over 10 years. Though this approach is not unexpected—as lawmakers promised to use deficits created by last year’s tax bill as an excuse to pursue such cuts—it is extremely troubling.

As Expected, House Budget Plan Targets Medicare and Medicaid

This week, House Republicans unveiled a 2019 budget proposal that would balance the federal budget in nine years—largely by significantly cutting and fundamentally restructuring Medicare and Medicaid. This approach is not unexpected. Lawmakers were clear that after passing a costly tax bill that drives up deficits, they would use these higher deficits to justify cuts to programs like Medicare. In the House budget resolution, they are keeping that promise: the budget would end Medicare and Medicaid as we know them.

New ACA Repeal Framework Resurrects Damaging Ideas from 2017

This week, the Health Policy Consensus Group—a consortium of think tanks and former and current lawmakers—put forward a new plan to repeal the Affordable Care Act (ACA) that would end Medicaid expansion and eliminate the ACA’s robust consumer protections for individuals with preexisting conditions, adults over 50, and women. If this sounds familiar, it should. Last year saw several plans to end the ACA’s Medicaid funding and consumer protections, often couched in language promising states more “flexibility.” These proposals would have caused millions of Americans to lose access to critical services, pay more for care, or even lose health coverage entirely.

Tax Changes, Demographics, and Costs Trigger Changes in Medicare’s Financial Future

In its annual report to Congress, the Board of Trustees for Medicare said the program’s hospital insurance trust fund (Part A) could lack funds to pay full benefits by 2026—three years earlier than projected in last year’s report. Despite this finding, the Medicare program itself remains strong and sustainable. The trustees report identifies several factors that impact the balance of program funds.

Surprise Administrative Decision Puts Millions at Risk of Losing Health Coverage

Last week, the Department of Justice (DOJ) asked a federal court in Texas to end the Affordable Care Act’s (ACA) protections for people with pre-existing conditions. The underlying legal challenge was filed earlier this year by 20 state attorneys general, who argue that without the individual mandate—which was eliminated in December’s Tax Cuts and Jobs Act—the entire is ACA unconstitutional. In an unexpected move, the DOJ declined to defend the ACA in this case, and instead asked the court to invalidate only the law’s provisions that prevent insurers from denying coverage or charging higher rates based on health status.

Medicare Rights Opposes Potential New Medicare Model that Puts Beneficiaries at Risk

Last week, the Medicare Rights Center submitted comments to the Center for Medicare & Medicaid Innovation (CMMI) in response to a request for information on a potential new Medicare model. CMMI—an offshoot of the Centers for Medicare & Medicaid Services (CMS), which is the agency that oversees the Medicare program—was created to develop and test new ideas in health care delivery. Most of these ideas involve different ways of paying providers such as doctors or hospitals.

In this request for information, CMMI asked interested parties to provide input on ways to design and test a model for Direct Provider Contracting (DPC). In a DPC model, a beneficiary could choose to join a primary care or specialty provider’s practice and potentially gain certain benefits such as reduced cost sharing or increased services that Medicare does not generally pay for. While this idea may be intriguing, CMMI did not provide any detail on how such a model would work, which leaves some dangerous options on the table.

Shifting Drugs from Part B to Part D May Create Winners and Losers

This week, Avalere Health, a Washington DC-based consulting firm that specializes in strategy, policy, and data analysis, released a study on the impact of moving the coverage of some drugs from Medicare Part B to Part D. While most drugs are covered under the Part D prescription drug program, Part B, the part of the Medicare program that covers outpatient medical services like office visits, covers a few. The drugs covered by Part B are usually ones that beneficiaries would not give to themselves. For example, if a provider administers the drug during an office visit, Part B instead of Part D, might cover that drug.

Earlier this month, the Trump Administration announced it would consider transitioning certain Part B drugs into Part D as part of a larger strategy to lower drug prices and out-of-pocket costs. This makes it essential to understand what effects the switch could have on people with Medicare.

Beneficiary Advocates Urge Centers for Medicare & Medicaid Services to Correct Inaccuracies in Medicare & You Handbook for 2019

This week, the Medicare Rights Center, the Center for Medicare Advocacy, and Justice in Aging sent a joint letter to Seema Verma, Administrator of the Centers for Medicare & Medicaid Services (CMS), on May 15, 2018, objecting to serious inaccuracies in the draft Medicare & You Handbook for 2019, and urging CMS to rectify the errors prior to disseminating the Medicare & You Handbook.

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