Medicare and the Healthcare Bill: The Latest

McConnell Trump Medicare

It’s only been a few days since the Senate released its version of the American Health Care Act (AHCA), aka Trumpcare, to replace the Affordable Care Act (ACA), aka Obamacare. Yet, for Medicare beneficiaries who have concerns about the future of their health insurance coverage and costs, it may feel like a lifetime. Since the bill was made public Thursday, the AARP has spoken out against it, President Donald Trump has tweeted his support for it, and various media outlets have been parsing the language of it.

Senate Majority Leader Mitch McConnell said he hopes to bring the Senate health care bill before the Senate for a vote before the July 4 recess. The bill still needs to be reviewed and analyzed by the Congressional Budget Office. The House version did not get a good review by the CBO, which spawned much discord on social media.

Media on Medicare

According to a Q&A by Kaiser Health News in the Philadelphia Inquirer, changes in Medicare in the AHCA will remain virtually the same as they did in the ACA. This means the annual wellness visit will still be covered. In addition, preventive care recommended by the U.S. Preventive Services Task Force will be covered without cost-sharing by Medicare beneficiaries.

Also remaining in place is the arrangement to close the prescription drug “donut hole” in Medicare Part D by 2020. What this means is that Medicare recipients who are faced with soaring drug costs will not encounter a coverage gap in their prescription drug plans and will not have to pay more than 25% of the costs for generic and brand-name drugs after meeting the deductible. Reporting by Kaiser Health also states that provisions in the AHCA will not affect job-based insurance plans and Medicare for seniors, but would instead affect insurance sold to individuals through the ACA’s online exchanges.

Attorneys at Epstein Becker Green penned a piece for JDSUPRA, noting that there will be minimal changes to the ACA’s Medicare provisions. Though they do point out that the AHCA will encourage “value-based purchasing innovations,” put an end to taxes on net investment income as well as high wages, and seek to change the payment formula for Medicare Advantage in order to align its costs with the per person costs of Original Medicare.

Meanwhile, at the Huffington Post, Social Security Works President Nancy Altman and Communications Director Linda Benesch are focusing on House Speaker Paul Ryan’s previous statements on Medicare, most notably his “decades long dream” of destroying it and replacing the guaranteed benefits with a program that uses voucher coupons. In their editorial, the two state that the cuts to Medicare aren’t being made now but they are on the horizon because, as they claim, Ryan and House Republicans “are raiding Medicare of necessary revenue” so that they have an excuse to bring the ax to it down the road.

CBS News’ Virginia affiliate, WTVR, focused on how the AHCA will benefit the wealthy. Currently, high-income households pay a 1.45% Medicare payroll tax on their wages ($200,000 if single, $250,000 if married) and then an additional 0.9% on wages above those amounts. Additional funding for Medicare comes from a 3.8% Medicare tax on investments. According to CBS analysis, these taxes and surcharges will be eliminated by 2023.

This parsing of data by CBS seems to verify the Huffington Post’s analysis about “raiding Medicare.” Also backing it up is a letter to the New York Times by Joe Baker, the President of the Medicare Rights Center. In it, he states that the “AHCA cuts more than $58 billion from Medicare reserves dedicated to paying for hospital care, depleting those resources two years earlier than anticipated.”

Much of the media analysis of the AHCA focuses on drastic cuts to Medicaid, which is not the same as Medicare. Although that may provide a little breathing room for seniors who do not require Medicaid, there still may be trouble brewing. As an editorial in Roll Call notes, the current plan to make cuts to Medicaid may be a blueprint to slash funding for and benefits from Medicare as well.

As the stories on the AHCA and repeal of ACA continue to roll out, you may see a lot more discussion about single-payer healthcare, aka “Medicare for all.” While states like California and New York are proposing their own versions, the topic is growing in popularity across the country. As the Pew Research Center notes, public support for single payer continues to increase in the wake of the Senate’s release of its version of the healthcare bill.

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