Tag: Medicare

Top 10 Medicare Bills Introduced in 2022

Mary Pat Campbell

Link: https://www.thinkadvisor.com/2022/04/28/top-10-medicare-bills-introduced-in-2022/

Excerpt:

Here’s a look at the top-performing Medicare bills introduced since Jan. 1.

We searched Congress.gov for new Medicare bills, then ranked the bills based on co-sponsorship bipartisanship and numbers.

Some of these bills could pass on their own. Others could surface as provisions in much larger bills, such as a Ukraine aid bill or a COVID-19 pandemic response funding bill.

What It Means

These measures seem to have the legislative mojo to go places.

Each sponsor has managed to overcome the current hostility between Republicans and Democrats and persuade at least one member of the opposite party to sign on as a co-sponsor.

Author(s): Allison Bell

Publication Date: 28 April 2022

Publication Site: Think Advisor

Despite a First-Ever ‘Right-to-Repair’ Law, There’s No Easy Fix for Wheelchair Users

Mary Pat Campbell

Link: https://khn.org/news/article/power-wheelchair-users-right-to-repair-law-no-easy-fix/

Excerpt:

The multibillion-dollar power-wheelchair market is dominated by two national suppliers, Numotion and National Seating and Mobility. Both are owned by private equity firms that seek to increase profits and cut spending. One way they do that is by limiting what they spend on technicians and repairs, which, when combined with insurance and regulatory obstacles, frustrates wheelchair users seeking timely fixes.

The $70 billion durable medical equipment market has been an attractive target for private equity investment because of the aging U.S. population, the increasing prevalence of chronic conditions, and a growing preference for older adults to be treated at home, according to the investment banking firm Provident Healthcare Partners. Medicare’s use of competitive bidding favors large companies that can achieve economies of scale in manufacturing and administrative costs, often at the price of quality and customer service.

Regulations set by Medicare and adopted by most Medicaid and commercial health plans have led to lower-quality products, no coverage for preventive maintenance, and enough red tape to bring wheelchairs to a halt.

Power wheelchair users have long been fighting for the right to repair their wheelchairs themselves or through independent repair shops. Medicare and most insurance companies will replace complex wheelchairs only every five years. The wheelchair suppliers that have contracts with public and private health insurance plans restrict access to parts, tools, and service manuals. They usually keep a limited inventory of parts on hand and wait until health plans approve repair claims before ordering parts.

Some chairs require a software passcode or a physical key for any repairs. Wheelchair users who make fixes themselves may void their warranty or lose out on insurance payments for repairs.

Author(s): Markian Hawryluk

Publication Date: 2 June 2022

Publication Site: Kaiser Health News

On Social Spending, the Question Isn’t “Can We Afford It?” but “Who Will Pay?”

Mary Pat Campbell

Link:https://jacobinmag.com/2021/11/social-spending-biden-reconciliation-bill-build-back-better

Excerpt:

There are three possible answers to the question of who pays for social expenses. First, governments can pay by taxing their citizens to fund social programs. Second, employers can pay by using corporate revenues to provide employment-related benefits. Third, individuals and families can pay out of pocket, rely on unpaid labor from friends and relatives, or make do without.

For much of the twentieth century, the United States had a workable answer to the “Who pays?” question that drew on a mix of all three sources. Government provided certain social benefits like Social Security, Medicare, and public education. Aided by government tax incentives, many employers offered a wide range of benefits like health insurance and pensions, creating what political scientist Jacob Hacker refers to as a “public-private welfare regime.” And with one-third of the labor force unionized, and even nonunion employers pressured to match union-scale wages and benefits, many workers earned enough to support their families and handle the social expenses not covered by government- and employer-based programs.

….

For its part, government social spending has been uneven. Large universal programs like Medicare and Social Security have proven resistant to most retrenchment efforts, and Obamacare included a major expansion of Medicaid — though this was blocked in some Republican-dominated states. Meanwhile, more means-tested programs targeting low-income Americans have proven more vulnerable. In a context where employers have sharply cut back their commitment to providing social benefits, and individuals and their families are faced with stagnating wages, government’s response has proven inadequate.

Author(s):Barry Eidlin

Publication Date:28 Nov 2021

Publication Site: Jacobin

How Will The Biden Medicare Dental Plan Affect The Trust Fund Solvency?

Mary Pat Campbell

Link:https://www.forbes.com/sites/ebauer/2021/09/20/how-will-the-biden-medicare-dental-plan-affect-the-trust-fund-solvency/

Excerpt:

Among the changes coming if the Democrats succeed in their $3.5 trillion reconciliation bill would be the inclusion of dental, vision, and hearing coverage through Medicare, possibly in 3 – 5 years due to implementation challenges, and with suggestions of a voucher/cash payout in the meantime. There is not yet an official cost estimate as the details are still being negotiated, but a similar proposal in 2019 would have cost $358 billion over 10 years.

At the same time, late last month, the latest Trustees’ Report for Medicare determined that the Medicare Part A Trust Fund will be exhausted in the year 2026, which, if you do the math, is a mere five years from now. At that point, Medicare would have to cut reimbursement rates for doctors by 9%, increasing to 20% in 2045, or even more if the report’s assumptions don’t pan out.

How will the new dental benefits — assuming they remain in the bill — affect Medicare Part A and its trust fund? Strictly speaking, not at all. The new benefits would be a part of Part B of the program, that is, doctors’ charges, rather than Part A, which covers hospital charges. In one respect, it would be its own benefit structure entirely, since, unlike “regular Part B” Medicare, the proposal would have the federal government pay 100% of the benefit’s costs, rather than requiring participants to pay a 25% cost-share premium. It would, in a way, become Medicare Part E.

Author(s): Elizabeth Bauer

Publication Date: 20 Sept 2021

Publication Site: Forbes

Nursing homes warn vaccine mandate could lead to staff shortages

Mary Pat Campbell

Link: https://thehill.com/policy/healthcare/570807-nursing-homes-warn-vaccine-mandate-could-lead-to-staff-shortages

Excerpt:

The Biden administration’s vaccination requirement is putting a squeeze on nursing homes as they try to balance protecting residents and retaining low-wage staff that have been reluctant to get the shot.

Later this month, the administration will outline a policy that requires all staff working at nursing homes to be vaccinated or risk the facilities losing federal funding.

The specifics of the policy are sparse so far, but it would effectively be a mandate for an industry that relies heavily on Medicare and Medicaid funding.https://aef67baff698e02f95a8ec2b0d53753d.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html

Only about 62 percent of nursing home and long term care facility staff are fully or partially vaccinated nationally, according to federal data compiled by the Centers for Medicare and Medicaid Services (CMS).

…..

“The biggest group of unvaccinated staff are certified nurse aides. They’re making close to minimum wage. They can make that, maybe even more, plus maybe even better benefits out in retail jobs, restaurant jobs. The vast majority of those employers are not imposing mandates,” Grabowski said.

Author(s): NATHANIEL WEIXEL

Publication Date: 4 September 2021

Publication Site: The Hill

Cut Spending For The Rich Before Raising Their Taxes

Mary Pat Campbell

Link: https://www.manhattan-institute.org/cut-spending-rich-raising-their-taxes

Graphic:

Excerpt:

Members of Congress have increasingly demanded large tax hikes on upper-income families to finance large spending increases on top of soaring baseline deficits. But even the most aggressive tax hikes on the rich would make only a small dent in the long-term budget deficits, and they would significantly harm the economy. Before considering any new taxes, lawmakers should first reduce federal spending benefits for high-income families. This bipartisan strategy would achieve both the redistributive goals of the left and the spending restraint goals of the right.

Such upper-income spending cuts have several advantages over new taxes: 1) they will not harm economic growth, 2) they increase future policy flexibility, 3) they are better targeted, and 4) they promote political compromise.

Several programs target spending to wealthy Americans. This report focuses on three of the largest: Social Security, Medicare, and farm subsidies, where basic reforms could save upward of $1 trillion in the first decade, and substantially more in future decades.

Author(s): Brian Riedl

Publication Date: 20 May 2021

Publication Site: Manhattan Institute

Prediction: Biden’s Answer To The Medicare Trust Fund Insolvency Is Hidden In His Budget Proposal

Mary Pat Campbell

https://www.forbes.com/sites/ebauer/2021/06/01/prediction-bidens-answer-to-the-medicare-trust-fund-insolvency-is-hidden-in-his-budget-proposal/

Excerpt:

According to the most recent report, from 2020, the Medicare HI (Hospital Insurance, or Part A) Trust Fund is projected to be emptied in the year 2026. That’s well before the Social Security Trust Fund’s projected insolvency in 2034, and when that happens, Medicare will only be able to pay 90% of Part A benefits, dropping down to 80% in 2038.

…..

When it comes down to it, I’ll suggest to readers that they don’t really believe that it matters. And with the Biden administration’s 2022 budget proposal comes a fairly strong indication that this is their point of view as well, that they expect, when the Trust Fund well comes dry, to simply tap general federal revenues for the necessary funds, in exactly the same manner as is done for Parts B (doctors) and D (drugs).

…..

This single sentence makes it clear that’s not the case: the only premiums paid by Medicare recipients are partial-cost payments for Parts B and D. For Part B, this is 25% of the cost for most retirees; for those with income above $85,000/$170,000 single/married, premiums are higher, reaching as much as 85% of the total cost for the highest earners. For Part D, the premium is set to cover 25.5% of the standard drug benefit, plus any extra costs charged by particular private providers for enhanced benefit levels, and an extra flat charge for higher earners. The remaining cost, 75% of Part B and 74.5% of Part D, is funded by the federal government through its general revenues.

Author(s): Elizabeth Bauer

Publication Date: 1 June 2021

Publication Site: Forbes

Why do Americans die earlier than Europeans?

Mary Pat Campbell

Link: https://www.theguardian.com/commentisfree/2021/may/04/why-do-americans-die-earlier-than-europeans

Excerpt:

A 30-year-old American is three times more likely to die at that age than his or her European peers. In fact, Americans do worse at just about every age. To make matters more grim, the American disadvantage is growing over time.

In 2017, for example, higher American mortality translated into roughly 401,000 excess deaths – deaths that would not have occurred if the US had Europe’s lower age-specific death rates. Pre-pandemic, that 401,000 is about 12% of all American deaths. The percentage is even higher below age 85, where one in four Americans die simply because they do not live in Europe.

…..

There have been many efforts to account for the US mortality disadvantage. There is no single answer, but three factors stand out. First, death rates from drug overdose are much higher in the US than in Europe and have risen sharply in the 21st century. Second is the rapid rise in the proportion of American adults who are obese. In 2016, 40% of American adults were obese, a larger proportion than in Europe. Higher levels of obesity in the US may account for 55% of its shortfall in life expectancy relative to other rich countries. Third, the US stands out among wealthy countries for not offering universal healthcare insurance. One analysis suggests that the absence of universal healthcare resulted in 45,000 excess deaths at ages 18-64 in 2005. That number represents about a quarter of excess deaths in that age range.

…..

Above age 65, healthcare insurance coverage is nearly universal via Medicare. An international review of medical practice by the National Academy of Sciences suggested that the US does comparatively well in identifying and treating cardiovascular diseases and many cancers. But the prevalence of these diseases, the principal killers in wealthy countries, is unusually high in the US. Heart disease, a type of cardiovascular disease and America’s number one cause of death for decades, is strongly linked to lifestyle factors such as obesity. Although the connection between obesity and health risks is well known, consumer preferences for unhealthy food are strong. Not just because humans are biologically vulnerable to sweets and fats, but because major food producers and distributors are incentivized to turn this weakness into profit.

Author(s): Samuel Preston, Yana Vierboom

Publication Date: 4 May 2021

Publication Site: The Guardian UK

Bill Reintroduced to Shore Up Social Security, Medicare

Mary Pat Campbell

Link: https://www.thinkadvisor.com/2021/04/15/bill-reintroduced-to-shore-up-social-security-medicare/

Excerpt:

A bipartisan group of lawmakers reintroduced Thursday legislation to shore up the Social Security and Medicare Trust Funds.

The Time to Rescue United States Trusts, or TRUST Act, would establish bipartisan, bicameral commissions to address the long-term solvency of major trust funds.

….

The Congressional Budget Office projects the Highway Trust Fund will be insolvent by 2022, the Medicare Hospital Insurance Trust Fund in 2026, the Social Security retirement fund in 2032, and Social Security Disability Insurance in 2035.

Author(s): Melanie Waddell

Publication Date: 15 April 2021

Publication Site: Think Advisor

Bipartisan Opportunism Is to Blame for California’s High Tax Rate

Mary Pat Campbell

Link: https://www.hoover.org/research/bipartisan-opportunism-blame-californias-high-tax-rate

Excerpt:

A current example of California’s bipartisan capitulation to public employees is OPEB—formally, “Other Post-Employment Benefits”—chiefly, health insurance for retired employees and their dependents costing the state $10 billion per year. Those benefits are provided even when the retiree or dependent has another job that offers insurance, is covered by Medicare, or is entitled to premium support from the Affordable Care Act.

No other state in America showers such subsidies on retired employees, who are already entitled to the highest pensions in the land. But both parties have been obstacles to OPEB reform because both fear retribution from government employee unions. If you have any doubt about that, check out donations to legislators on both sides of the aisle.

Author(s): David Crane

Publication Date: 12 March 2021

Publication Site: Hoover Institution at Stanford University

Is WA Gov. Jay Inslee Single-handedly Responsible for America’s COVID Outbreak?

Mary Pat Campbell

Link: https://townhall.com/tipsheet/bethbaumann/2021/03/13/is-wa-gov-jay-inslee-single-handedly-responsible-for-americas-covid-outbreak-n2586203

Excerpt:

Washington State’s Aging and Long-Term Support Administration, which falls under the Department of Social and Health Services, directed nursing homes to accept COVID-positive patients that were no longer needing “acute care” in a hospital. The goal was to “transition” those patients to “alternative settings” 

“Our primary strategy to create capacity in acute care hospitals is working with participating patients and families to transition to nursing homes,” a March 20, 2020 memo stated. “Once in the nursing home, Home and Community Services staff will work the eligible individual and their family to transition to a permanent home and community-based setting of their choice.”

In exchange for taking in those patients, nursing home facilities would receive an additional $100 Medicare add-on for up to six months, The Post Millennial. That funding was part of two Medicaid waivers the state filed. 

Author(s): Beth Baumann

Publication Date: 13 March 2021

Publication Site: Townhall

Cuomo Killing the Disabled and the Elderly: This Time It’s Personal

Mary Pat Campbell

Link: https://marypatcampbell.substack.com/p/cuomo-killing-the-disabled-and-the

Graphic:

Excerpt:

But the other problem, of course, was that Cuomo wasn’t the only governor who sent sick people back into nursing homes. In addition to New York, there was also Michigan, California, New Jersey, and Pennsylvania.

Except it seems Cuomo was the only one who had his staff falsify data. So perhaps the others can get away with just admitting they made decisions that were very unwise.

As it is, the New York state legislature is starting an impeachment investigation, and I assume they’re not going to half-ass it like other impeachments we have heard tell of.

Author(s): Mary Pat Campbell

Publication Date: 11 March 2021

Publication Site: STUMP on Substack