On the threshold
The Future of Medicare as We Know It Will Be Affected by This Election
Medicare is the federal health insurance program for people who are 65 and older and a small group of other folks. It consists of several parts: Part A (Hospital Insurance), Part B (Medical Insurance, which covers doctors’ services, outpatient care, home health services, and other medical services), and Part D (which covers outpatient prescription drugs). The Congressional Budget Office states that
Nearly all Medicare beneficiaries enroll in the program soon after they become eligible, typically either at age 65 or two years after they qualify for Social Security Disability Insurance benefits. Part A benefits are paid from the Hospital Insurance Trust Fund (funded largely through payroll taxes); Part B and Part D benefits are paid from the Supplementary Medical Insurance Trust Fund (about 25 percent funded by premiums paid by enrollees and about 75 percent funded from general revenues).
I know of baby boomers who aren’t yet able to retire and qualify for Medicare who put off major medical care (to the extent is feasible) until they are covered by Medicare. Medicare, such that it is, is a bright spot for most Americans who are retired. But things are changing!
But Medicare may be under attack – at least according to Save Medicare Now, whose website* lists these good questions to ask our elected officials and candidates:
•What specific steps will you take to preserve and strengthen Medicare for all beneficiaries, whether they are in traditional Medicare or a Medicare Advantage plan?
• How will you make Medicare more affordable for all the people who rely on it to make sure they get access to the care they need?
• Will you fight attempts to privatize Medicare by unfairly favoring private Medicare Advantage plans and/or by turning it over to big insurance companies?
• Medicare is a popular program, but there are significant gaps in what it covers, including most oral health, vision and hearing care. Do you think Medicare should cover these things? If so, how do we get there?
• Most people want to remain in their own homes as long as possible, but Medicare makes it hard for people with chronic conditions and longer-term illnesses to get home health care. Will you help ensure that all people who qualify can get home health care under Medicare?
• Some hospitals pretend people haven’t been formally “admitted” and are just “under observation” so they must pay out-of-pocket for nursing home care after they leave. Would you support pending legislation that would count all time a Medicare patient spends in the hospital toward the 3-day requirement to get nursing home coverage? What about removing the requirement altogether?
• At best you can generally get only 100 days of nursing home coverage if you are on Medicare. Do you think Medicare should include a long-term care benefit? If so, how would you accomplish that?
What Can We Do About Our Ever-Rising Health Care Costs?
This seems to have become something we all expect – that health care costs continue to rise in this country and as the baby boomers age, and these result in greater per capita costs to Medicare. Did you know that the Affordable Care Act helped to reduce Medicare spending? Remember all those tax cuts from earlier this year? Many of the people left behind on those tax breaks are going to start feeling the pinch soon. The midterm elections may determine whether our elected officials in Washington choose to strengthen Medicare or to gut it.
If this is news to you, consider that cutting Medicare is one way that some members of Congress would manage the deficit. This is an interesting development, particularly considering that a “Medicare for all” options is becoming more popular, even among Republicans.
Hmmm…. Maybe we need a health care revolution to stop our bleeding?
I often wonder when the credit agencies will start asking folks not what their monthly rent or mortgage payment is but rather what their monthly health insurance premium is! My monthly premium for my HSA qualified plan (among the cheapest available) continues to rise and for the last couple years it is larger than my mortgage payment!
That’s all for now and don’t forget to return your ballots on time!
*Thanks to Professor Rebecca Morgan, a contributor to ElderLawProfBlog for psoting about the Center for Medicare Advocacy’s website Save Medicare Now changes to Medicare.
©2018 Barbara E. Cashman, www.DenverElderLaw.org