The Healthcare Leadership Council – comprised of leaders of major medical systems, drugmakers, health insurers and medical-device makers – on Wednesday offered the debt panel a proposal for achieving $410 billion in Medicare savings over 10 years without cutting reimbursements, National Journal reports.
The proposal includes development of an insurance exchange in which beneficiaries would use vouchers to purchase private health plans rather than using the traditional Medicare fee-for-service system. The group estimates the voucher plan would save about $172 billion over 10 years.
Mary Grealy, HLC's president, said, "Medicare reform is inevitable; and it should be addressed sooner rather than later," adding, "Policy makers can hold that off by chopping at Medicare budgets, but that just means fewer providers seeing Medicare patients and further cost shifting" (Sanger-Katz, National Journal, 9/14).
Analysts have compared the plan to House Budget Committee Chair Paul Ryan's (R-Wis.) Medicare proposal, which he released as part of the GOP fiscal year 2012 budget resolution (H Con Res 34) earlier this year (Baker, "Healthwatch," The Hill, 9/14). Grealy said the plan has a "very significant" difference with Ryan's plan in that it does not require that seniors purchase private plans and instead gives them the option to accept the vouchers or remain in traditional Medicare plans.
The proposal also would raise the Medicare eligibility age from 65 to 67, overhaul the program's deductibles and copayments and make changes to the medical liability system.
Many analysts doubt the debt panel will be able to implement major changes proposed by HLC in the short time before its cost-cutting plan is due at the end of November (Norman , CQ HealthBeat, 9/14).
Medicaid Advocates Urge Panel To Avoid Program Cuts
On Wednesday, a group of advocates for Medicaid beneficiaries with chronic illnesses lobbied the debt panel against authorizing cuts to Medicaid as part of a deficit-reduction strategy, CQ HealthBeat reports.
They said it would be better if the panel failed to develop a strategy and automatic cuts kicked in under the sequestration process, since those cuts cannot affect Medicaid.
Ron Pollack, president and CEO of Families USA, said all proposals he has heard for cutting Medicaid would shift federal costs to states. He added, "The states can't bear that additional burden and in turn what the states are going to do is shift the burden to the people who can least bear that burden" (Norman , CQ HealthBeat, 9/14).
Panel Could Find Savings by Addressing 'Dual Eligibles'
Also on Wednesday, the National Association of Medicaid Directors encouraged the debt panel to let states have a bigger share of savings from improved management of the roughly nine million U.S. residents who qualify for both Medicare and Medicaid, known as "dual eligibles." According to NAMD, that would allow the panel to achieve Medicaid savings without burdening state budgets.
Matt Salo, executive director of NAMD, said letting states benefit more from Medicare savings would generate "huge" reductions in outlays for both programs.
Salo also said the debt panel could streamline the process for states applying for federal waivers to overhaul their Medicaid programs. He said the process should require far fewer waivers for states to make changes, such as moving beneficiaries into managed-care programs (Reichard, CQ HealthBeat, 9/14).
Blue Dogs Say Panel Will Not Cut Medicare Benefits
On Wednesday, members of the fiscally conservative Democratic Blue Dog Coalition attempted to reassure Medicare beneficiaries that the debt panel will not recommend cuts that will affect their benefits, The Hill's "Healthwatch" reports.
Rep. Mike Ross (D-Ark.), said, "No one is going to vote to cut benefits for seniors and for those who are near the Medicare and Social Security age, Democrat or Republican," adding, "Politically it would be suicide."
The Blue Dogs recently sent a letter to the panel urging it to seek $4 trillion in deficit cuts, instead of the $1.5 trillion the committee is charged with finding under the recent budget agreement (Pecquet, "Healthwatch," The Hill, 9/14).
Panel Unlikely To Seek More in Deficit Cuts
An anonymous member of the debt panel said it is unlikely to "go big" and find more than $1.5 trillion in budget cuts, as some are urging, The Hill reports.
The lawmaker said it is unrealistic to expect cuts as high as $3 trillion or $4 trillion from the panel (Bolton, The Hill, 9/14).
Panel To Hold First Private Meeting
On Thursday, members of the debt panel will have their first closed-door meeting, National Journal reports.
It was scheduled following complaints by Senate Minority Whip Jon Kyl (R-Ariz.), a member of the committee, who said he was concerned by the lack of real policy work happening on the panel (O'Donnell, National Journal, 9/14).