July 25, 2019 | Updates

Medicare’s Anniversary A Reminder Program Is Already At Risk

WASHINGTON – As Medicare marks its 54th anniversary this month and some lawmakers and presidential hopefuls continue to push for an expansion of the at-risk program, it is important to remember that a recent report from Medicare’s trustees paints a picture of its future described in news reports as “troubled,” “shaky,” “grim” and “sobering.”

Underscoring the severity of the problem, The Wall Street Journal reports that the “latest projections suggest the [program’s funding] problem could affect not only future retirees, but also current ones.  Today’s newest retirees will be 72 when Medicare’s hospital trust fund is depleted … said Maya MacGuineas, the president of the Committee for a Responsible Federal Budget.  ‘That fact that we now can’t guarantee full benefits to current retirees is completely unacceptable…’”

Modern Healthcare notes that the trustees’ report “should cause concern for hospitals” because, as The Associated Press reports, the program’s projected shortfalls “could mean that hospitals, nursing homes, and other medical providers would be paid only part of their agreed-upon fees.”  With many hospitals already facing serious financial stress, The New York Times reports that experts are growing increasingly worried about the “violent upheaval” a one-size-fits-all system like Medicare for all would cause the nation’s hospitals, noting that “[s]ome hospitals, especially struggling rural centers, would close virtually overnight…”

The Hill reports that Senator Joe Manchin (D-W.V.) pointed to the trustees’ dire projections recently as he joined the growing list of high-profile Democrats offering pointed criticism of the push by some for expanding the at-risk program: “’We can’t even pay for Medicare for some and to go Medicare for All, we can’t take care of those who are depending on it right now,’ Manchin said at The Hill’s Future of Healthcare Summit.”

Meanwhile, research also warns of the risks to hospitals and patients posed by so-called “moderate” fallback proposals, such as “public option” or “Medicare buy-in” schemes.  One study found that “[f]or hospitals, the introduction of a public plan that reimburses providers using Medicare rates would compound financial stresses they are already facing, potentially impacting access to care and provider quality.”  Another study found that government insurance systems like “buy-in” or “public option” could force hospitals to limit the care they provide, produce significant “layoffs” and “potentially force the closure of essential hospitals.”

As former Senator Heidi Heitkamp (D-N.D.) recently wrote in The Washington Post“[c]hampioning a health-care policy that threatens to close rural hospitals and limit patients’ access to vital services is not a winning message” for Democratic candidates.



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