Medicare

President Obama’s Medicare chief, appearing before a House committee for the first time since his recess appointment in July, strongly denied Republican claims that he supports rationing healthcare.

A 2008 quote from Centers for Medicare and Medicaid Services Administrator Don Berwick about his love for the British national health system raised some Republicans’ eyebrows after his nomination last year. Thursday morning, Berwick fought back against the Republican accusations, saying that they have “no substance.”

"My entire life has been spent fighting rationing," Berwick, a pediatrician by trade, told the House Ways and Means Committee Thursday morning.

The healthcare law has strengthened the privately-run Medicare Advantage program, Medicare's chief testified Thursday. 

The government should "stay out" of deciding a patient's end-of-life care, President Obama's Medicare chief said Wednesday morning, weighing in on what's become a heavily politicized issue over the past two years.

Medicare Administrator Don Berwick, who Republicans have hammered for past statements about healthcare rationing, said the government should allow doctors to have whatever discussions they want with their patients, including conversations about advanced care planning.

End-of-life care, which consumes a large chunk of healthcare dollars, became a hot-button issue during the healthcare reform debate when some conservatives accused the Obama administration of trying to create government-run "death panels" that would have ultimate power to ration costly care to the elderly and disabled. The claim was rebuked as Politifact's top lie in 2009, but the stigma has stuck with the issue.

Sen. Mike Johanns (R-Neb.) on Monday night introduced an amendment to the Federal Aviation Administration (FAA) authorization bill (S. 223) that would repeal widely despised language in last year's healthcare law that requires more tax reporting for small companies.

The Johanns amendment, S.A. 3, would repeal section 9006 of the Patient Protection and Affordable Care Act, which requires companies and other organizations to file 1099 tax reporting forms for all goods and services transactions valued at more than $600. Republicans have said this language is an unnecessary burden on small companies, and even Democrats and the Obama administration quickly agreed last year that the provision should be repealed.

President Obama has renominated Don Berwick, who avoided a Senate Finance Committee hearing before his recess appointment in July.

An Obama official said the Medicare actuary is still underestimating the healthcare reform law's long-term savings.

Federal spending on healthcare programs will more than double over the next 10 years, according to a decade-long outlook issued by the nonpartisan congressional scorekeeper on Wednesday.

Spending on Medicare, Medicaid and other healthcare programs will jump from $810 billion in 2010 to $1.8 trillion in 2021, the Congressional Budget Office said. That spending in 2021 will represent 7.4 percent of that year's GDP, up from 5.8 percent in 2011.

Compared to last year’s report, the new CBO figures predict faster growth of healthcare spending in terms of GDP. The 2010 outlook predicted healthcare spending in 2020 would represent 6.8 percent of the GDP.

The report warns that Medicare spending over the decade could jump $250 billion if Congress continues to provide temporary patches to the formula determining Medicare physician rates. Medicare doctors are scheduled to receive about a 25 percent decrease in Medicare reimbursements starting in 2012, but Congress has acted each year since 2003 to delay scheduled cuts.

The CBO report also projects faster growth in Medicaid enrollment in light of the healthcare reform law. The 2010 report projected that 76 million people will be enrolled in Medicaid in 2020, while the new report predicts the number will be closer to 97 million in 2021.

President Obama's signal that he's open to more cuts to federal health programs during the State of the Union address earned him a scolding from the AARP, a key ally in getting his healthcare reform passed. Centrist Democrats, however, embraced the idea as key to avoid a debt crisis.

"The only way to tackle our deficit is to cut excessive spending wherever we find it — in domestic spending, defense spending, healthcare spending, and spending through tax breaks and loopholes," Obama said Tuesday. "This means further reducing healthcare costs, including programs like Medicare and Medicaid, which are the single biggest contributor to our long-term deficit."

The president's fiscal commission has proposed tackling Medicare head-on, including by cutting payments to doctors and hospitals, having beneficiaries pay a greater share of out-of-pocket costs or even raising the age at which people become eligible for program. Obama said he doesn't "agree with all their proposals" but that they "made important progress" and made it "crystal clear" that reforming entitlements is crucial.

"We were pleased to hear the President acknowledge the vital importance of Social Security and the need to protect this lifeline for future generations, but we are disappointed that he, like his fiscal commission did late last year, seeks to address this bedrock of financial security in the context of reducing a deficit it didn't cause," AARP CEO Barry Rand said in a statement. "Furthermore, any attempt to control spending in Medicare and Medicaid without addressing the causes of skyrocketing costs throughout the health care system will not reduce these costs, but rather shift them on to the backs of people of all ages and generations."

Some Senate Democrats vowed to take on the challenge nonetheless.

Democrats on the House Budget Committee deflected hard questions Wednesday about their healthcare reform law's fiscal consequences by seeking to make panel Chairman Paul Ryan (R-Wis.) and his Roadmap for America's Future the stars of the show.

Ryan has proposed replacing Medicare with healthcare vouchers in the future for younger Americans.

During the hearing, Democrats responded to concerns that their law contains unsustainable cuts to Medicare payments for hospitals and other healthcare providers by turning the tables on Ryan.

The federal government recovered more than a record-high $4 billion in healthcare fraud prevention and enforcement efforts in fiscal 2010, according to a report released Monday that highlights boosted oversight efforts from the Obama Administration.

The report highlights new efforts to fight healthcare fraud through improved cooperation between the Health and Human Services and Justice departments, heightened attention to fraud hot spots and new anti-fraud tools provided by the healthcare reform law. About $2.5 billion of the recovered funds came from healthcare fraud judgements.

"Many of the savings can be traced directly back to steps this administration has taken over the past two years," HHS Secretary Kathleen Sebelius said during a press conference Monday afternoon.

The administration touted the creation of HEAT in 2009 to prevent waste, fraud and abuse in Medicare and the expansion of the Medicare Fraud Strike Force teams. In fiscal 2010, strike force teams in seven cities imprisoned 146 individuals and racked up 140 indictments against 284 defendants who billed Medicare for almost $600 million, according to HHS.