Medicare

Congressional Democrats were practically salivating Tuesday at the news that Rep. Paul Ryan (R-Wis.) might propose bigger Medicare cuts in his next budget outline. 

Ryan might change his plan to affect more people who are near retirement, which skeptics see as abandoning the promise to protect anyone 55 or older. That has been a key part of the sales pitch for the Ryan plan, and the primary weapon against Democratic charges that the proposal would hurt seniors.

Bringing more people into the new system would likely help Ryan save more money from Medicare, potentially moving his proposal closer to balancing the budget without deep cuts to defense or discretionary spending. But it could also open up a new line of attack from Democrats, who have already hammered the Ryan plan in campaign ads.

Centrist Republicans are unhappy with the potential change, because they've defended their votes for the Ryan plan largely by noting that it wouldn't affect anyone 55 or older.

Senate Democrats on Tuesday released a list of statements Republicans have made defending the Ryan plan, including this one from Speaker John Boehner (R-Ohio): "We’ve put forward our plan. And our plan said that no one 55 or older would have any changes to their current plan.”

Boehner was noncommittal about the possible changes during a Tuesday news conference, saying only that "we’ll let them work it out and see what outcome they get."

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Key Republican lawmakers reassured hospitals Tuesday that they would not push to overhaul Medicare's flawed doctor payment formula with more provider cuts.

Reps. Kevin Brady (R-Texas) and Charles Boustany (R-La.) said structural changes to Medicare should help pay to repeal Medicare's sustainable growth rate (SGR), a major priority in the healthcare world. 

"I'm tired of going through the same old dance," said Brady, who leads the Ways and Means Subcommittee on Health. "My goal is to not pay for this by continuing to squeeze providers." 

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Sen. Sherrod Brown (D-Ohio) slammed Republican proposals to raise Medicare's eligibility age as a slap in the face to working-class people.

Addressing a hospitals conference Tuesday, Brown motioned to his own suit and tie and said "people who dress like this — we can retire later."

"The people who are cleaning your hotel room, the people who are serving dinner here … can't work until they're 70 years old," Brown said. 

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Sen. Lamar Alexander (R-Tenn.) said President Obama's inability to show respect for Congress is the reason the sequester took effect.

Alexander spoke at a conference of hospital executives in Washington Tuesday where he called Obama a "talented and intelligent person" who refuses to show leadership on entitlement reform.

"I've never seen anything like this before," Alexander told the Federation of American Hospitals. "This is very different from what we've seen in the past." 

Ryan: New Medicare plan won't affect Americans 'in or near retirement'

ICYMI: GOP centrists balk at Ryan Medicare shift

Funding bill keeps money for Obama healthcare law

The dwindling group of middle-of-the-road House Republican lawmakers decried the potential change in age.

The Medicare agency overpaid private Medicare Advantage plans by at least $3.2 billion between 2010 and 2012, government auditors said Monday.

In a new report, the Government Accountability Office (GAO) criticized how the Centers for Medicare and Medicaid Services (CMS) calculates payment rates for Medicare Advantage.

According to the audit, CMS inadequately adjusts the "risk scores" for private Medicare beneficiaries compared with public, fee-for-service ones. 

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An expert panel is urging that U.S. healthcare abandon fee-for-service payments and transition to a new system by the end of the decade in a bid to slow cost growth and improve outcomes.

In a report out Monday, the National Commission on Physician Payment Reform (NCPPR) also recommended repealing Medicare's sustainable growth rate (SGR) formula and paying for the move by cutting overutilization of Medicare services.

The guidance was part of 12 recommendations endorsed by the panel, which was convened last year by the Society of General Internal Medicine. 

The Obama administration's proposed cuts to Medicare Advantage (MA) are receiving greater attention on Capitol Hill thanks to an intense backlash from the health insurance industry. On Thursday, leading GOP lawmakers wrote to Marilyn Tavenner, acting administrator of the Medicare agency, expressing strong concerns over the proposed 2 percent cut to the plan scheduled for next year.

"According to external estimates, the combined effect of the administration’s sequester, [healthcare law] cuts and higher taxes, and harmful new policies will result in at least an 8 percent cut to the MA program for calendar year 2014," the lawmakers wrote. "While the president promised that Americans could keep the health plans they liked, we are concerned that the combined effects of these policies will jeopardize beneficiary access to the MA plans of their choice."

Lawmakers Sen. Orrin Hatch (R-Utah), ranking member of the Senate Finance Committee, Rep. Fred Upton (R-Mich.), chairman of the House Energy and Commerce Committee, and Rep. Dave Camp (R-Mich.), chairman of the House Ways and Means Committee, sent the letter.

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The health insurance industry touted a poll Thursday finding that nine in 10 seniors are happy with their Medicare Advantage (MA) coverage.

America's Health Insurance Plans (AHIP) also warned that only 4 percent of the healthcare law's cuts to MA have taken effect so far.

The messaging is part of AHIP's push against further Medicare Advantage cuts proposed by the Obama administration this month.