Friday, March 27, 2015

180 House Democrats Just Voted to Cut Medicare Benefits, Paving Road for Future "Entitlement Reform"

The House passed its "doc fix" deal yesterday 392 to 37.

Party leaders were glowing in self-congratulation:
Pelosi praised the deal, saying it had been a “privilege” to work with Boehner “in a bipartisan way on this legislation.
"I hope it will be a model of things to come," she said.
Boehner likewise touted the bipartisanship, and argued pass of the bill was a step toward broader entitlement reform.
"This is what we can accomplish when we focus on finding common ground," he said.
Ah, "entitlement reform." Sound familiar? 
The deal was opposed by the National Committee to Preserve Social Security and Medicare.
Here is NCPSSM explaining their opposition:
While the National Committee supports the payment system reforms in the House leadership package, we oppose plans to pay for nearly half of the offsets in the bill by increasing costs for Medicare beneficiaries. Most of this offset would come from further means testing Medicare Part B and D premiums. Higher-income Medicare beneficiaries are already paying more and expanding Medicare means testing of premiums further erodes the social insurance nature of the program. It also reaffirms our concern that interest in using means testing as an offset for various pieces of legislation is ongoing and will result in more middle-class seniors shouldering the cost of higher and higher premiums.
Cost savings would also be achieved by requiring Medigap plans to have a deductible. These policies are purchased primarily by middle and lower-income beneficiaries to ensure their health care costs are affordable and predictable. Making Medigap coverage less comprehensive could cause some people to forgo necessary care, which could lead to higher health costs. Even without the offsets paid by beneficiaries, the Kaiser Family Foundation estimates that Medicare beneficiaries would automatically contribute $58 billion over the next ten years in Part B premiums to replace the SGR.
In addition, our support for SGR legislation has been contingent on including provisions to make the Qualified Individual (QI) program and the therapy cap exceptions process permanent. The “Medicare Access and CHIP Reauthorization Act” would make the QI program permanent, but not the therapy cap exceptions process.
We regret that House leaders did not improve the SGR package by dropping plans to require seniors and people with disabilities to pay more for Medicare and by including other offsets we support, such as restoring rebates from drug manufacturers for the drugs used by individuals who are dually eligible for Medicare and Medicaid and for people receiving the Medicare Part D Low-Income Subsidy (LIS). Additional offset proposals we support include increasing manufacturer discounts for brand name drugs in Medicare Part D to 75 percent, effectively closing the coverage gap “donut hole” for brand name drugs in 2017, three years sooner than  under current law; promoting lower pharmaceutical costs by providing for faster development of  generic versions of biologic drugs; and prohibiting "pay-for-delay" agreements between brand  name and generic pharmaceutical companies that delay entry of generic drugs into the market which would provide prescription drug savings and would lower costs for beneficiaries.
The US needs to have genuinely universal health care, and increasing out-of-pocket expenses for Medicare takes us in exactly the opposite direction. 
33 Republicans and 4 Democrats voted against the bill.

The Republicans opposed it because the cost of the bill was not fully offset.

The only 4 Democrats to oppose the bill were Jim Cooper (TN-05), Jerry Nadler (NY-10), Jan Schakowsky (IL-09), and Pete Visclosky (IN-01).

I can't vouch for the rationales for Coooper and Visclosky, but Nadler and Schakowsky have traditionally been strong supporters of Social Security and Medicare.

In the deal, Democrats got a two-year extension of the authorization of the Children's Health Insurance Program (CHIP), although Senate Democrats have been pushing for a four-year extension instead. Moreover, it is simply wrong to treat the welfare of seniors and the welfare of children as a zero-sum game in policy making, as the bill negotiated by Boehner and Pelosi does.

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