Monday, November 2, 2009

Speaker Pelosi’s Health Care Takeover: Bad for Seniors

The Republican Conference has compiled a list of provisions in the Pelosi health care bill that would harm American seniors:

Millions Lose Their Current Coverage. The Congressional Budget Office (CBO) has estimated that provisions in H.R. 3962 would lead to a total of $170 billion in cuts being taken from Medicare Advantage plans that provide a choice of health care options to seniors. These harmful and arbitrary cuts could result in Medicare Advantage plans dropping out of the program, harming beneficiary choice and causing 3 million seniors to lose their current coverage; millions more seniors could see premiums rise or additional benefits curtailed. According to former Clinton Administration official Ken Thorpe, while every senior had access to a Medicare Advantage plan in 2007, millions of seniors did not have a choice of plans in 1999—and the significant cuts in the Democrat bill mean that the promise of “If you like your current plan, you can keep it” would likely ring hollow for many Medicare Advantage beneficiaries.

Reduced Access—Or Higher Premiums. In order to keep to the President’s promise of a deficit-neutral bill, H.R. 3962 excludes language providing adjustments to the Medicare formula that governs physician reimbursement levels. As a result, physicians would receive a 21 percent cut in payment levels beginning in January, and further reductions thereafter. While Democrats have introduced separate stand-alone legislation (H.R. 3961) to address the payment issue, the more than $200 billion cost of that bill is not offset with other spending reductions, so seniors would pay one-quarter of the corresponding increase in physician spending through higher Part B premiums—as much as $70 billion worth.

Part D Premium Increases. The bill would begin a phased-in process of filling in the Part D coverage gap, or “doughnut hole.” However, CBO has previously stated that filling in the “doughnut hole” immediately would cause a 50 percent spike in average Part D premiums when compared to current law projections—and these higher costs would be passed on to American seniors.

Does Not Address Medicare’s Long-Term Solvency. Although the legislation includes more than $400 billion in Medicare savings provisions, the Administration’s own actuaries have confirmed that the bill would increase overall health spending—exacerbating the long-term trends that have placed the Medicare program in financial peril.

Opens the Door to Government Rationing. Democrats have repeatedly refused to eliminate cost grounds as a factor in coverage decisions, and H.R. 3962 includes no such limitations on making reimbursement decisions on cost grounds. Therefore, providers may be concerned that the bill could lead to delay or denial of life-saving treatments for seniors, particularly given President Obama’s own comments on this issue: “The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here….There is going to have to be a very difficult democratic conversation that takes place.”

End-of-Life Counseling. Provisions in H.R. 3962 would expand the definition of Medicare physician services to include consultations regarding end-of-life decision-making. This provision could result in government-paid consultations encouraging assisted suicide or other forms of euthanasia.