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Why Medicare politics are heating up : Shots

by | Mar 14, 2023 | Health Blog | 0 comments


Prescription drug protection is only one a part of Medicare, the federal authorities’s medical health insurance program for folks age 65 and over.

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d3sign/Getty Photos

Prescription drug protection is only one a part of Medicare, the federal authorities’s medical health insurance program for folks age 65 and over.

d3sign/Getty Photos

The White Home launched President Biden’s $6.8 trillion proposed finances final week, itemizing his priorities for the upcoming fiscal yr. Amongst different issues, Biden singled out Medicare — the federal medical health insurance program for folks aged 65 or older. Republican leaders insist they will not be threatening cuts to Medicare in upcoming finances negotiations, however others within the occasion have floated the concept of creating adjustments over time to this system — together with profit cuts they are saying might be essential to preserve Medicare solvent.

NPR’s Michel Martin, as co-host of All Issues Thought-about, sat down this week with veteran well being care journalist Julie Rovner, of Kaiser Well being Information, to get a greater sense of the place the controversy is headed over fund Medicare, an costly, however widespread program. The next excerpt of their dialog has been edited for size and readability.

MARTIN: So, what’s the situation right here?

ROVNER: Medicare’s trustees say that within six years, the trust fund is going to run out of reserves, and so it will not be capable to pay the entire present advantages. So mainly, with a purpose to deliver down the associated fee, you’ve got three choices: You can also make the people who find themselves on this system pay extra, you can also make taxpayers who assist assist this system pay extra, or you possibly can pay well being care suppliers — docs and hospitals and all these of us — much less.

Everyone considers any of these issues, “cuts,” though paying suppliers much less is usually only considered a cut to the providers. If the cuts get too massive, and the well being care suppliers say “We’ll stroll away from this system,” that is an issue too.

However Medicare may be very widespread, and I feel within the State of the Union, when the president mentioned he wasn’t going to do something to Medicare, folks kind of slapped again and mentioned, “However Medicare goes to go broke if we do not do something.” So within the finances, Biden mentioned, nicely, listed below are a few issues that we might do, none of which have an effect on how a lot beneficiaries pay.

MARTIN: What are the highest traces of what President Biden’s proposing, with reference to Medicare?

ROVNER: It is truly pretty small. Final yr, for the primary time, Medicare was given authorized permission to barter the value of medicine. There’s a brief listing of medicine. This finances would make the listing longer, and it will have these negotiations occur quicker. It might additionally elevate a tax on very high-income earners — these incomes over $400,000. The Biden finances would elevate that Medicare tax from 3.8% to five% on these excessive earners.

MARTIN: Republicans have mentioned that they will stability the finances over the following decade, however will not contact Medicare. Is {that a} credible stance?

ROVNER: It’s, however provided that they go after Medicaid — the truly bigger public medical health insurance program for folks with low incomes — and the subsidies on the Reasonably priced Care Act, which the president has now additionally mentioned he will not go after. It’s attainable to stability the finances with out touching Medicare or Social Safety or elevating taxes, however you would need to reduce a lot from the remainder of the finances. That is why we’ve not seen a Republican plan but. They’re nonetheless making an attempt to determine it out.

MARTIN: Senate Minority Chief Mitch McConnell has already mentioned publicly that Biden’s plan to extend the Medicare tax on excessive earners, “is not going to see the sunshine of day.” So what are we more likely to see subsequent?

ROVNER: Properly, in some unspecified time in the future, you realize, the 2 events are going to have to return collectively earlier than the Medicare belief fund runs out of cash. This isn’t the primary time we have been inside this shut interval the place the belief fund might run out of cash. It is occurred a number of occasions up to now. Finally, the events do get collectively and determine some strategy to shore it up. And I am positive that may occur this time, too, however I believe this yr goes to be extra of a combat main as much as the 2024 elections.

MARTIN: The talks over the debt ceiling are approaching. The leaders of each events have mentioned that Medicare is off the desk. However is it conceivable that Medicare will not be implicated in some unspecified time in the future in these talks?

ROVNER: No. In fact Medicare goes to be implicated in some unspecified time in the future in these talks. Initially, what Republican leaders say will not be essentially what the entire Republican rank and file will do. That is true of the Democrats, too, so it is arduous to think about that Medicare will not be placed on the desk in a roundabout way, form or type.

MARTIN: So, what is going to you be listening to as these discussions proceed over the following couple of weeks and months?

ROVNER: One thing must be carried out to Medicare, lest it run out of cash. So I feel that just about the whole federal panoply of well being applications goes to be up for dialogue — and that is what I will be watching.

MARTIN: I am simply questioning, is that this the sort of topic that the general public actually can concentrate on, can actually get galvanized round?

ROVNER: It will possibly and it will possibly’t. The trick is how this will get negotiated and the way it will get offered to the general public as as to if it’s going to truly have an effect on their well being care.

Julie Rovner is the Washington correspondent for KHN and host of “What The Well being?” — KHN’s weekly well being coverage information podcast. After almost eight years of hosting Weekend All Things Considered, Michele Martin is taking over a brand new internet hosting position on NPR’s Morning Version.



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