Issue Brief posted November 20, 2014
Medicare’s SGR: Fixing It the Right Way, Not in a Lame Duck Session
Congress needs to junk the sustainable growth rate (SGR) formula that governs Medicare physician payment. Under the formula, if Medicare physicians’ payments in any given year increase by more than the economy’s growth, an automatic and proportionate reduction in their reimbursements is imposed the following year. Conceptually flawed and practically draconian, the formula…
Backgrounder posted October 30, 2014
A Fresh Start for Health Care Reform
Despite President Barack Obama’s insistence that the national health care debate is over, and that he will not “re-litigate” the misnamed Patient Protection and Affordable Care Act (PPACA), the practical concerns, aggravated by implementation glitches and policy failures, guarantee that the debate over the PPACA is far from over.
In the next phase of the health care…
Backgrounder posted September 4, 2014
Progress in Medicare Advantage: Key Lessons for Medicare Reform
Medicare Advantage (MA) is a program of competing private health plans. For the vast majority of senior citizens, it is the only viable alternative to enrollment in traditional Medicare. For Members of Congress, its record also provides valuable lessons for comprehensive Medicare reform.
MA is an increasingly attractive option for millions of senior and disabled…
Issue Brief posted August 1, 2014
The 2014 Medicare Trustees Report: A Dire Future for Seniors and Taxpayers Without Reform
The recently released annual Medicare trustees report reiterates a decades-old message: The Medicare program faces an unsustainable financial future. Unless the program is reformed, it will impose a huge financial burden on American taxpayers and jeopardize access to care for seniors.
While these facts are incontrovertible, the Obama Administration’s allies and some in…
Backgrounder posted April 28, 2014
Four Years of Obamacare: Early Warnings Come True
But we have to pass the bill, so you can find out what is in it, away from the fog of controversy.
—Nancy Pelosi, Speaker of the U.S. House of Representatives, March 9, 2010
It is not our job to protect the people from the consequences of their political choices.
—Chief Justice John Roberts, National Federation of Independent Business v. Sebelius, June 28,…
Issue Brief posted March 14, 2014
Medicare SGR Replacement Is Not Worth More Deficit Spending
Congress is considering compromise legislation (H.R. 4015 and S. 2000) to repeal and replace the unworkable Medicare Sustainable Growth Rate (SGR) formula for updating physician payments. Since 2003, Congress has prevented its own 1997 formula from going into effect because the Medicare physician payment cuts, often draconian, would threaten seniors’ access to medical…
Issue Brief posted March 11, 2014
Proposed Rules for Part D Would Create Undue Disruption for Seniors
The Obama Administration’s Centers for Medicare and Medicaid Services (CMS) has announced that it will not finalize controversial elements of its proposed Medicare rule. The proposed rule would have undercut patient choice and reduced the competition that controls costs in the Medicare drug program (Part D). Many key stakeholders and Members of Congress expressed…
Backgrounder posted February 3, 2014
CBO Confirms: Medicare Premium Support Means Savings for Taxpayers and Seniors
A major report by the Congressional Budget Office (CBO) confirms that Medicare premium support (a defined-contribution system of health-plan financing) would make the financially troubled federal program more fiscally sustainable.
The CBO finds that, in a new competitive system of health plans, private plans can offer the same benefit and services as traditional…
Issue Brief posted January 24, 2014
Replacing the Medicare SGR: Getting the Policy and the Financing Right
This year, Medicare physicians face a 24 percent pay cut. The reason: Congress updates Medicare doctors’ payments by a formula called the Sustainable Growth Rate (SGR). While complex, the SGR formula attempts to limit the growth in Medicare physician payment to growth in gross domestic product (GDP). If physician payments are less than GDP growth in any given year, then…