Five cuts the debt commission might make to Medicare, Medicaid
By Suzy Khimm
NYT
Medicare and Medicaid will be spared from the first round of cuts in the debt-ceiling deal. But the Joint Congressional Committee tasked with finding $1.5 trillion or more in deficit reduction is going to be looking hard at both programs. Here are five options they’re likely to consider:
1) Raise the Medicare eligibility age, increase premiums for wealthy recipients, and increase deductibles and co-pays. President Obama backed all of these changes during the negotiations last month, echoing the details of the deficit-reduction plan from Sens. Tom Coburn (R-Okla.) and Joe Lieberman (I-Conn.), which would save $600 billion in Medicare spending. The Lieberman-Coburn plan is “the most likely model for Medicare cuts from a bipartisan fiscal committee,” says Tevi Troy, a former George W. Bush staffer and health policy expert. Those changes would elicit howls from liberals and make it tougher for Democrats to cast themselves as the program’s staunchest defenders, but the White House’s backing could override these concerns.
2) Give states more leeway in Medicaid to scale back eligibility and benefits, as well as payments to nursing homes: The GOP’s most controversial Medicaid proposal—Rep. Paul Ryan’s (R-Wisc.) plan to block grant the program—won’t pass muster. But House Republicans have been quietly floating other reforms, some of which have picked up support from some Democratic governors. One is the State Flexibility Act, which would allow states to modify their Medicaid eligibility and benefit requirements, reducing both federal and state spending. If the specter of direct “benefit cuts” scares off Democrats, the committee could turn its focus to providers instead. Nursing homes receive a huge chunk of Medicaid dollars, for instance, and they could be starved of some money. Such cuts would eventually affect beneficiaries, if nursing homes reduce services and access in response, but the effect is more indirect—and thus politically palatable.
(More here.)
NYT
Medicare and Medicaid will be spared from the first round of cuts in the debt-ceiling deal. But the Joint Congressional Committee tasked with finding $1.5 trillion or more in deficit reduction is going to be looking hard at both programs. Here are five options they’re likely to consider:
1) Raise the Medicare eligibility age, increase premiums for wealthy recipients, and increase deductibles and co-pays. President Obama backed all of these changes during the negotiations last month, echoing the details of the deficit-reduction plan from Sens. Tom Coburn (R-Okla.) and Joe Lieberman (I-Conn.), which would save $600 billion in Medicare spending. The Lieberman-Coburn plan is “the most likely model for Medicare cuts from a bipartisan fiscal committee,” says Tevi Troy, a former George W. Bush staffer and health policy expert. Those changes would elicit howls from liberals and make it tougher for Democrats to cast themselves as the program’s staunchest defenders, but the White House’s backing could override these concerns.
2) Give states more leeway in Medicaid to scale back eligibility and benefits, as well as payments to nursing homes: The GOP’s most controversial Medicaid proposal—Rep. Paul Ryan’s (R-Wisc.) plan to block grant the program—won’t pass muster. But House Republicans have been quietly floating other reforms, some of which have picked up support from some Democratic governors. One is the State Flexibility Act, which would allow states to modify their Medicaid eligibility and benefit requirements, reducing both federal and state spending. If the specter of direct “benefit cuts” scares off Democrats, the committee could turn its focus to providers instead. Nursing homes receive a huge chunk of Medicaid dollars, for instance, and they could be starved of some money. Such cuts would eventually affect beneficiaries, if nursing homes reduce services and access in response, but the effect is more indirect—and thus politically palatable.
(More here.)
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