Monday, November 11, 2024

Medicare's Latest Pay Cut Will Harm Seniors (Connecting the Dots: The American Medical Association, Medicare, Medicaid, Health Insurance, FDA, Obamacare, The Center for American Progress & Soros Funding, All Networking)

Medicare's Latest Pay Cut Will Harm Seniors (Connecting the Dots: The American Medical Association, Medicare, Medicaid, Health Insurance, FDA, Obamacare, The Center for American Progress & Soros Funding, All Networking)

Newsmax.com

By Sally PipesMonday, 11 November 2024 01:26 PM EST

(Dreamstime)

https://www.newsmax.com/sallypipes/medicare-doctors-healthcare/2024/11/11/id/1187542/

Doctors are getting a pay cut in 2025. That's the upshot of a rule issued by Medicare earlier this month.

Patients will be the ones who pay the price for Medicare's parsimony. Seniors and younger people alike will find it harder to secure access to doctors and care.

Physician practices' finances have been under stress for years. Next year's looming 2.9% reduction in reimbursement is the fifth pay cut Medicare has proposed since 2021. After accounting for inflation, Medicare payments to doctors fell nearly 30% between 2001 and 2024, according to the American Medical Association.

The costs associated with operating a practice — like rent, utilities, medical equipment, time spent battling insurance companies over things like prior authorization, and wages for staff — haven't fallen. They're up more than 50% since 2001. Even as Medicare proposes to cut physician payments next year, it admits that doctors' expenses are set to increase 3.5% in 2025.

"To put it bluntly," AMA President Dr. Bruce A. Scott recently said, "Medicare plans to pay us less while costs go up. You don't have to be an economist to know that is an unsustainable trend."

Medicare currently covers nearly 48 million American patients. This makes it the second-largest provider of health coverage in the nation, next to Medicaid. And the Medicare population is growing. The country is aging, and more Baby Boomers are retiring.

Asking doctors to see more beneficiaries for less money is unsustainable indeed.

Some practices will close or sell to hospitals or corporate entities rather than try to make the math work with lower Medicare reimbursements.

That's already been happening in recent years. Between 2019 and 2024, hospitals and corporate entities acquired more than 44,000 practices.

Others will respond to lower payments by reducing the number of Medicare beneficiaries they see. As a result, the supply of care available to them will go down.

So seniors may have to wait longer for care. They may lose access to their doctor. Or they may not find one who will take them as a patient.

Lower Medicare reimbursements and higher operating costs will likely cause providers to demand higher payments from commercial insurers. Private insurers paid an average of 129% of what Medicare paid for physicians' services between 2010 and 2020, according to one recent analysis by the Congressional Budget Office.

That number will almost certainly go up, as a matter of financial necessity. Consolidating providers will also enjoy more negotiating leverage.

The result will be higher premiums for the privately insured. Narrower provider networks might come about, too, as insurers search for ways to limit costs.

There is, of course, still time for lawmakers to prevent next year's cuts in Medicare physician reimbursement from taking effect. A bipartisan group of lawmakers in the House introduced legislation in late October that would stop Medicare's looming reimbursement cut and provide doctors with a slight pay increase for 2025 tied to inflation.

Congress needs to take action before the end of this year. Otherwise, patients could find doctors a lot harder to come by.

Connecting the Dots:

Akin, Gump, Strauss, Hauer & Feld, LLP was lobby firm for American Medical Association.

Vernon E. Jordan Jr. is a senior counsel for Akin, Gump, Strauss, Hauer & Feld, LLP and an honorary trustee at the Brookings Institution (think tank).

Mark B. McClellan was a senior fellow at the Brookings Institution (think tank) and a commissioner for the U.S. Food and Drug Administration (FDA).

Foundation to Promote Open Society was a funder for the Brookings Institution (think tank).

George Soros was the chairman for the Foundation to Promote Open Society.

Harold H. Koh was a trustee at the Brookings Institution (think tank), the State Department legal adviser for the Barack Obama administration and is Howard K. Koh’s brother.

Howard K. Koh is Harold H. Koh’s brother and is the assistant secretary at the U.S. Department of Health and Human Services for the Barack Obama administration.

Centers for Medicare & Medicaid Services (CMS) is a division of the U.S. Department of Health and Human Services.

Kathleen Sebelius is the secretary at the U.S. Department of Health and Human Services for the Barack Obama administration and her counselor at HHS was Dora Hughes.

Dora Hughes was Kathleen Sebelius’s counselor at HHS and is a senior policy adviser at Sidley Austin LLP.

Michelle Obama was a lawyer at Sidley Austin LLP.

Barack Obama was an intern at Sidley Austin LLP.

James David Vance worked at Sidley Austin LLP and is the Vice President for the Donald Trump Administration.

Cameron F. Kerry is a senior counsel at Sidley Austin LLPJohn F. Kerry’s brother and a fellow at the Brookings Institution (think tank)

Foundation to Promote Open Society was a funder for the Brookings Institution (think tank) and the Center for American Progress.

George Soros was the chairman for the Foundation to Promote Open Society and a supporter for the Center for American Progress.

Donald M. Berwick is a senior fellow at the Center for American Progress and was an administrator for the Centers for Medicare & Medicaid Services.

Tom Daschle is a director at the Center for American Progress and was a nominee for health and human services secretary for the Barack Obama administration.

Center for American Progress was a funder for America's Health Insurance Plans.

Scott Armstrong is a director at the America's Health Insurance Plans, a member of the Medicare Payment Advisory Commission and the president & CEO for the Group Health Cooperative.

Richard A. Barasch is a director at the America's Health Insurance Plans and the chairman & president & CEO for the Universal American Corporation.

Mark T. Bertolini is a director at the America's Health Insurance Plans and the chairman & president & CEO for Aetna Inc.

Bruce G. Bodaken is a director at the America's Health Insurance Plans and was the chairman & president & CEO for the Blue Shield of California.

Gail K. Boudreaux is a director at the America's Health Insurance Plans and the EVP for the UnitedHealth Group Inc.

Mary K. Brainerd is a director at the America's Health Insurance Plans and the president & CEO for HealthPartners Inc.

Angela F. Braly is a director at the America's Health Insurance Plans and was the president & CEO for Blue Cross and Blue Shield of Missouri.

William M. Cameron is a director at the America's Health Insurance Plans and the chairman & CEO for American Fidelity Assurance.

James G. Carlson is a director at the America's Health Insurance Plans and was the chairman & president & CEO for the Amerigroup Corporation.

David M. Cordani is a director at the America's Health Insurance Plans and the president & CEO for the CIGNA Corporation.

Michael W. Cropp is a director at the America's Health Insurance Plans and the president & CEO for Independent Health.

Michael M. Dudley is a director at the America's Health Insurance Plans and the president for Sentara Health Plans Inc.

Mark B. Ganz is a director at the America's Health Insurance Plans and the president & CEO for Cambia Health Solutions, Inc.

Jay M. Gellert is a director at the America's Health Insurance Plans and the president & CEO for Health Net, Inc.

Vicky B. Gregg is a director at the America's Health Insurance Plans and the president & CEO for the BlueCross BlueShield of Tennessee.

Patricia A. Hemingway Hall is a director at the America's Health Insurance Plans and the president & CEO for the Health Care Service Corporation.

George C. Halvorson is a director at the America's Health Insurance Plans and the chairman for Kaiser Permanente.

Daniel J. Hilferty III is a director at the America's Health Insurance Plans and the president & CEO for Independence Blue Cross.

Daniel J. Houston is a director at the America's Health Insurance Plans and was a director at Catalyst Health Solutions.

Michael B. McCallister is a director at the America's Health Insurance Plans and the chairman for Humana Inc.

Kevin P. McCarthy is a director at the America's Health Insurance Plans and the EVP for the Unum Group.

Unum in the US

http://www.unumgroup.com/About/UUS.aspx

For more than 37 years, Unum has been the leading provider of group disability benefits in the U.S.1

J. Mario Molina is a director at the America's Health Insurance Plans and the chairman & president & CEO for the Molina Healthcare Inc.

Daniel P. Neary is a director at the America's Health Insurance Plans and the chairman & CEO for Mutual of Omaha.

Robert A. Reed is a director at the America's Health Insurance Plans and the president & CEO for the Physicians Mutual Insurance Company.

James Roosevelt Jr. is a director at the America's Health Insurance Plans and the president & CEO for the Tufts Health Plan.

Eric H. Schultz is a director at the America's Health Insurance Plans and the president & CEO for the Harvard Pilgrim Health Care.

Charles D. Baker Jr. was a director at the America's Health Insurance Plans and is the president & CEO for the Harvard Pilgrim Health Care.

Anthony L. Watson is a director at the America's Health Insurance Plans and the chairman & CEO for the HIP Health Plan of New York.

Debbie J. Ahl was a director at the America's Health Insurance Plans and is the president & CEO for the Sterling Life Insurance Company.

K. Rone Baldwin was a director at the America's Health Insurance Plans and is the EVP & COO for the Guardian Life Insurance Company of America.

Christy W. Bell was a director at the America's Health Insurance Plans and is the EVP for the Horizon Blue Cross Blue Shield of New Jersey.

Frank J. Branchini was a director at the America's Health Insurance Plans, is the president & COO for Emblem Health and the CEO for Group Health Inc.

Benjamin M. Cutler was a director at the America's Health Insurance Plans and is the chairman & CEO for USHEALTH Group Inc.

Joseph A. Frick was a director at the America's Health Insurance Plans and is the vice chairman for Independence Blue Cross.

H. Edward Hanway was a director at the America's Health Insurance Plans and the chairman & CEO & president for the CIGNA Corporation.

Robert I. Lufrano was a director at the America's Health Insurance Plans and the CEO for Blue Cross and Blue Shield of Florida.

Frederick J. Manning was a director at the America's Health Insurance Plans and is the chairman & CEO for the Celtic Insurance Company.

David M. McDonough was a director at the America's Health Insurance Plans and is the president & CEO for the Trustmark Insurance Company.

Adrienne Morrell was a lobbyist at the America's Health Insurance Plans and is a lobbyist for Health Net, Inc.

Ronald A. Williams was a director at the America's Health Insurance Plans and the chairman for the Emergency Medical Services Corp.

Jeannine M. Rivet was a director at the America's Health Insurance Plans and is the EVP for the UnitedHealth Group Inc.

Lewis G. Sandy was a director at the America's Health Insurance Plans and is the SVP for the UnitedHealth Group Inc.

Tom Daschle was an adviser for the UnitedHealth Group Inc., the nominee for health and human services secretary for the Barack Obama administration and a director at the Center for American Progress (think tank).

Center for American Progress (think tank) was a funder for America's Health Insurance Plans.

Open Society Foundations was a funder for the Center for American Progress (think tank).

George Soros is the founder & chairman for the Open Society Foundations, was the chairman for the Foundation to Promote Open Society and a supporter for the Center for American Progress (think tank).

Foundation to Promote Open Society was a funder for the Center for American Progress (think tank).

Akin, Gump, Strauss, Hauer & Feld, LLP was the lobby firm for the Center for American Progress (think tank), the America's Health Insurance Plans and the American Medical Association.

Vernon E. Jordan Jr. is a senior counsel for Akin, Gump, Strauss, Hauer & Feld,

an honorary trustee at the Brookings Institution (think tank) and married to Ann Dibble Jordan.

Mark B. McClellan was a senior fellow at the Brookings Institution (think tank) and a commissioner for the U.S. Food and Drug Administration (FDA).

Foundation to Promote Open Society was a funder for the Brookings Institution (think tank) and Center for American Progress.

George Soros was the chairman for the Foundation to Promote Open Society and a supporter for the Center for American Progress (think tank).

Center for American Progress was a funder for the America's Health Insurance Plans.

Tom Daschle is a director at the Center for American Progress, was a nominee for health and human services secretary for the Barack Obama administration and a special policy adviser at Alston & Bird

Thomas A. Scully is a senior counsel at Alston & Bird, the president & CEO for the Federation of American Hospitals and an administrator for the Centers for Medicare & Medicaid Services (CMS).

Timothy P. Trysla is a partner at Alston & Bird and was a senior policy adviser to the administrator for the Centers for Medicare & Medicaid Services (CMS).

Centers for Medicare & Medicaid Services is a division of the U.S. Department of Health and Human Services.

Marilyn B. Tavenner is the administrator for the Centers for Medicare & Medicaid Services (CMS) and was the group president of outpatient services for the Hospital Corporation of America.

Donald M. Berwick was an administrator for the Centers for Medicare & Medicaid Services (CMS) and is a senior fellow at the Center for American Progress.

Foundation to Promote Open Society was a funder for the Center for American Progress and the and the Committee for Economic Development.

George Soros was the chairman for the Foundation to Promote Open Society and a supporter for the Center for American Progress (think tank).

Trevor Fetter was a trustee at the Committee for Economic Development and a director at the Federation of American Hospitals.

 Jack O. Bovender Jr. was a trustee at the Committee for Economic Development and the chairman & CEO for HCA Holdings Inc.

Nancy-Ann DeParle is a director at HCA Holdings Inc., was the White House health czar & deputy chief of staff for the Barack Obama administration and an administrator for the Health Care Financing Administration.

Health Care Financing Administration was the predecessor for the Centers for Medicare & Medicaid Services (CMS).

Hospital Corporation of America was the predecessor for HCA Holdings Inc.    

Donna S. Morea was a trustee at the Committee for Economic Development and the EVP for the CGI Group Inc.

CGI Group Inc. was the Obamacare contractor that developed Healthcare.gov web site.

Obamacare is Barack Obama’s signature policy initiative.

Kenneth M. Duberstein was the VP for the Committee for Economic Development and is the chairman & CEO for the Duberstein Group, Inc.

Duberstein Group, Inc. is the lobby firm for the America's Health Insurance Plans.

Scott Armstrong is a director at the America's Health Insurance Plans and a member of the Medicare Payment Advisory Commission.

Dan L. Crippen was the SVP for the Duberstein Group, Inc. and a director at the Congressional Budget Office (CBO).

CBO Confirms: Biden-Harris Election Year Medicare Cost-Shifting Policy Will Cost Taxpayers Billions in 2025

October 03,2024

https://www.finance.senate.gov/ranking-members-news/cbo-confirms-biden-harris-election-year-medicare-cost-shifting-policy-will-cost-taxpayers-billions-in-2025

Washington, D.C.--The nonpartisan Congressional Budget Office (CBO) released its analysis of a newly announced Biden-Harris program intended to paper over the flaws of the so-called Inflation Reduction Act (IRA).  Based on CBO estimates, this election-year stunt to artificially lower the cost of seniors’ Part D premiums will cost taxpayers at least $7 billion in 2025, including $2 billion in additional interest on our already ballooning debt.  CBO also notes the underlying partisan policy changes to seniors’ prescription drug coverage could cost up to $20 billion more in 2025 than previously assumed.

This analysis is in response to a request from U.S. Senate Finance Committee Ranking Member Mike Crapo (R-Idaho), U.S. Senate Budget Committee Ranking Member Chuck Grassley (R-Iowa), U.S. House Budget Committee Chair Jodey Arrington (R-Texas), U.S. House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-Washington) and U.S. House Ways and Means Committee Chair Jason Smith (R-Missouri).

Ranking Member Crapo Statement:

“The Congressional Budget Office has confirmed that the Biden-Harris Administration’s latest 2024 gimmick will spend billions in taxpayer dollars to blanket over the consequences of the rushed, partisan so-called Inflation Reduction Act.  This type of executive overreach treats the Treasury as a piggy-bank, exacerbating inflation and sidestepping Congress to advance conveniently timed political aims.”

Ranking Member Grassley Statement:

“When Democrats unilaterally enacted major changes to Medicare two years ago, they set seniors up for new expenses and fewer options.  This nonpartisan CBO analysis confirms CMS’s cost-shifting plan is a dishonest election-year gimmick to cover up those consequences. Rather than coming to the table and legitimately addressing its partisan mistakes, the Biden-Harris administration threw taxpayer dollars at the problems it created, putting Americans on the hook for tens-of-billions more dollars.”

Chair Arrington Statement:

“As predicted, the Biden-Harris Inflation Reduction Act not only quelled investment for new cures, but caused Medicare prescription drug plan premiums to skyrocket, and Democrats are scrambling to cover it up before the election.

“In July, the Biden-Harris CMS scrambled to create a new federal program that will send billions of tax dollars to large health insurance companies to cover up a massive flaw in their so-called Inflation Reduction Act.

“Now, CBO confirmed that the Administration’s election year Hail Mary will cost taxpayers an astounding $7 billion next year alone, and $21 billion over the planned 3-year demo, adding to the more than $2 trillion in Biden-Harris executive spending.”

Chair McMorris Rodgers Statement:

“The CBO confirms the $7 billion cost for just one year of the Biden-Harris administration’s politically motivated scheme to buy off big insurance companies just weeks before an election.  The American people should not be fooled by this illegal, last-ditch attempt to cover up Democrats’ disastrous policies that significantly raised Medicare Part D premiums.  President Biden and Vice President Harris should abandon this ill-fated plan and work on bipartisan solutions to lowering the cost of care, like the Lower Costs, More Transparency Act."

Chair Smith Statement:

“The so-called Inflation Reduction Act – which is law as a result of Vice President Harris’ tie-breaking vote in the Senate – has led to a predictable spike in the cost of prescription drug coverage for America’s seniors.  Rather than change course, the Biden-Harris Administration is cutting taxpayer-funded blank checks to large health insurers to sweep the mess under the rug.  It is a shameful attempt to delay the inevitable fallout of a failed policy that leaves taxpayers footing the bill today and seniors paying the price tomorrow.”

Background:

Congressional Democrats included policies in the IRA that significantly redesigned the Medicare Part D prescription drug benefit at an initial estimated cost of nearly $30 billion over ten years.

These policy changes restructured the Medicare Part D prescription drug benefit and take effect in 2025.  As a result, Medicare prescription drug plan (PDP) sponsors responded by significantly increasing their plan bids and base beneficiary premiums for 2025, as well as reducing the number of plans offered to seniors next year.

In response, on July 29, 2024, the Biden-Harris Centers for Medicare and Medicaid Services (CMS) announced a new Medicare Part D Premium Stabilization Demonstration program, which will send Federal dollars to large health insurance companies to artificially lower the cost of seniors’ Part D premiums.

The bottom line:

The Premium Stabilization Demonstration program will shift financial liability onto American taxpayers by applying a uniform reduction of $15 to the base beneficiary premium, establishing a year-over-year limit of $35 on how much a plan’s total Part D premium can increase, and adjusting risk corridors to shift financial liability from large insurance companies to taxpayers.

Under the Biden-Harris Administration, average Medicare Part D premiums increased by over 11 percent from 2021 to 2024, costing seniors an average of $52 more per year for their prescription drug coverage.  On the contrary, under the Trump Administration, average Part D premiums decreased by over 5.5 percent, saving seniors an average of $27 a year.

As a result, before the announcement of the Biden-Harris Administration’s election-year bailout of health insurance companies, seniors’ premiums had increased under this Administration at more than twice the rate that they decreased under the Trump Administration.

While the Trump Administration lowered costs by increasing free-market competition, the Biden-Harris Administration has subjected seniors to soaring prescription drug costs with sloppy partisan policymaking and one-size-fits-all “Washington knows best” mandates. 

Because of Democrats’ rushed, partisan policymaking in the IRA, America’s seniors were faced with sharp increases in their prescription drug premiums as well as fewer choices for coverage.

To cover up rising premiums ahead of November, the Biden-Harris Administration announced a demonstration program, which will buy down premium increases by sending billions of taxpayer dollars directly to large insurance companies.  A recent editorial from The Wall Street Journal called the plan “a Medicare election bribe for seniors.”

Resources: Past Research

Shock Report: Federal Government Will Bill Peoples' Estates After Death To Pay For Medicaid Expenses (Past Research on Medicare & Medicaid)

Monday, December 16, 2013

https://thesteadydrip.blogspot.com/2013/12/shock-report-federal-government-will.html

A Gun to the Head: Obamacare Medicaid Expansion and the Federal Takeover of State Governments (Past Research on Medicare & Medicaid)

Saturday, November 22, 2014

https://thesteadydrip.blogspot.com/2014/11/a-gun-to-head-obamacare-medicaid.html

THE AMERICAN MEDICAL ASSOCIATION GOES INSANE (Past Research on the American Medical Association)

Friday, May 21, 2021

https://thesteadydrip.blogspot.com/2021/05/the-american-medical-association-goes.html

J. D. Vance (Connecting the Dots: J.D. Vance, Sidley Austin LLP, Obama, CNN, Kimberly Cheatle, U.S. Secret Service, PepsiCo, U.S. Secret Service, Pence, FBI, Merrick Garland, Alejandro Mayorkas, O'Melveny & Myers LLP & Soros Funding, All Networking) (Past Research on Sidley Austin LLP & J.D. Vance)

Monday, July 15, 2024

https://thesteadydrip.blogspot.com/2024/07/j-d-vance-connecting-dots-jd-vance.html

Who is Involved in Your Healthcare? (Connecting the Dots: America's Health Insurance Plans, the Center for American Progress (Think Tank), Vaccine Manufacturer’s & the Soros Funded Think Tanks All Networking) (Past Research on the America's Health Insurance Plans)

Thursday, October 13, 2022

https://thesteadydrip.blogspot.com/2022/10/who-is-involved-in-your-healthcare.html

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