Tag Archives: Centers for Medicare and Medicaid Services

Hiding The Increased Cost Of Medicare Premiums Caused By The Passage Of The Inflation Reduction Act

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The Inflation Reduction Act did a lot of things. One of the things it did not do was reduce inflation. We are now finding out that it will cause a significant increase in the cost of Medicare Insurance.

On Wednesday, Fox News posted an article about the use of taxpayer money to delay the increases until after the election.

The article explains:

In a move critics say is designed to shield the Biden-Harris administration from election fallout, the administration has leveraged taxpayer funds to mask upcoming increases in Medicare premiums.

Under the Inflation Reduction Act (IRA), which was intended to cap out-of-pocket drug costs for Medicare beneficiaries, insurers are poised to significantly hike monthly premiums, with average bids for Part D plans expected to triple by 2025.

In response to potential voter backlash, the Centers for Medicare and Medicaid Services (CMS) rolled out a three-year “demonstration project” to subsidize these premiums, aiming to keep them artificially low. However, despite the appearance of relief, some critics are saying that taxpayers will fund a dramatic increase in subsidies — from $30 per recipient per month in 2024 to $142.70 in 2025 — raising concerns about the long-term impact on government spending and debt. 

The article notes:

Research published by Fidelity, an investment research group, shows that a 65-year-old retiring today can expect to spend $165,000 on health care in retirement, a 5% increase from last year and more than double the estimate from 2002.

Yet, there appears to be a disconnect for many Americans between the actual projected cost of health care in retirement and how much they expect to spend on those expenses. The average American thinks they will spend about $75,000 on health care and other medical expenses, less than half of Fidelity’s calculation, according to the research.

The estimate assumes that an individual is enrolled in Medicare – including Part A and Part B, which cover most hospital care and doctor’s visits – and Part D, which covers prescription drugs. Other expenses such as Medicare premiums, over-the-counter medications, dental and vision care and other costs typically not covered by Medicare are “left to retirees to manage on their own,” the report said.

As of April 2024, about 67.3 million Americans were enrolled in Medicare, according to the Centers for Medicare and Medicaid Services. Of those, about half were enrolled in a Medicare Advantage plan, while about 80% were covered by Medicare Part D.

“They just want to get through the election,” Grogan (former President Trump advisor Joe Grogan) said. “They’re hoping after the election they can face it, but its gonna need to be dealt with in the next 12–18 months. They did not believe it would be this bad and its only gonna get worse.” 

Medicine was much more efficient and much cheaper before the government got involved. It is time to let medicine become a free-market part of the economy. More competition will provide more care at a more reasonable price for everyone.

 

 

Good News For American Families

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The Washington Examiner posted an article today about changes made to the current federal regulations regarding healthcare insurance.

The article reports:

Last Wednesday, Health and Human Services Secretary Alex Azar announced a finalized rule granting consumers greater access to affordable health insurance policies. Under the new rule, people will be allowed to purchase short-term, limited-duration health insurance plans for periods as long as 12 months. Currently, the maximum period allowed is only three months. Plans can be renewed after the 12-month period, but they cannot extend beyond 36 months.

Short-term health insurance plans are significantly cheaper than most Obamacare plans because they don’t include many of the costly essential health benefits mandated under federal law and because they are sold for a limited duration. These plans do not provide comprehensive coverage, but they are an excellent option for people who are relatively healthy but can’t afford to pay for an outrageously priced Obamacare plan.

This means that a family whose insured member is changing jobs or between jobs can get coverage at a reasonable price. The plans cannot extend for more than three years, but hopefully Congress will find its backbone and totally repeal ObamaCare by then.

The article further states that although premiums under ObamaCare have risen drastically, that is not the entire problem:

Premiums are not the most important cost to consider, however, because some people who purchase health plans through an Obamacare exchange receive large subsidies to help offset their plan’s high premiums. A much more important factor is the high cost of deductibles and other out-of-pocket costs. The average family enrolled in a Silver Plan will pay a maximum of $13,725 for out-of-pocket expenses, with Silver Plan deductibles increasing by 13 percent in just the past year alone.

Working families can’t afford to pay more than $13,000 to cover out-of-pocket expenses. In fact, health insurance this expensive is virtually useless.

The high costs associated with an Obamacare plan are a big reason why the Centers for Medicare and Medicaid Services predicts about 600,000 Americans will sign up for a new short-term health insurance plan next year. By 2022, CMS expects 1.6 million to be enrolled in a short-term plan.

The article concludes:

The healthcare system is failing, and has been for decades. Despite the promises made by former President Barack Obama and the congressional Democrats who passed Obamacare into law, the legislation has only made things worse. Congress needs to pass a bill to repeal and replace Obamacare. But since that has yet to occur, the Trump administration is doing everything it can to help young people and working families gain affordable coverage. It’s great to finally have a presidential administration that’s truly committed to reducing health insurance costs rather than appeasing far-left activists in the Democratic Party.

True.

Teaching Responsibility To Those Who Have Somehow Avoided The Lesson

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Yesterday Fox News posted a story about Kentucky‘s plan to follow President Trump’s suggestion to add a work requirement for receiving Medicaid.

The article reports:

Under the new rule, adults age 19 to 64 must complete 80 hours of “community engagement” per month to keep their care. That includes working a job, going to school, taking a job-training course or volunteering.

“There is dignity associated with earning the value of something that you receive,” Kentucky Gov. Matt Bevin said. “The vast majority of men and women, able-bodied men and women … they want the dignity associated with being able to earn and have engagement.”

One of the comments under this article on the site where I saw it posted commented that benefits were not for the benefit of the recipients, but to make sure how the recipients voted. Unfortunately we have created a group of people in America who would rather receive free things that the rest of us pay for than earn those things himself. I realize that some people need these benefits and have valid reasons for wanting them, and we need to help these people. However, we need to end the free ride for those who are taking advantage of the situation.

Note that the requirement is 80 hours a month. That is not a lot. That is approximately 20 hours a week. That is not an unreasonable requirement.

Your Tax Dollars At Work

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Fox News reported yesterday that illegal immigrants and others whose citizenship status was unclear received up to $750 million in ObamaCare subsidies as of June 2015.

The article reports:

The report, produced by Republicans on the Senate Homeland Security and Governmental Affairs Committee, examined Affordable Care Act tax credits meant to defray the cost of insurance premiums. It found that as of June 2015, “the Administration awarded approximately $750 million in tax credits on behalf of individuals who were later determined to be ineligible because they failed to verify their citizenship, status as a national, or legal presence.”

The review found the credits went to more than 500,000 people – who are illegal immigrants or whose legal status was unclear due to insufficient records. 

The Centers for Medicare and Medicaid Services confirmed to FoxNews.com on Monday that 471,000 customers with 2015 coverage failed to produce proper documentation on their citizenship or immigration status on time – but stressed that this does not necessarily mean they’re ineligible.  

The people who make comments like “that does not necessarily mean they’re ineligible” have obviously never raised teenagers.

The Senate report states that it is doubtful that the IRS will be able to recoup the money as there is no concrete plan to locate the people who illegally took the subsidies.

The article concludes:

The Senate report says the IRS and HHS initially failed to coordinate on a plan for recouping funds, and claimed that a subsequent plan from the IRS to recoup the money is still “ineffective and insufficient.”

In a July letter to Johnson, IRS Commissioner John Koskinen assured that the agency is “committed to identifying and efficiently addressing” improper payments. He reiterated that anyone “not lawfully present” who enrolls for ObamaCare coverage “must repay” the advance premium credit payments, and would be breaking the law if they don’t.

And the government has suddenly become efficient????

This May Be One Of Many Reasons ObamaCare Is So Expensive

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On Tuesday, The Washington Free Beacon posted an article about an Inspector General audit of the Department of Health and Human Services. The purpose of the audit was to determine if the ObamaCare healthcare sign-up sites were monitoring the people who were signing up to see if they were eligible for ObamaCare.

The article reports:

The IG found that the internal controls did not always correctly verify Social Security numbers, citizenship status, annual household income, and family size information to determine eligibility.

One applicant understated her income by $7,000. According to the IG, the marketplace should have compared this income data to available electronic data sources and realized that the applicant’s income was more than 10 percent below the income listed on these data sources. Then, the marketplace should have asked the applicant for additional evidence of income.

Instead, this applicant was not only verified, but was approved to receive the advance premium tax credit.

Another example of weak internal controls was found in efforts to verify citizenship status. The marketplace did not always verify this information through the Social Security Administration and the Department of Homeland Security, as was required.

The IG found that not only were there problems with internal controls, but once discrepancies were found, they were not handled properly.

…This report comes on the heels of a Government Accountability Office (GAO) report that found Healthcare.gov approved coverage for fake accounts. GAO performed undercover tests and fabricated personal data of fake applicants for coverage under Obamacare. In 11 of 12 of these fake applications, the online marketplace approved coverage and granted each account $30,000 in premium tax credits.

Sounds like a typical government program to me.

 

Another Glitch In ObamaCare

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There has been another glitch in ObamaCare. Actually, it is considerably more than a glitch. Yesterday the Daily Caller reported that more than 300,000 people who signed up for ObamaCare are in danger of losing their coverage if they do not provide more information about their citizenship and immigration status.

The article reports:

Obamacare administrator the Centers for Medicare and Medicaid Services announced Tuesday that the agency sent letters notifying 310,000 customers who have failed to fix errors in their citizenship or immigration data that their coverage will be terminated Sept. 30 if they don’t submit proof by Sept. 5.

The customers are part of close to 1 million Obamacare sign-ups who submitted applications with citizenship and immigration information that didn’t square with federal records. CMS claims 450,000 of those cases have been resolved, but it’s not clear how many of those “closed” cases resulted in more canceled policies.

CMS claims it reached out to customers between five and seven times, through mail, phone and e-mail, to try to straighten out the citizenship and immigration errors. They’ve pledged to reach out again with two more phone calls and one more e-mail before Sept. 5.

The article also explains that applications with income verification issues will be addressed at a later date. This means that people who have had their premiums subsidized by the government may be faced with an unexpected hefty tax bill.

What a mess!

Agreement On Something From Both Sides Of The Political Spectrum

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It’s rare when the right and left agree on anything. It is really rare when publications on the far right and the far left agree, but that has happened on the issue of rationing drugs for the elderly. This article is based on articles in The American Spectator and The Huffington Post.

The American Spectator reports:

Buried beneath the avalanche of recent news reports about the latest Obamacare-mandated funding cuts to the Medicare Advantage (MA) program is a related but far more disturbing story — the Centers for Medicare and Medicaid Services (CMS) has taken a major step toward rationing medications to the elderly. Since passage of the Medicare Modernization Act of 2003, seniors enrolled in the Medicare prescription drug program have been guaranteed access to “all or substantially all” of the drugs in several classes of pharmaceuticals. President Obama’s health care bureaucrats, however, have proposed removing three of these classes from the “protected” list.

The Huffington Post reports:

A proposed rule issued by the Centers for Medicare and Medicaid Services (CMS) would make significant changes to the Medicare Part D prescription drug program. In short, the rule change affects what are known as the “protected classes” of pharmaceuticals under Part D — classes of drugs in which, under current law, coverage must be provided for “substantially all” medicines. The logic in maintaining these protected classes is inarguable. Medicare beneficiaries coping with serious, chronic illnesses should have access to the medications that they and their physicians have deemed the most effective treatment for their conditions.

Medications are not interchangeable. One drug can have vastly different effects, and side effects, on different patients. Thus, Medicare Part D is structured to ensure that patients who require antidepressants, antipsychotics and immunosuppressants (critical drugs for patients who have undergone organ transplants) have access to the unique medicines they need to protect their lives and health.

…The best way to make Medicare more cost-efficient is to help patients better manage their chronic illnesses and avoid long hospitalizations and expensive acute care episodes. The CMS proposed rule change will do just the opposite. Restricting access to the medicines patients need to manage depression, avoid organ transplant rejection, and treat psychosis will drive healthcare utilization in far more costly ways. That’s a betrayal of Medicare’s promise of access to care for our most vulnerable, older Americans.

The Obama Administration seems to forget that senior citizens vote. Senior citizens also pay attention. ObamaCare may have been passed with the support of the AARP, lulling seniors into a false belief that the it would not be harmful to them, but many seniors are waking up to the fact that serious cuts to Medicare are part of the President’s plan for ObamaCare. Senior citizens and Americans have been lied to about ObamaCare. It is time to repeal it and start over.

 

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I Wish Someone Had Read The Bill Before They Passed It

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There is new bad news coming out about ObamaCare every day. The President has unilaterally changed the law so many times it seems as if he is making it up as he goes along (maybe he is), and now there is a new twist for senior citizens.

On December 12, the Washington Examiner reported that beginning January 1, there will be major cuts to programs in Medicare and Medicaid that help senior citizens.

The article reports:

An estimated 3.5 million poor and ill homebound senior citizens will wake up on New Year’s Day to discover Obamacare has slashed funding for their home health care program.

It will happen because the Centers for Medicare and Medicaid Services quietly issued a regulation Nov. 22 announcing a 14-percent cut over the next four years in funding for the Home Health Care Prospective Payment program.

The rule cuts Medicare payments to home health care providers by 3.5 percent each year beginning in 2014, for a total cut of 14 percent.

…Nearly a half million skilled home care workers are also projected to lose their jobs over the next four years due to the cuts, according to the program’s supporters.

The cuts may also have a disproportionate impact on minorities and those living in underserved rural communities.

A November 2013 study by Avalere Health, a Washington, D.C., health care business analysis firm, found that two out of three home health care recipients fall at or below the federal poverty line.

The study also estimated that one in four seniors getting home health care are age 85 or older.

Federal officials had discretion to keep Medicare home payments at the same level or impose a maximum 3.5 percent cut each year through 2017 to reach the 14-percent reduction.

But CMS opted to impose the maximum reduction, beginning on New Year’s Day 2014.

The cuts that are being made to Medicare are being made to fund ObamaCare. In other words, ObamaCare takes money from the care of the elderly and uses that money to fund a government takeover of the health insurance agency.

The article reports some push-back from Congress on the issue:

Fifty-one senators appealed in a September letter to Tavenner to reject the proposed cuts to home health care agencies, saying enactment “would raise serious concerns about access to care for vulnerable seniors.”

There were 35 Democratic signers of the letter to Tavenner, 15 Republicans and one independent.

Also in September, 142 members of the House of Representatives wrote Tavenner that “home health is a critical service that allows patients to be treated in a cost effective manner in the environment they prefer — their home.”

Sixty-six House Democrats joined 76 House Republicans in signing that letter.

As January 1 rapidly approaches, the promises made about ObamaCare are becoming nightmares for the American public.

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Six????

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Oversighthouse.gov reported yesterday that the enrollment numbers in ObamaCare are not good.

The website reported:

WASHINGTON – House Oversight and Government Reform Committee Chairman Darrell Issa, R-Calif., today released new HealthCare.gov meeting notes stating that as of 10/2/2013, there were “248 enrollments.” According to meeting notes from the day before, “6 enrollments have occurred so far with 5 different issuers.”

The numbers come from notes taken during “War Room” meetings at the Center for Consumer Information and Insurance (CCIIO), part of the Center for Medicare and Medicaid Services (CMS) tasked with implementing ObamaCare. The meetings were comprised of Administration officials and contractors discussing the standing issues and problems with the disastrous launch of HealthCare.gov.

The first set of notes, taken the morning of October 2nd, states, “6 enrollments have occurred so far with 5 different issuers… Issuers include BCBS NC, BCBS Kansas City, and CareSource. Healthcare Service Corporation had the 2 enrollments.”

At the next meeting held the afternoon of October 2nd, the notes add that “[a]pproximately 100 enrollments have happened as of this meeting.”

At the morning meeting held October 3rd, the notes say that “[as] of yesterday, there were 248 enrollments.”

The website provides a link to some of the meetings concerning ObamaCare. I really do wonder what the future of this program will be. It obviously is not providing healthcare for the majority of uninsured people in America. It seems as if it is only responsible for causing those people who were already insured to lose their health insurance.

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Don’t Confuse Optics With Facts

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Often, the best reporting on events in America comes from the British papers. Today’s U.K. Daily Mail is an example of that fact.

An article in the U.K. Daily Mail today reports that only three of the thirteen people standing behind President Obama during his speech yesterday had actually enrolled in ObamaCare. That’s interesting since they were standing there to show their support of ObamaCare.

The article explains who the people in the photo-op were:

They include the state of Delaware‘s first Obamacare insurance participant – and, so far, its only one – along with a Tennessee woman who enrolled less than a day before the press event, and a Washington, D.C. man that the Obama White House has used on two previous occasions to symbolize the administration’s policy positions.

The other ten included small business owners, twenty-somethings enrolled in their parents’ health insurance plans, a pharmacist, and both self-employed and part-time workers.

The article further reports:

The federal government’s most optimistic numbers, released unceremoniously over the weekend, suggest that fewer than 500,000 Americans have created online Obamacare accounts, the first step toward obtaining coverage in a healthcare exchange.

Published numbers of actual enrollees, including figures MailOnline obtained from employees who crunch those numbers for the Centers for Medicare & Medicaid Services, indicate a far lower total.

The Department of Health and Human Services has said it will only make the actual enrollment totals public once each month, beginning in mid-November.

I don’t mean to be cynical here, but I wonder if a glitch in the system will prevent the enrollment totals from being made public for a while.

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This Is What Happens When You Ignore The Bidding Process

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Back in the days of dinosaurs when America had a space program, one of the astronauts commented that he had mixed emotions about sitting on the launch pad knowing that every piece of the spaceship he was on was supplied by the lowest bidder. Having said that, the space program generally worked pretty well, and the bidding process was successful in finding the people who were able to do the job at the lowest cost. Contrast the success of NASA in sending astronauts into space with the rollout of the ObamaCare website.

The Washington Examiner reported on Sunday that the usual government bidding process was not followed in hiring the firm to design and implement the ObamaCare website.

The article reports:

Rather than open the contracting process to a competitive public solicitation with multiple bidders, officials in the Department of Health and Human Services’ Centers for Medicare and Medicaid accepted a sole bidder, CGI Federal, the U.S. subsidiary of a Canadian company with an uneven record of IT pricing and contract performance.

CMS officials are tight-lipped about why CGI was chosen or how it happened. They also refuse to say if other firms competed with CGI, or if there was ever a public solicitation for building Healthcare.gov, the backbone of Obamacare’s problem-plagued web portal.

It gets even more interesting. Today the Washington Examiner reported on exactly who runs CGI.

That article reports:

Prior to the official award, senior CGI executives met with top White House officials and attended a number of invitation-only addresses by President Obama.

Two of the meetings attended by CGI executives were with Vivek Kundra, Obama’s chief information officer. Kundra was a key figure in Obama administration information technology initiatives across the government.

The article reports that the executives of CGI had close ties with the government and possible conflicts of interest.  John Loonsk was a former director for health information technology at HHS, which awarded the Obamacare web project. He is now CGI’s chief medical officer, as well as a member of the initiative.

This may be totally innocent, but it sure doesn’t look that way. The Obama Administration has a history of picking winners and losers, and it looks like that is what they did in awarding the information technology contract to implement ObamaCare. As a result of this, we have an electronic sign-up system that puts the people who sign up at risk for identity theft–assuming they can get far enough into the system to input their personal information.

The total failure of the ObamaCare website is one of a multitude of reasons the program should be delayed for at least a year. It would be better to scrap ObamaCare and start over, but if that is not possible, a one-year delay would give the government some time to at least try to fix the problems.

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The Obama Administration Targets Women And Children First

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Actually, the Obama Administration targets the elderly, and women and children first. Today’s American Spectator posted an article about a recent announcement from the Centers for Medicare and Medicaid Services (CMS) that it plans to cut an extra 2.2 percent from the Medicare Advantage (MA) program. This new cut, which came as a surprise to everyone except Obama’s health care commissars, will be added to the $200 billion in cuts Obamacare has already mandated for MA. What does this have to with low-income and minority seniors? The administration’s new Medicare cuts will come directly out of their pockets.

Medicare Advantage is one of the most popular health care plans among senior citizens. It is successful because it involves competition in the private sector.

The article reports:

… The MA plans are already taking a huge hit pursuant to Obamacare’s $200 billion cut, and they will be unable to absorb these newest slashes in the program without passing at least some of the costs to the patients in the form of increased co-pays and deductibles.

And it is by no means an exaggeration to say that these extra out-of-pocket costs will hit the seniors who can least afford them. America’s Health Insurance Plans (AHIP), a trade group to which many MA carriers belong, recently issued a report confirming that reality: “Sixty-one (61) percent of all minority (nonwhite) beneficiaries enrolled in Medicare Advantage in 2011 had incomes of $20,000 or less; 59 percent of African-American and 75 percent of Hispanic Medicare Advantage beneficiaries had incomes of $20,000 or less.”

…”This reduction in funding will leave many vulnerable seniors with fewer benefits, higher out-of-pocket costs, and in some cases the loss of their current MA coverage.”

It will indeed. As AHIP reminds us, “The Congressional Budget Office projects that the reform law’s payment cuts alone will result in three million fewer people enrolled in Medicare Advantage.” The group goes on to point out that Obamacare is already expected to increase the out-of-pocket expenses endured by MA enrollees: “Actuaries at Oliver Wyman estimate that the health insurance tax will result in seniors facing $220 in higher out-of-pocket costs and reduced benefits next year and $3,500 in additional costs over the next ten years.”

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Obamacare Is Already Costing Americans A Lot Of Money

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This is a chart from the Washington Free Beacon showing the financial impact of Obamacare even before it is completely put into effect:

Obamacare's $17 trillion surprise

The article reports:

Staff at the Senate Budget Committee, which calculated the figure using methods based on those used by the Centers for Medicare and Medicaid Services (CMS), found that total unfunded obligations for federal health care programs have jumped from $65 trillion in 2009 to $82 trillion in 2011.

Added to the government’s existing obligation for entitlement programs like Social Security, Medicare, and Medicaid, the total now comes to almost $100 trillion.

That is almost seven times the United States’ annual gross domestic product (GDP).

It seems to me that it is becoming very obvious that Obamacare will not save Americans any money. There are much better ways to do healthcare reform–tort reform, portability, risk pools for people with pre-existing conditions. All of these can be done without federal control. It’s time to remind the government that they govern at the consent of the governed–we are citizens–not subjects.

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Why We Don’t Need Obamacare

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Yesterday the Wall Street Journal posted an article detailing how much healthcare costs have risen in America during the decade of 2000 to 2010.

The article reports:

New data show that health spending over the past several years has been normalizing toward the rate of general inflation, rather than growing higher and higher, as had been the case almost continuously since the 1970s. This moderation in the growth rate of spending predates the national recession. And it puts the lie to the claim that we need government to put the brakes on an “out-of-control” health-care system.

As the graph nearby shows, the growth rate of national health expenditures, according to data compiled by the Centers for Medicare and Medicaid Services, has been moderating since 2002.

[Kleinke]

The chart shows that all of the hype about runaway healthcare costs was simply political hype.

J. D. Kleinke, who wrote the article, has the solution for fixing healthcare in America:

But we know that this slow, steady moderation in health-care spending is good news. True, it is not fast enough. But the decade-long trendline shows the way toward good policy for the future. If we really want to tame the health-care cost beast and make insurance “affordable,” we would double down on all of the positive developments.

We would liberate people with their own money from layer upon layer of arcane, localized insurance rules. We would fix the tax code to uncouple health insurance from employment and let people purchase their own mix of services and coverage. And we would let them do so in a competitive, national market just like with auto insurance—instead of holding them hostage in fragmented, local markets while shaking down their employers to subsidize a system that wants desperately to change itself.

The bottom line here is simple–people do a better job of spending their own money than the government does. Taking the government bureaucracy out of healthcare will make it more available and less expensive for everyone.

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