President Obama and Democrats in Congress pushed for cuts to Medicare Advantage to "pay for" ObamaCare. These cuts will have a devastating impact on Senior's ability to access care under the Medicare program. It has recently been discovered that the Administration is now using a slush fund to temporarily stave off the impact of these devastating Medicare Advantage cuts - at least until the election.

According to the Washington Examiner:

"According to a Government Accountability Office report published yesterday, the administration has been doling out cash from an $8 billion slush fund to temporarily cushion the blow from these cuts. The pain will come later, presumably after his re-election."

You can read the full commentary from the Examiner here.

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Two U.S. Senators, Dr. Tom Coburn and Dr. John Barrasso, have released a document aimed at explaining the impact of ObamaCare on Medicaid and, in turn, on America's seniors.  The Doctors write that: "seniors will soon be facing fewer choices in Medicare, in large part due to the way Congress has mismanaged the program. As physicians, we are writ- ing to offer you our perspective about some of the big challenges the Medicare program faces. We hope that being honest about the problems will increase your interest in prov- en solutions to save the program."

They also stated: "We have to act soon to save Medicare, while there is still time. What we need is a reform of Medicare that builds on what already works in the program. As physicians with over five decades of combined experience practicing medicine, we are committed to real reforms that save Medicare and put the program on a sustainable path. We believe that real Medicare begins with replacing many of the Medicare changes in the new law with proven solutions that will lower costs, increase your control as a patient, reduce bureau- cracy and government interference, and preserve the promise of Medicare for the next generation."

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Senator Joe Liberman (Independent-CT) has offered a plan to reform Medicare and, he says, extend the solvency of the program for another 20 years. The fact that he has offered a plan for reform proves that reform is absolutely necessary to save this vital program for seniors. He joins Republicans for calls to reform Medicare.  Noticeably absent, however, are the President and Congressional Democrats.

Lieberman offered the details of his plan in The Washington Post.  The plan includes the following:

1. Raising the age for Medicare eligibility, starting in 2014, by two months until it reaches 67 in 2025. For someone who turns 65 in 2014, Lieberman says, they will wait an additional 60 days before becoming eligible for Medicare. Lieberman says, "that’s a small sacrifice to ask for the benefits you will receive from a healthy Medicare program for the rest of your life."
2. Reforming "the complex Medicare benefit structure" by creating a single Part A and Part B deductible; requiring co-pays for all Medicare services; while capping out-of-pocket costs.
3. Raising premiums for new enrollees in Part B (doctor’s services) and Part D (prescriptions) "starting in 2014 to 35 percent of program costs."  Lieberman points out that: "asking Americans to pay more won’t be popular, but doing nothing and allowing Medicare to go bust won’t be popular either."
4. Reforming Medigap (but Lieberman does not offer specific for reforms in this area). 
5. Increasing taxes on "higher-income Americans" forcing them to "pay an additional 1 percent of every dollar they earn over $250,000 to help save the program."

Politico reports that ObamaCare's rationing board, the Independent Payment Advisory Board or IPAB, which is supposed to consist of 15 members empowered to make sweeping decisions about seniors access to care under Medicare and set prices is swiftly losing support among Democrats.

According to Politico: "several House Democrats have signed on to support a bill to repeal the Independent Payment Advisory Board, a panel created by the law that is supposed to help control rising costs in Medicare. The National Committee to Preserve Social Security and Medicare, a prominent supporter of the law, is now actively lobbying for its repeal, too."  Just last month, President Obama proposed giving IPAB even greater authority to make cuts in Medicare as part of his revised budget proposal.

A few observations about IPAB and ObamaCare:

(1) Opposition to IPAB by House Democrats makes it politically impossible for Congress to enact the President's latest proposal in his budget.  If the board lacks support now, the President's proposal to give more power and authority to an unelected board of 15 bureaucrats who have control over individual American's health care decisions will never pass.  This means that the President STILL has yet to put forward any realistic, workable plan to rein in spending and to reduce the deficit.  Despite this, the President and his party continue to demagogue the only viable plan to rein in spending - the House Republican's Path to Prosperity budget.

(2) The elimination of IPAB, which seems increasingly likely, reveals that ObamaCare and the means to "pay for" it is nothing but a house of cards.  First, during consideration of the bill, Democrats proposed cutting Medicare Advantage to "pay for" ObamaCare's new entitlement program.  Secretary Sibelius has since admitted that the Administration had double counted these savings (first to "save" Medicare and second to finance ObamaCare vouchers).  Second, Congress repealed the 1099 tax provision which was supposed to raise revenue to pay for ObamaCare but proved to be an unworkable revenue provision, the inclusion of which in ObamaCare was nothing more than a sham revenue provision.  Third, the IPAB which was supposed to rein in spending to ensure entitlement costs don't get even more out of hand but that provision is proving unpopular and history will show unworkable as well.

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Deroy Murdock has posted a compelling piece on National Review Online about the financial perils facing America's seniors due to Medicare's impending bankruptcy (which will occur in 2020 and a problem made worse by ObamaCare).  

House Republicans have been willing to lead on the issue by reforming Medicare in ways that would affect only those under the age of 55 while leaving the program the same for those over the age of 55.  Democrats, for their part, have indicated they have no plan to save Medicare and would not be putting forward a plan of their own.  Instead, Democrats have used false claims, smear campaigns, and demagoguery to attack the only viable plan to save Medicare.

Here is what the press is stating about the Democrats' false and misleading claims:

1. The Associated Press writes, “Democrats are distorting the fundamentals of a Republican plan to reshape Medicare, falsely accusing the GOP of pushing a proposal that tells the elderly ‘you're on your own’ with health care and that lets insurers deny coverage to the sick.”
2. The Washington Post's Jennifer Rubin writes, "A number of separate, neutral fact-checking groups have lambasted the Dems for misleading the public on Ryan’s Medicare reform plan."
3. Glenn Kessler, also of the Post writes that DNC Chair Debbie Wasserman-Schultz has said the Republican plan "would 'allow insurance companies to deny you coverage and drop you for pre-existing conditions.'  Neither of those claims are true."
4. The Wall Street Journal wrote: "the debate on Capitol Hill and in the media is too often fueled by partisan fear mongering instead of a thoughtful examination of the facts."

Here are what non-partisan, fact-checking groups have said about Democrats' claims:

1. The St. Petersburg Times' PolitiFact called the claims "FALSE."
2. Additional resources can be found here, here and here.

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One of the "cost saving" measures contained in ObamaCare are the provisions related to Accountable Care Organizations (ACO) which will create an HMO like program in Medicare.  Seniors will not have a choice if they are assigned to an ACO but will be assigned based on their previous year's use of the health care system.  Critics have noted that the ACO regulations issued by the Obama Administration earlier this year will cause doctors to violate the Hippocratic Oath by putting cost containment above patient care (this will occur because doctors who are part of an ACO will get paid based on costing savings).

The Heritage Foundation has issued a new document detailing some of the specific problems of the ACO regulations, among these problems:  "The only way ACOs can work to reduce costs is to become a more integrated and closed network of providers who follow data-driven protocols for care. That means they can’t let their beneficiaries go to see just any specialist. The ACO needs patients to see only the ACO’s preferred list of specialists. But that will be nearly impossible to enforce if beneficiaries never agreed to become part of the managed care environment of an ACO in the first place.”

This is a big price for seniors to pay when the ACOs are likely to save 0.05% (yes, 5/100ths of 1%) of all anticipated Medicare spending during the first three years of the ACO program.

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Marking the one-year anniversary of ObamaCare becoming law, the majority staff at the House Ways & Means Committee issued a summary of the bad effects ObamaCare has had over the past year.  Their summary is similar to one put together by AHEC staff earlier this month and published at A Line of Sight.

The Ways and Means (WAM) summary contained the following:

• March 2010: Higher Costs for Employers, Fewer Jobs for Workers & States Revolt
• April 2010: Higher Health Care Spending & Seniors’ Health Care in Jeopardy
• May 2010: Myth of Small Business Credit Dispelled as Employers & More States Join the Repeal Effort
• June 2010: White House Admits You Can’t Keep What You Have and Like
• July 2010: Entire States Seek to Be Exempt from the Democrats’ Health Care Overhaul, Americans Begin Paying Higher Taxes, & Individuals Start Losing Their Health Insurance
• August 2010: Seniors Learn They Will Lose Retiree Prescription Drug Coverage
• September 2010: Employers Forced to Get a Waiver or Cancel Insurance
• October 2010: Workers Forced to Pay Higher Health Care Costs
• November 2010: American People Back GOP Pledge to Repeal 
• December 2010: Law Declared Unconstitutional
• January 2011: Law Again Declared Unconstitutional and Insurance Companies Stop Offering Coverage
• February 2011: Administration Admits to Budget Gimmicks & CBO Says Law Will Mean Fewer Jobs 
• March 2011: While Employers Struggle, Unions & State Governments Get Help; Waivers Total More than 1,000

Details of the WAM analysis can be found here.

On March 2, 2011, The Department of Health & Human Services (HHS) Office of Inspector General (OIG), issued a report detailing that in 2007 and 2008 Medicare's Part D improperly paid $3.1 million to reimburse insurers for the cost of drugs for the treatment of erectile disfunction (ED). Federal law prohibits using taxpayer dollars for the reimbursement of ED drugs.  

While the amount paid for these drugs is relatively small given the size of the Part D program, Part D spending in 2007 and 2008 totaled $133 billion, these payments are further evidence that HHS is unable to properly protect tax dollars from misuse.  After all, while private insurance companies have real incentives to prevent improper payments and other waste, government bureaucracies have no such incentive.

The OIG should give taxpayers reason to question the wisdom of ObamaCare, which grants HHS even more power over healthcare and our tax dollars.  After all, if the taxpayers cannot trust HHS to properly manage this aspect of healthcare, can we really trust them with the expansive grant of power given by ObamaCare?

Today, AHEC released its March Newsletter which is focused on how ObamaCare places the cost burden of "reform" on the backs of hard-working, young adults between the ages of 20 and 34.  The newsletter details what impact various policies contained in ObamaCare will have on young adults, including:

   (1) The individual mandate - how it forces young adults to subsidize other people's health insurance,
   (2) Treating 19 to 25 year olds as a dependent "child" of their parents - and its subsidizing impact,  
   (3) Changes to HSAs - how ObamaCare makes consumer-centered policies less attractive,
   (4) ObamaCare's new tax burden - a burden that will be born by young workers and young families, and 
   (5) Exchange subsidies - how these will create perversive incentives and wage disparity. 

Each of these provisions will have a negative affect on many young adults.  You can find the newsletter here.


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