Repeated efforts to repeal and undermine the Affordable Care Act (ACA) have led to growing public awareness of the importance of access to health coverage and accompanying patient protections. Recognition of the important role of the ACA and Medicare, and growing support for Medicaid, have combined to shape public support for expanding health coverage, instead … Read more

Recently, the Center for Medicare Advocacy laid out our Medicare Platform for the New Congress. One of the core considerations for Medicare, now and in the future, is the need to expand and Improve Medicare for all current and future beneficiaries, not just those in private Medicare plans. One of the key issues faced by beneficiaries … Read more

On April 18, 2018, Senators Chris Murphy (D-CT) and Jeff Merkley (D-OR) introduced the “Choose Medicare Act.”  The Act would create a new Medicare plan, “Medicare Part E,” which would allow virtually all Americans to choose the traditional Medicare program in addition to now-available private insurance options. Medicare Part E would be available on the … Read more

  FOR IMMEDIATE RELEASE November 15, 2017 Contact: Center for Medicare Advocacy – Matt Shepard: 860-456-7790, mshepard@MedicareAdvocacy.org Medicare Rights Center – Mitchell Clark: 212-204-6286, mclark@medicarerights.org Tax Cut Bill Just Got Worse.  Health Care at Risk. As the House and Senate rush to make changes to their versions of the bill, it keeps getting worse and worse, … Read more

The proposed Affordable Care Act (ACA) repeal legislation, the American Health Care Act, would cause 24 million people to lose coverage by 2026 and cut Medicaid by $880 billion over the next ten years, according to the Congressional Budget Office (CBO), a non-partisan, independent group of budget economists and analysts used to score the financial … Read more

March 7, 2017, Washington, DC – Last night House Republicans presented a bill to repeal the Affordable Care Act (ACA) and cut Medicaid payments to states.  While the new bill, “America Health Care Act” (AHCA) lacks either an estimate of how many people will lose their health insurance coverage as a result of the bill … Read more

Health Savings Accounts (HSAs) Defined Health Savings Accounts (HSAs) are savings accounts that allow consumers to put money aside to pay for certain “qualified health expenses” on a tax-free basis. HSAs are used in tandem with high deductible health plans (HDHPs), which are health insurance plans that require high deductibles to be paid prior to … Read more

Last night, President Trump, in a speech to Congress, discussed health care but offered no new insight into his Administration’s plans concerning the Affordable Care Act, Medicaid and Medicare.  A day after noting that “nobody knew health care could be so complicated”, the President stated "[t]onight, I am also calling on this Congress to repeal … Read more

Many Americans are greatly concerned that repeal of the Affordable Care Act (ACA) will once again leave people with pre-existing conditions without health insurance. The ACA replacement proposal released by Speaker Ryan on February 16 would move coverage from the general ACA marketplace to specific High Risk Insurance Pools. These High Risk Pools would separate … Read more

According to a recent report from Vox, Congressional plans to repeal key provisions of the Affordable Care Act (ACA) will have devastating consequences for thousands of Americans each year. Vox’s Julia Belluz cites evidence to estimate that 24,000 Americans would die annually if Congress repeals vital provisions of the ACA without simultaneously enacting an appropriate … Read more

The Administration and the Republican Congress threaten to repeal the Affordable Care Act (ACA), and have suggested various ideas about what a replacement to ACA would include. To better understand these proposals we’ve compiled a list of ACA replacement materials available from colleagues and partnering organizations. Though there is no consensus about what an ACA … Read more

For Immediate Release Contact: Liz Posner lposner@douglasgould.com 646-214-0514 February 9, 2017 – WASHINGTON – Today, the Senate voted by a narrow margin of 52 – 47 to confirm Rep. Tom Price as Secretary of Health and Human Services. In light of Sec. Price’s previous statements threatening Medicare, Medicaid, and the Affordable Care Act, the Center … Read more

On January 24, 2017 the Task Force on America’s Health and Retirement Security, chaired by Marilyn Moon, Ph.D. and led by Principal Investigator Peter Arno, Ph.D., released a new study showing the dramatic negative impact of raising Medicare’s eligibility age to 67 – assessing results on uninsured rates if the ACA stays in place and, what we … Read more

On January 23, 2017, Senators Susan Collins (R- ME) and Bill Cassidy (R- LA) introduced the Patient Freedom Act of 2017 (S. 191) billed as a “comprehensive replacement plan for Obamacare.” [1] According to a summary of the bill outlined on Sen. Collins’ website, it “repeals burdensome federal mandates” but “keeps essential consumer protections.”  The … Read more

Today U.S. Rep. Tom Price (R – Ga.) faced a hearing before the Senate Health, Education, Labor and Pensions (HELP) Committee to determine his qualification to become Secretary of Health and Human Services.  Next week, on January 24th, he will face an additional hearing before the Senate Finance Committee, which will vote on his nomination. … Read more

“Medicare saved my life. Without this program, I would be dead. I'm not exaggerating; it's no hyperbole when I say Medicare saved my life. I have a life threatening illness and if I had no access to doctors or medicines, I wouldn't be here. A few years ago, I had been prescribed Bactrim, which caused … Read more

On December 13, 2016, President Obama signed into law the 21st Century Cures Act (Public Law No: 114-255, also known as “Cures”, H.R. 34[1]).  The bill, which passed with overwhelming bipartisan support, addresses a wide range of issues, including medical research, the drug approval process, and, added in the final days leading up to passage, … Read more

As we approach a new year, a new Administration and a new session of Congress, the catastrophic risks to health care coverage include threats to repeal the Affordable Care Act – without an agreed-upon replacement, turning Medicaid into a block grant or per capita cap program, and further privatizing Medicare. Several recently-issued/updated reports underscore some … Read more

The President-Elect and Republican leaders in Congress have promised to repeal, and at some point, “replace” the Affordable Care Act.  They also plan to gut the Medicaid program by imposing block granting or per-capita caps.  Speaker Ryan, Trump’s nominee for HHS Secretary Rep. Price, and many others in Congress also want to further privatize Medicare … Read more

Nominations Of Rep. Tom Price To Head The Department Of Health & Human Services And Seema Verma To Head The Centers For Medicare & Medicaid Services Threaten Medicare and Medicare Beneficiaries November 29, 2016 – Despite statements during the campaign that he would protect Medicare, the President-Elect is indicating otherwise with his selections of Rep. … Read more

The visionaries who designed, launched and supported Medicare to help all American families. The Medicare program for its invaluable contribution to desegregating American hospitals. The Medicare program for helping to keep older Americans out of poverty. The Medicare program, for insuring people with disabilities, who, like older Americans, were left behind by private insurance. The … Read more

Jul 19, 2016 by Gretchen Jacobson and Tricia Neuman This Issue Brief, available at http://kff.org/medicare/issue-brief/turning-medicare-into-a-premium-support-system-frequently-asked-questions/, is an excellent breakdown of what a "Premium Support" structure – also referred to as "Defined Contributions" or "Vouchers"  – would mean for Medicare and Medicare beneficiaries. Topics addressed include: What is premium support? How could a premium support system for Medicare affect beneficiaries’ premiums … Read more

As reported this week in The Hill, President Obama is calling on Congress to add a “public option” to the Affordable Care Act (ACA) to improve his signature health law.  “Public programs like Medicare often deliver care more cost-effectively by curtailing administrative overhead and securing better prices from providers,” Obama writes in the Journal of … Read more

The Center for Medicare Advocacy’s comments on the Medicare prospective payment system for skilled nursing facilities (SNFs),[1] submitted June 20, 2016, support the recommendation of the Medicare Payment Advisory Commission (MedPAC) not to increase reimbursement to SNFs for FY 2017.  MedPAC reports that SNFs have enjoyed Medicare margins exceeding 10% for 15 consecutive years. With … Read more

June 25, 2015 Today, the U.S. Supreme Court issued a decision in King v. Burwell (No. 14-114), a case challenging one of the central pillars of health insurance coverage offered through the Marketplaces, also known as Exchanges, created through the Affordable Care Act (ACA). The case challenged whether tax credits and subsidies that make health care more affordable for … Read more

On March 13, 2014, Center for Medicare Advocacy Executive Director and Founder Judith Stein testified before the House Energy & Commerce Committee, Subcommittee on Health, at a hearing entitled "Keeping the Promise: Allowing Seniors to Keep Their Medicare Advantage Plans If They Like Them."   That testimony is summarized below. The Center for Medicare Advocacy recognizes … Read more

This week, President Obama unveiled his Fiscal Year 2015 Budget.[1] With respect to Medicare, it is very similar to last year’s proposed budget, both good and bad. One significant improvement over last year's budget is that it no longer seeks to alter the way the federal government measures inflation for purposes of paying Social Security benefits … Read more

Overview The current Medicare physician payment formula, known as the "Sustainable Growth Rate" (SGR), was designed to control the growth in aggregate Medicare expenditures for physicians' services.[1]    If implemented as intended under the law, the SGR would lead to significant cuts to physician payment (for example, if the SGR were to go into effect in … Read more

The Medicare Part D Prescription drug program is forbidden by law from getting the best prices for prescription drugs. Unlike the Veterans Administration and Medicaid, Medicare is at the mercy of drug company pricing, forbidden from seeking lower prices for its enrollees. Allowing Medicare to get fair drug prices would save billions of taxpayer dollars a year, without … Read more

Legislation was introduced on October 4th that could lead to a cap on the home health services available to a Medicare beneficiary.  In the midst of a government shutdown, Representatives Matheson (D-Utah) and Guthrie (R-Kentucky) introduced the "Medicare Home Health Fraud Reduction Act" (H.R. 3245).  This bill would establish maximum annual reimbursements to Medicare home … Read more

Next week, Medicare celebrates its 48thbirthday.  Since 1965 Medicare has been a critical source of health and economic security for generations of Americans while evolving to meet the needs of those who rely on the successful program. Medicare brought millions of older Americans out of poverty, and continues to provide access to comprehensive health care … Read more

Five years ago this month, the Medicare Improvements for Patients and Providers Act (MIPPA)[1] became law. Since then, MIPPA has successfully increased enrollment in the Medicare Savings Program and helped ensure that thousands of Medicare beneficiaries are able to afford necessary medical care. Despite MIPPA's success, Medicare low-income programs remain under-enrolled. Federal policy makers should … Read more

A new study published in Health Affairs reports that immigrant workers in the United States disproportionately contribute to the Medicare Program and help ensure its financial solvency and strength.[1] The study's authors found that between 2002 and 2009, $115 billion of the Medicare Trust Fund was generated solely by immigrants.  The Medicare Trust Fund pays … Read more

Today, the Medicare Trustees issued their annual report on Medicare's financial status.   According to this year's report, the Part A (Hospital Insurance) Trust Fund has sufficient reserves to fully pay Medicare benefits until 2026 – two more years than projected in last year's report.  Since 1970, the Trustees have projected the Medicare Trust Fund would … Read more

This week, the House Ways and Means Subcommittee on Health held a hearing on proposals to reform Medicare at which critical issues facing the Medicare program and current and future beneficiaries were discussed. The Center for Medicare Advocacy, together with California Health Advocates and the Medicare Rights Center, submitted joint testimony to the Committee outlining … Read more

As part of the annual update to inpatient hospital reimbursement under the Medicare program, the Centers for Medicare & Medicaid Services (CMS) is again considering observation status.  This time CMS is proposing "a time-based presumption of medical necessity for hospital inpatient services based on the beneficiary's length of stay."  78 Fed. Reg. 27486, 47644 (May … Read more

In the midst of ongoing budget discussions, policymakers are considering a wide array of approaches for cutting spending and saving federal dollars. The Center for Medicare Advocacy recently wrote of ways to strengthen the Medicare program while achieving significant savings.[1] Included in our analysis was a proposal that would save taxpayers billions of dollars: reinstating … Read more

This article is part of a NAELA Journal symposium edition that focuses on "The Future of Elder Law and Special Needs Planning." This article will provide an overview of the policy debate that led to the creation of the Medicare program.  It will identify key cost and quality problems facing the program and review solutions … Read more

The role of private managed care in Medicare and Medicaid has been growing at a rapid pace in recent years. The Center for Medicare Advocacy has written widely on the dangers of turning these successful community health care programs over to profit-driven private insurers.  Despite the efforts of the Center and other advocacy groups, however, … Read more

In its most recent report on nursing home payments and quality, February 2013, the Office of Inspector General (OIG), Department of Health and Human Services (HHS) reports that many skilled nursing facilities (SNFs) failed to provide adequate care planning and discharge planning to residents and provided "egregious" care to some residents, yet were paid by … Read more

Yesterday, President Obama unveiled his Fiscal Year 2014 Budget.[1]   It contains significant changes to the Medicare program – including some that would strengthen the program's fiscal stability, and some that would weaken the program and shift costs to beneficiaries.  On the one hand, it offers serious improvements to strengthen Medicare's financial footing: proposals that allow … Read more

The Medicare program can be confusing for those trying to navigate the differences between Parts A, B, C, and D.  Since the program's inception in 1965, changes made to the program have made it a more complex system for beneficiaries, particularly with the introduction of private insurance plans to the Medicare program.  Medicare beneficiaries can … Read more

Since the landmark Affordable Care Act (ACA) was signed into law on March 23, 2010,[1] it has increased access to needed health services, reduced costs and improved care for millions.  Yet, as this progress continues and the law’s most impactful provisions near implementation, threats to the law continue, through repeal efforts, budget cuts and legal … Read more

The Affordable Care Act (ACA) is beginning to rein in Medicare Advantage (MA) overpayments by bringing MA payment more in line with what traditional Medicare spends on a given beneficiary.  The insurance industry is not only fighting this payment reform, but has launched a campaign against a 2.3% reduction in payment projected for 2014.[1]   This … Read more

In the wake of the tragedy in Newtown, Connecticut policymakers, the media, and advocates across the country have turned their attention to the state of mental health care in the United States. In addition to societal stigma, people with mental health needs often face barriers to adequate medical coverage and treatment for their conditions. While … Read more

Statement of Judith Stein, Executive Director, Center for Medicare Advocacy Nothing new. Paul Ryan’s “new” budget proposal recycles ideas that will harm older people, people with disabilities, families and Medicare. It is a plan about a governing philosophy, not about saving money, preserving Medicare, or reducing the national deficit. We know we need action to … Read more

March is Women's History Month, honoring generations of women who have made, and are making, invaluable contributions to society. The Medicare program has been a critical lifeline for American women and their families for decades, contributing to lower poverty rates and providing health and economic security. Because women constitute the majority of beneficiaries on Medicare, … Read more

In testimony submitted today to the U.S. House Committee on Ways & Means, California Health Advocates, the Center for Medicare Advocacy, Inc. and the Medicare Rights Center urged lawmakers to reject Medicare redesign proposals that burden older adults and people with disabilities with added health care costs. The joint statement pressed policy makers to adopt … Read more

As policymakers in Washington continue to debate ongoing budget issues involving federal spending and the deficit, proposals that affect Medicare beneficiaries remain on the table as targets for federal savings. However, the details and repercussions of proposals for people who rely on Medicare, Social Security, and Medicaid for health and economic security remain unknown for … Read more

Two recent cases – one in Georgia and the other in Pennsylvania – enforce nursing home quality of care standards through actions by United States Attorneys.   In neither case had the regulatory agencies cited deficiencies for the significant care problems at the three facilities in question.   In addition, two of the three facilities have high … Read more