A new study out this month in the Annals of Family Medicine highlights the reality facing many people with health insurance and Medicare and their families: high out-of-pocket costs and cost-sharing.  These costs have a considerable effect on their household budgets and decisions about their care.[1] The study explored the social, medical, financial, and legal … Read more

In the past few weeks, the media spotlight on the country's fiscal issues has led to a flurry of attacks on Medicare.[1] Pundits and some policymakers decry Medicare spending as "the largest driver of the federal debt" and argue that the program on which millions of American families rely is unsustainable and must be radically … Read more

This week, the U.S. House of Representatives voted to approve legislation passed by the Senate to address  the "fiscal cliff"- the concurrent expiration of tax cuts and the beginning of automatic spending cuts (the Sequester) set to take place on January 1st. The deal, also known as the American Taxpayer Relief Act  (the Relief Act)[1], … Read more

Among proposals aimed at reducing federal spending for Medicare, some are suggesting that Medigap insurance be restructured to increase the cost-sharing burden on beneficiaries and/or add a surcharge for those that choose plans offering "first-dollar" or "near first-dollar" coverage.   These proposals operate under the assumption that charging beneficiaries more in up-front, out-of-pocket costs will deter … Read more

One of the deficit reduction proposals being discussed to achieve savings from Medicare is to introduce new cost-sharing for home health care. As a means to ward off such potential home health co-payments, some instead suggest capping Medicare payment for episodes of care, effectively limiting the duration of time individuals could access home health services. … Read more

In November, the Office of Inspector General (OIG) issued a report entitled, "Improvements are Needed at the Administrative Law Judge Level of Medicare Appeals."  The report can be found at https://oig.hhs.gov/oei/reports/oei-02-10-00340.pdf.   In the report, the OIG interprets the overall percentage of fully favorable decisions awarded to appellants by Administrative Law Judges (ALJs) as evidence that … Read more

The Center for Medicare Advocacy has represented Medicare beneficiaries since 1986. As one of the few advocacy organizations in the nation solely serving Medicare beneficiaries, we strongly oppose home health episodic payment caps or any other such defined payment limits. The counterpart to this notion, caps on outpatient therapy, has created significant barriers to necessary … Read more

Despite Medicare's remarkable success as a health and economic lifeline for American families, proposals to dramatically alter the program have resurfaced in the context of deficit reduction. While not a new idea, proponents of increasing Medicare's eligibility age from 65 to 67, or higher, have put the proposal in the spotlight recently as policymakers search … Read more

Although passage of the Affordable Care Act (ACA) has achieved considerable savings for the Medicare program, Medicare is still being targeted by policymakers looking to negotiate a large "grand bargain" deficit-reduction package. Many of the proposals to achieve Medicare savings would shift costs from the federal government to Medicare beneficiaries As the debt and deficit … Read more

Over two years after becoming law, the Affordable Care Act (ACA) continues to improve health care and lower costs for millions of Americans, including those who rely on Medicare. The recent election was key to the future of the landmark legislation, which will expand access to health care coverage and work to improve quality of … Read more

Medicare: Just the Facts! Misinformation about Medicare and the Affordable Care Act is widespread and increasing as the election nears.  Below, we try to dispel misinformation and base discussions on a factual foundation.  Spread the word. Help set the record straight! The Fact Here's Why The Affordable Care Act does NOT cut Medicare for beneficiaries. … Read more

DEMOCRATIC HOUSE STEERING AND POLICY COMMITTEE FORUM SAVING MEDICARE FOR TODAY AND IN THE FUTURE October 2, 2012 _____________________ Leader Pelosi and members of the Committee, thank you for holding this important Forum and for honoring me with the opportunity to appear before you. I am Judith Stein, founder and executive director of the Center … Read more

September 20, 2012 With the Balanced Budget Act of 1997 (BBA1997), Congress began an expansion of preventive benefits and services available through Medicare.[1]   The Medicare Modernization Act of 2003 (MMA) added additional preventive services.[2]  The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made refinements to Medicare's preventive services.[3]  Finally, the Patient Protection … Read more

As reported in the New York Times on Friday September 7, 2012, Center Attorney Toby Edelman writes to explain the importance of Medicaid to long-term care recipients, and how the Ryan Budget, which purports not to affect current Medicare beneficiaries, would actually have an "immediate and devastating impact" on those who rely on this vital program. … Read more

In March 2012, the House of Representatives passed the House Budget Committee Fiscal Year 2013 Budget Resolution, The Path to Prosperity: A Blueprint for American Renewal – called here, the Ryan Budget.[1]   In August 2012, the Republican Party adopted the Ryan Budget's principles for Medicare and Medicaid in its Platform for 2012, We Believe in … Read more

According to researchers from the Urban Institute, writing in the New England Journal of Medicine, Medicare's purported dire financial condition isn’t actually all that dire.  Given the aging of our population, increases in enrollment have obviously contributed to spending growth. But, according to the Urban Institute, “in recent years "spending growth per enrollee slowed in … Read more

Medicare has been front and center in the media and on the campaign trails this week. As part of our Medicare Truth Squad efforts to debunk myths and claims about the Medicare program, today we focus our attention on a pervasive myth that keeps going around. Some policymakers, candidates, and members of the media have … Read more

Noting that "[w]e are excited about the demonstrations and would like them to succeed," the Center for Medicare Advocacy (the Center), and thirty-two other national consumer advocacy and provider organizations have called on the Centers for Medicare & Medicaid Services (CMS) to scale back the scope, size, and timing of state-based demonstrations that would change … Read more

Yesterday, the House of Representatives voted once again to repeal the Affordable Care Act with a 244-185 vote. Despite the Supreme Court affirming the law, House leaders proceeded in scheduling yet another vote to end it – the 33rd such attempt. Meanwhile, more data has been released showing the Affordable Care Act continues to help … Read more

Last week, the Supreme Court upheld the constitutionality of the Affordable Care Act (ACA), but did place potential limits on the Medicaid expansion portion of the law.[1] The several opinions by the Justices are lengthy (a total of 193 pages in the "slip opinion" released by the Court and 81 pages in the version published … Read more

Today, the Supreme Court of the United States issued a landmark decision upholding the Affordable Care Act (ACA). The individual mandate, in addition to other provisions – including those that improve Medicare – was ruled constitutional.[1] The law can now continue to help older and disabled Americans, children with special needs, people with pre-existing conditions, … Read more

Contact: Judith Stein (860) 456-7790 or jstein@medicareadvocacy.org Today, the Supreme Court of the United States issued a landmark decision upholding the Affordable Care Act (ACA). The individual mandate, in addition to other provisions – including those that enhance Medicare – was ruled constitutional. "This ruling is good news for people with Medicare, the Medicare program, … Read more

Originally Published at Nieman Watchdog, in ASK THIS, June 14, 2012 (available at http://niemanwatchdog.org/index.cfm?fuseaction=ask_this.view&askthisid=00569), we offer reporters and editors a checklist for stories when the Supreme Court rules on the Affordable Care Act (ACA): 1. Did the Court strike down (or uphold) the entire law?   2. If the entire law is struck down: What will happen to the … Read more

Introduction In its June 2012 Report to the Congress, the Medicare Payment Advisory Commission (MedPAC) included an examination of current options and activity with respect to programs that integrate – or have the potential to integrate – Medicare and Medicaid services and financing for those individuals with coverage from both programs, often referred to as … Read more

Originally Published at Nieman Watchdog, in ASK THIS, June 14, 2012 Health care expert Judith Stein, director of the Center for Medicare Advocacy, offers reporters and editors a checklist for stories when the Roberts Court's ruling on the Affordable Care Act is released. The Center for Medicare Advocacy suggests reporters and editors consider the following when … Read more

On May 9, 2012, the Center for Medicare Advocacy (the Center) testified before the Subcommittee on Health, Committee on Ways and Means, U. S. Congress.  The Subcommittee hearing was called by its Chair, Wally Herger (R-CA), to explore the implementation of the Congressionally-mandated Durable Medical Equipment Prosthetics Orthotics and Supplies (DMEPOS) competitive bidding program. Alfred … Read more

New data released this week shows that families and individuals who rely on Medicare continue to see direct benefits from the Affordable Care Act by saving billions of dollars on prescription drug costs.[1] So far in 2012, older and disabled Americans have saved an average of $837 on their drug purchases after reaching the donut-hole … Read more

On April 23, 2012, the Government Accountability Office (GAO) released a report that concludes, among other things, that a Medicare demonstration program providing bonus payments to Medicare Advantage (MA) plans mainly benefits plans whose performance is no more than average.  While the program is supposed to reward quality, in practice it largely rewards plans receiving … Read more

Medicare Trustees issued their annual report on Medicare's financial status on April 23, 2012.  According to this year's report, the Hospital Insurance (Part A) Trust Fund has sufficient reserves to pay out the full amount of Medicare Part A benefits until 2024 – the same projection made in last year's report.  Should nothing else change, … Read more

The Future of Long-Term Care: Saving Money by Serving Seniors Senate Special Committee on Aging April 18, 2012 2:00 p.m. Statement for the Record Toby S. Edelman Senior Policy Attorney Center for Medicare Advocacy 1025 Connecticut Avenue, NW, Suite 709 Washington, DC  20036 The Center for Medicare Advocacy suggests that huge savings in the cost … Read more

This week, the Supreme Court heard arguments over the constitutionality of the Affordable Care Act (ACA, or health care reform).  As we wrote last week, ACA helps millions of American families by extending health care to those who are either uninsured or underinsured.[1] As the arguments before the Court have revealed, the path to health … Read more

It's been two years since President Obama signed the landmark Affordable Care Act (ACA) into law on March 23, 2010.[1]  When fully implemented, ACA will provide access to health insurance for virtually all Americans.  Along the way to full implementation, ACA has already helped American families gain access to needed care, while reducing costs and … Read more

News and investigations of waste, fraud, and abuse in the Medicare program have made waves in the past few weeks. Recently, the Department of Justice uncovered a massive $375 million fraud scheme committed by several providers of Medicare-covered home health care services in Texas. Such an egregious case is indeed shocking and offensive, and federal … Read more

Last week, the Senate Health Education Labor and Pensions Subcommittee on Primary Health and Aging held a hearing to discuss the growing dental crisis in America. As the Center recently wrote, most people who rely on Medicare go without basic dental care due to lack of coverage. The Senate hearing revealed dismaying new facts about … Read more

This week, President Obama unveiled his Fiscal Year 2013 Budget.[1]  Overall, the Center for Medicare Advocacy believes that the budget demonstrates a commitment to  keeping the Medicare program strong and keeping the program's promise to older Americans and individuals with disabilities who rely on the program to provide quality, affordable health care.  The Center is … Read more

This year brings another election season, another Congressional session, and another opportunity to fortify Medicare, both for those who rely on it now and for future generations. Medicare has been strengthened during the past few years.  However, dangerous rhetoric and schemes to weaken and dismantle the program threaten the health and economic security of millions … Read more

For Immediate Release January 25, 2012                                                                Contacts:  Judith Stein  (860)456-7790                     David Lipschutz   (202)293-5760 … Read more

The payroll tax extension that finally became law on December 23, 2011 includes many provisions that will help Medicare beneficiaries and lower income families (Temporary Payroll Tax Cut Continuation Act of 2011, H.R. 3765; no public law number assigned yet). The payroll tax in question is a reduction in Social Security payroll tax paid by … Read more

The nearly nine million Medicare beneficiaries who are also eligible for some form of Medicaid, the so-called dual eligibles, are the subject of federal, state and local policy discussions because many of them are among the highest users of health care services in the country and thus are very costly to both Medicare and Medicaid.  … Read more

With six days left until their November 23rd deadline, the Supercommittee has yet to reach a deal that meets its target of achieving $1.2 trillion in federal savings. Republicans on the panel tasked with reducing the deficit have indicated their latest proposal, which seeks to lower the top tax rate in exchange for closing certain … Read more

The Affordable Care Act (ACA), passed in March 2010, has been implemented steadily over the past two years.[1]  Implementation of various provisions will continue next year and in 2013, with the core of the ACA – expanded health insurance coverage for nearly 30 million people – occurring in 2014.[2] ThisAlert will review some of the … Read more

Part B Cost-Sharing Lower Than Expected for 2012 Today the Obama Administration announced that, overall, Part B cost-sharing will be less than projected for all beneficiaries in 2012.  The Part B deductible will decrease by $22 in 2012, from $162 per year in 2011 to $140 in 2012.  Further, monthly Part B premiums will increase … Read more

"Patients should pay more for their health care." Both Republicans and Democrats, including President Obama, promote policies to increase patients' costs as a solution to curbing the use of "inappropriate" health care services and controlling health care costs.  The President's plan for deficit reduction refers to this idea as creating incentives for the use of … Read more

Nearly one in five Medicare beneficiaries rely on Medicare Supplemental insurance policies (Medigap) to fill in the gaps of some of their Medicare coverage.  As noted by the Kaiser Family Foundation, "Medigap policies help shield beneficiaries from sudden, relatively high out-of-pocket costs due to an unpredictable medical event, and also allow beneficiaries to more accurately … Read more

Last week, President Obama unveiled his recommendations to Congress's Joint Select Committee on Deficit Reduction ("Super Committee").[1]  The President's Plan for Economic Growth and Deficit Reduction seeks to pay for the President's jobs bill and produce net savings of more than $3 trillion over the next decade.[2]  The proposal includes $320 billion in savings from … Read more

On August 19, 2011, the Centers for Medicare & Medicaid Services (CMS) announced Round 2 of its DMEPOS competitive bidding program.[1]  Bidding is to begin in January 2012.  Round 2 adds more product categories for competitive bidding and expands the number of competitive bidding areas (CBAs) affected. CMS also announced on August 19ththat it will … Read more

In final rules setting out Medicare reimbursement rates for skilled nursing facilities (SNFs) for Fiscal Year (FY) 2012 (which starts October 1, 2011), the Centers for Medicare & Medicaid Services (CMS) reduced reimbursement by $3.87 billion, or 11.1%.[1]  The reduction was targeted, correcting the "unintended excess payments" that occurred in therapy-related reimbursement for FY 2011, … Read more

  Policymakers and pundits continue to propose Medicare changes that would have severe repercussions for beneficiaries and their families. These proposals will continue to make news as deficit discussions heat up.  Too often, however, they are based on false information, which is repeated as fact by the media, pundits and policymakers. We aim to correct public misinformation about Medicare.  … Read more

Congress continues to propose Medicare changes that will have severe repercussions for beneficiaries and their families. Policymakers and pundits are feeding the media and the public misinformation about Medicare. The truth is, most people with Medicare are low-income and most pay more for health care than other insured Americans.  Nonetheless, Medicare Works. For 46 years it has … Read more