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This Week in Health Care Reform - March 7th, 2014

Proposed cuts to Medicare Advantage payments threaten to place additional strain on vulnerable populations; meanwhile, House GOP unity is put to the test; Democrats lead on key issues, but without any election edge; and, the latest change to implementation should come as no surprise.


Health Care Reform

Medicare Advantage Under Attack: As has been covered here, Medicare Advantage continues to find itself at the center of a churning advocacy maelstrom as supporters rally to defend the popular program from the latest round of cuts proposed by the Centers for Medicare & Medicaid Services (CMS).  Already, a laundry list of vocal and ardent supporters has stood up on behalf of the 15 million seniors and persons with disabilities that depend on the program for their health care needs.  Most recently, members of the U.S. House GOP Doctors Caucus added their name to the cause, submitting a letter to CMS urging the agency to protect beneficiaries by maintaining current Medicare Advantage payment levels for next year.  Having weathered last year’s payment cuts, Medicare Advantage is in danger of no longer being able to absorb further cuts to its underlying payment structure and supporters worry that enrollees will find themselves increasingly exposed to higher out-of-pocket costs, reduced benefits, plan exits, and limited choice.  With more than a quarter of the total Medicare population happily enrolled in a Medicare Advantage plan, what’s only now coming to light is how disproportionately the proposed cuts would impact some of the most distressed and vulnerable beneficiaries enrolled in the program.  Earlier this week, the American Action Forum, a center-right policy institute led by former Congressional Budget Office (CBO) director, Douglas Holtz-Eakin, offered up its own insight, highlighting the disparate effects that CMS’ proposed payment cut would have on low-income seniors (more than 2-out-of-5 Medicare Advantage beneficiaries have incomes under $20,000 a year).  Efforts to persuade CMS to abandon further distressing this critical program by maintaining level funding in 2015 continue to draw supporters from all over the spectrum.  Find out how you can lend your support to the cause by visiting the Coalition for Medicare Choices and by letting us know why you think Medicare Advantage is so important. 

ACA Alternative: This week, House Republicans (with the help of 27 of their Democrat colleagues) passed their latest bill (their 50th) aimed at altering or eliminating some component of the sweeping health care law.  Their target this time – the individual mandate; specifically, the penalty levied against individuals who fail to obtain coverage by the end of the open enrollment period (March 31st).  The bill seeks to postpone enforcement of the tax penalty for one year.  And, while it has little to no hope of passage in the Senate – much less clearing the President’s desk – the vote could prove to be the penultimate test of GOP unity in the House, as the party seeks to coalesce around a replacement bill for the Affordable Care Act.

Issues Edge: Should one be looking for a reminder of just how polarizing and divisive health care reform remains some four years after the Affordable Care Act was first signed into law, then that person need look no further than the nearest polling data on the issue.  Case in point, the latest Washington Post/ABC News poll, released this past Tuesday, in which 44 percent of Americans said they trusted Democrats more than Republicans to handle health care, the myriad of issues associated with implementation of the health care law notwithstanding.  However, while the results indicate that support of the Affordable Care Act could be an issue for Democrats (36 percent of respondents stating that a candidate’s support of the law would make them less likely to support that candidate), the parties appear to be just about neck-and-neck on a generic ballot, with 46 percent of people saying they would vote for the Democrat versus the 45 percent who said they would vote, instead, for the Republican, were the election held today.  Regardless, what the majority did agree on (68 percent) was their inclination to look for someone not already serving in Congress.

Canceled Plan Reprieve: On Wednesday, the Administration announced that it was further extending canceled health plans that failed to meet new coverage requirements under the Affordable Care Act by two more years.  The announcement extends the earlier decision that had allowed Americans to keep their existing health plans through 2014, after millions had received notices that their current plans were being canceled.  Reaction was predictably partisan, as Republicans decried this latest delay as “reek(ing) of politics”, given Democrats’ not unfounded worry that another wave of cancellations on the eve of November’s midterm elections would do little to improve their chances of, at best, retaking the House, or, at worst, maintaining their hold on the Senate.        

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