House passes Boehner-Pelosi Medicare deal in resounding vote

[PoliticAverse]

Source: The Hill

The House on Thursday overwhelmingly voted to repeal automatic payment cuts to doctors under Medicare, endorsing a rare bipartisan deal that Speaker John Boehner (R-Ohio) negotiated with Democrats.

The bill, which passed by a vote of 392-37, puts Congress on the precipice of ending a fight nearly two decades old over a formula known as the sustainable growth rate (SGR).

Since 2003, lawmakers have put off cuts under the Medicare formula 17 times, perennially punting the solution through short-term “fixes” that, over time, ran up the cost of abolishing the formula to nearly $200 billion dollars.

Facing a new deadline for the cuts at the end of March, Boehner said he decided it was time to make a deal.

Read more: http://thehill.com/policy/healthcare/237068-house-passes-medicare-deal-in-overwhelming-392-37-vote

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Roll Call of the vote: http://clerk.house.gov/evs/2015/roll144.xml

Text of the bill: http://thomas.loc.gov/cgi-bin/query/z?c114:H.R.2:

Summary page: http://thomas.loc.gov/cgi-bin/bdquery/z?d114:H.R.2:

[NV Whino]

1. It makes me very nervous when the Republicans are for something the Democrats are for.

They've solved one issue, but I wonder what's hidden underneath the good stuff.

[still_one]

3. The bill is hard enough to read, but one thing I saw was a 2 year extension of the abstinence only

education program. If they are so concerned about saving money, that doesn't seem like the best way to utilize resources. Most public schools have a sex education program, with parents consent, so I wonder why this would be necessary

I agree with your skepticism, and the way the bill is written, where they refer to other document, section xxx, paragraph yyy, blah blah blah, is almost impossible for the lay person to follow without spending a significant amount of time

[Faryn Balyncd]

4. Providers are happy, Republicans are happy, insurance companies are not unhappy...

So who is going to pay the price?....expect that Americans on Medicare will be hit with higher costs of Medicare Supplement plans, and/or Medicare Part B fees, and/or higher deductibles, or possibly scenarios where providers bill for more uncovered services (in which patients not only pay the full charge, but often at fantasy "regular" which often are up to 500-600%, or in some documented cases, up to 1300% higher) than the (profitable) rates paid by Medicare and insurance companies.

[still_one]

5. The bill is very difficult to read, so I have no idea what those increased costs to the

beneficiaries will be. It would be nice to see some specifics, and what income levels would be obligated to pay co-payments or deductibles?

That is probably why it is so difficult to decipher, because the devil is in the details so to speak

[Faryn Balyncd]

7. I expect you are correct.

[antigop]

9. I'm looking for this info as well

Here is what I found

http://www.thefiscaltimes.com/Columns/2015/03/20/Congress-Medicare-Fix-Could-Leave-Seniors-Paying-More

It’s the other half of the cuts that get problematic. There would reportedly be more means-testing for Medicare beneficiaries, increasing premiums for seniors showing income over $133,000 and couples over $266,000. These seniors would have to pay 65 percent of their total costs under the new plan. This would go up at higher incomes. Means-testing historically dips lower and lower as budgeters try to get more out of beneficiaries, so this continues that ratcheting process for Medicare. It’s not necessarily where this line is set now but where it might go in the future that should cause concern.

Under the deal, new Medigap policies — privately sold but publicly managed plans which fill in spaces in Medicare coverage — would need a $250 deductible starting in 2020. Virtually every senior I’ve ever spoken with says that they need supplementary coverage because Medicare doesn’t stretch far enough. But this would raise out-of-pocket expenses on all 9 million seniors with a Medigap plan, including the 86 percent of these beneficiaries who have incomes under $40,000, and almost half with incomes below $20,000. So this cut hits those who can’t really afford it. (This idea, along with the means-testing, was in President Obama’s budget, incidentally.)

The proper term for this is cost-shifting, pushing funding for a public program onto those who get the benefits. Medigap was created to deal with cost-shifting in Medicare, and now Congress may look to shift costs within it as well. And like means-testing, cost-shifting is prime terrain for double-dipping over time.

[still_one]

2. Geez, I tried to read the specifics of the bill, and it is a convoluted as everything that comes out

of Congress.

What is the bottom line? Are their income limits. There was talk about deductibles and copayments from beneficiaries. What are they, and are their income levels for those who cannot afford those increases?

[antigop]

10. see post 9. That's all I have found. nt

[still_one]

11. Thanks

[antigop]

12. I also found this, but it doesn't say much...

http://talkingpointsmemo.com/dc/house-vote-medicare-doc-fix-chip

Now the tough part: significant long-term cuts to Medicare spending.

The legislation requires seniors who make more than $133,500 to pay more for Medicare coverage starting in 2018, and reduces spending on "first dollar" coverage of supplemental Medigap plans enjoyed by some from 2020 onward.

It also extends the Children's Health Care Program for two years.

[wordpix]

6. hey House members, where are the drug cost cuts?

I'm talking about the monopoly Big Pharma holds when it comes to selling prescriptn drugs. We can't go to Canada, Mexico or anywhere else to buy them cheaper, and that includes the fed. government's purchasing power for Medicaid, Medicare, and ACA subsidy recipients.

Example: I did conventional chemo with drugs that are decades old and the "allowed charge" by the provider was $23K/round with $21K for the drugs alone. I found an NIH site showing my exact chemo regimen cost $3600/round for the drugs + administration.

$23K for an IV drip of conventional chemo vs. $3600 actual cost. Of course the federal health care programs will go under as a result, since this kind of thievery is unsustainable for the public to support.

[Faryn Balyncd]

8. Good point.

This once was an issue that received bi-partisan support.

Bill Clinton, Al Gore, George W. Bush, John Kerry, Ron Paul, John McCain, and President Obama all at one time spoke positively about the issue of re-importation of pharmaceuticals from Canada. Bush stated he supported re-importation as a free market solution to anti-competitive forces in the 2000 presidential debates, and promised to "look at" Canadian re-importation of USA manufactured drugs again during the 2004 campaign, before signing a bill banning Canadian re-importation and signing Medicare Part D bill which expressly forbade Medicare to use its purchasing influence to negotiate lower drug prices.

[freshwest]

13. And HRC voted for it in the Senate. I think the only states that do it are by the border.

Since then, as you say, Bush messed it up for his pals. Last I've seen of it were mail-order, with an American doctor's RX included, but that may have been shut off.

Recently the Koches purchased the suppliers of generic drugs and the price is breaking the bank for seniors and insurers. The increase is due to their control of the materials needed.

It's a rip-off of huge proportions, the next one after passage of the Medicare Part D which was impossible for many to get into. AARP supported that bill, turns out one of the heads is a GOP who took over and pushed it.

Years ago I read in the the AARP magazine they suggested to separate SSDI from SS. Now the GOP has changed the rules so that they can cut 20% off of that demographic, thus stealing the years of FICA taxes they paid in while working because they didn't make it to the new ages for retirement set to go into effect over decades as passed during the Reagan era.

The only answer has been single payer which HRC promoted, then Obama put it in the ACA as an option for states. ACA planned to lift the income cap on SS which was unfair, as those who get higher SS didn't pay at the same rate as lower payers.

They squealed and I'm guessing this may be part of the outrage on the means shifting. Of course, this junk would not be a part of health care if we had UHC and sufficient tax revenue to make it work. Because that is what it requires.

VT is the only state who has voted it through their own legislature, IIRC, but CA may follow their lead. There was a strong movement in WA to get it but the legislature voted for a different plan while accepting Medicaid expansion.

IDK which state is doing this the right way, and VT's has not come online yet, AFAIK.