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📢 URGENT: Protect Medicaid for Millions of People with Medicare

Julie Carter

Senior Federal Policy Associate

New Data Show Very Few People with Medicare Choose to Switch Plans Each Year

A new data note from the non-profit Kaiser Family Foundation (KFF), however, reveals that very few people with Medicare end up switching plans during the fall. Among MA and PDP plan enrollees who did not receive low-income subsidies, fewer than 8% of people enrolled in MA plans chose to switch to another MA plan in 2016. The pattern is similar for standalone drug plans–just over 8% switched from one PDP to another. This could mean that beneficiaries have reviewed and are happy with their coverage, but it might highlight a more troubling reality– people may not know they can switch plans or may find the process of comparing plan options too burdensome.

Poll Finds Many Americans Worried about Health Care Costs and Struggle to Afford Care

A recent poll and study by Gallup and West Health found that most Americans are worried about rising health care costs, and many are also concerned about bankruptcy from major health events. Older adults have somewhat more confidence about their access to quality care than younger people, but they still experience difficulty with affordability, especially when it comes to paying for prescription drugs. These findings and more are an important indicator that more must be done to bring down health care costs.

Upcoming Medicare Additions for Treatment for Opioid Use Disorder

The Centers for Medicare & Medicaid Services (CMS) recently finalized a rule that expands Medicare coverage for Opioid Use Disorder (OUD). Recent legislation, the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, established a pathway for this more comprehensive Medicare coverage of OUD services. Beginning on January 1, 2020, Medicare Part B will cover OUD treatment—including methadone for Medication Assisted Therapy (MAT)—furnished by an Opioid Treatment Program (OTP) under a bundled payment mechanism. This means a significant improvement in access to OUD care for people with Medicare, including for those who are dually eligible for Medicaid.

Court Blocks Sweeping Rule that Would Negatively Impact Patient Access to Care

This week, a federal court blocked a Trump administration rule that would have allowed health plans and providers to refuse to provide certain types of care they disagreed with on moral or religious grounds. Set to take effect on November 22, the rule would have permitted individuals to deny care even in circumstances where performing the refused service was a significant portion of their jobs, and even where the refusal could prevent patients from receiving the service altogether.

Big Changes May Be in Store for Medicare Part D

Some changes are in store for Part D in 2020 and policymakers are contemplating even more. The Kaiser Family Foundation (KFF), a nonpartisan nonprofit focused on national health issues, recently outlined what the program will look like next year under current law, and under recent legislative and administrative proposals.

Ways to Expand Access to Dental Coverage for People with Medicare

Currently, Medicare does not cover most dental services. The Kaiser Family Foundation (KFF), a non-partisan, non-profit focused on national health issues, recently released an issue brief discussing various options to increase access to dental coverage for people with Medicare. According to the brief, nearly two out of every three Medicare beneficiaries have no dental coverage, leading many to go without necessary care.

Lawsuit Seeks to Improve Medicare Beneficiary Access to Nursing Facilities

Currently, people with Medicare cannot appeal the decision to classify them outpatients, but a court case—Alexander v. Azar—may change that. In 2011, seven plaintiffs filed a class action lawsuit to try to gain the right to appeal the decision to classify them as outpatients in observation stay instead of as inpatients who would potentially be eligible for SNF coverage. After many twists and turns, the case has finally made it to trial this week in a Connecticut court. If successful, the lawsuit would ensure that beneficiaries can appeal decisions made by hospitals that reduce their eligibility for Medicare coverage of SNF care.