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Lindsey Copeland

Federal Policy Director

CMS Extends Important Relief Opportunity, Creates Permanent Fix for those Affected

The Centers for Medicare & Medicaid Services (CMS) recently announced a year-long extension, through September 30, 2019, of a critical relief pathway for current and former Marketplace enrollees who mistakenly delayed Medicare enrollment. The agency also agreed to develop a more permanent solution for people who are affected.

Under this policy, people who are eligible for Medicare and have Marketplace coverage can apply to enroll in Medicare Part B without penalty. Those who have already transitioned to Medicare can request that any Part B late enrollment penalties they may have received be reduced or eliminated.

Medicare Rights Opposes Punitive “Public Charge” Proposal for Harm to Families and People with Medicare

The Department of Homeland Security recently released a proposed “public charge” rule that could greatly harm families and prevent people with Medicare from accessing the services and supports they need. The proposal would dramatically expand the government’s “public charge” test, which considers whether immigrants are likely to use public benefits when deciding whether or not to grant entry to the United States or permanent resident status.

Medicare Rights Asks CMS to Ensure Important Relief Opportunity Is Available to Those Who Need It, Now and in the Future

Today, the Medicare Rights Center and a diverse coalition of 80 state and national organizations representing health plans, consumers, and advocates urged the Centers for Medicare & Medicaid Services (CMS) to retain a policy that helps some Medicare beneficiaries correct problems with their Part B enrollment resulting from confusion or misinformation with Medicare and the Affordable Care Act Marketplaces. Under this relief, Medicare-eligible individuals with Marketplace coverage can apply to enroll in Part B without penalty, and those who have already transitioned to Medicare can request that any Part B late enrollment penalties be reduced or eliminated.

Medicare Rights Comments on Proposed Changes to Medicare’s DME Program

This week, the Medicare Rights Center submitted comments in response to a proposal from the Centers for Medicare & Medicaid Services (CMS) that would, in part, make major changes to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.

Through the DMEPOS bidding program, medical equipment suppliers compete for Medicare’s business based on quality and price, by submitting bids to serve beneficiaries in a specified geographical region. In the proposed rule, CMS is seeking to effectively suspend this program when current contracts expire at the end of 2018, and until new contracts are awarded under the outlined new payment methodology. CMS does not provide a time frame for when new contracts would begin.

Dangers of Surprise Medical Bills Underscore Importance of Medicare’s Beneficiary Protections

This week, Kaiser Health News (KHN) and National Public Radio (NPR) published and broadcast the story of 44 year-old Drew Calver, a high school teacher in Austin, Texas who faced an outrageous hospital bill.

In the wake of a life-threatening heart attack, Mr. Calver was rushed to a nearby emergency room, where he was admitted to the hospital and underwent surgery. The heart attack was a shock for Calver, an avid swimmer and triathlete. Adding to his surprise was the bill he faced afterwards: the hospital charged $164,941 for the surgery and four days in the hospital. His insurer paid the hospital $55,840. The hospital then billed Mr. Calver for the unpaid balance of $108,951.31.

Medicare Rights Submits Comments Opposing Harmful Medicaid Work Requirements

Last week, the Medicare Rights Center submitted comments to the U.S. Department of Health and Human Services (HHS) on Medicaid waiver proposals from Kentucky and Mississippi. Both states are seeking the agency’s permission to require low-income, “able-bodied” adult residents to work, volunteer, or train for a job in order to maintain their Medicaid coverage.

In both sets of comments, we express our concerns that the proposed changes would undermine access to health care for low-income people who are not yet eligible for Medicare, including older adults and people with functional limitations or chronic conditions. Such individuals may not be administratively classified as “disabled”—and therefore exempt from the work requirements—but they may nevertheless face significant health challenges that drive unemployment or underemployment.

As Health and Financial Challenges Grow, More Older Adults File for Bankruptcy

According to a recent study featured in the New York Times, bankruptcy among older Americans is on the rise. The rate of people age 65 and older filing for bankruptcy is three times what it was in 1991, and this group now accounts for 12% of all filers, a far greater share than in 1991 (2%).

Driving the surge, the study suggests, is a three-decade shift of financial risk from government and employers to individuals. This pattern—which includes people waiting longer for full Social Security benefits, employers replacing pensions with defined contribution savings plans, and soaring out-of-pocket health care costs—has transferred many of the health and economic challenges associated with aging onto older adults.

Trump Administration Expands “Short-Term” Health Plans, Jeopardizing Coverage for Millions

This week, the Trump Administration issued a final rule expanding the availability of “short-term” health plans that do not have to comply with the Affordable Care Act’s (ACA) consumer protections and coverage requirements.

In particular, short-term plans are free from the ACA’s insurance regulations–including the mandate to cover essential health benefits like maternity care, prescription drugs, and mental health treatment—as well as from the health law’s consumer protections that prevent insurers from charging sick people more than healthy people, excluding coverage of pre-existing conditions, and denying coverage based on medical history.

Under the final rule, these policies will now last up to 12 months, and consumers will be able to renew them for a maximum of 36 months. Previously, the plans were limited to three months and were not renewable.

Medicare Rights Center Offers Beneficiary Perspective on Proposed Changes to Medicare Part D

Today, Joe Baker, president of the Medicare Rights Center, participated in a Capitol Hill briefing on Tackling Prescription Drug Prices: An Examination of Proposed Medicare Part D Reforms. Hosted by the National Coalition on Health Care, the goal of this educational briefing was to shed light on proposed reforms to Medicare Part D, identify the trade-offs involved, and explore the impacts on Medicare beneficiaries.

As Federal Deficits Increase, so Do Threats to Medicare

Last week, the Medicare Rights Center explained how the House majority’s budget plan for 2019 would fundamentally restructure Medicare and Medicaid, slashing more than $2.1 trillion from the programs over 10 years. Though this approach is not unexpected—as lawmakers promised to use deficits created by last year’s tax bill as an excuse to pursue such cuts—it is extremely troubling.