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.

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.

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.

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.

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.

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.

This week, House Republicans unveiled a 2019 budget proposal that would balance the federal budget in nine years—largely by significantly cutting and fundamentally restructuring Medicare and Medicaid. This approach is not unexpected. Lawmakers were clear that after passing a costly tax bill that drives up deficits, they would use these higher deficits to justify cuts to programs like Medicare. In the House budget resolution, they are keeping that promise: the budget would end Medicare and Medicaid as we know them.

A recent report from the Kaiser Family Foundation (KFF) examines Medicare Part D data from the Centers for Medicare & Medicaid Services (CMS). The resulting analysis presents findings on Part D enrollment, premiums, and cost sharing in 2018, as well as key trends over time.

On Friday, President Trump and U.S. Department of Health and Human Services (HHS) Secretary Azar outlined the Administration’s strategy to reduce drug prices. The Administration further described the plan, “American Patients First,” in a blueprint document also unveiled Friday.

The much-anticipated plan is a mix of existing policies laid out in the Administration’s 2019 budget request, as well as some new ideas designed to drive down drug prices and lower costs. Though neither the speech nor the blueprint offers much detail about the Administration’s next steps, there are several aspects of the plan that could significantly impact people with Medicare. This includes potential changes to how certain drugs are covered by Medicare, as well as proposals to reconsider the obligations of Pharmacy Benefit Managers (PBMs), and arrangements between Part D plans and drug manufacturers.

This week, the U.S House of Representatives Committee on Ways and Means Health Subcommittee held a hearing on the Medicare Advantage (MA) program. MA allows people with Medicare to choose a private insurance option instead of traditional Medicare. Witnesses included representatives from two MA plans—Andrew Toy of Clover Health and Daphne Klauser of Independence Blue Cross—who spoke to their experience administering MA plans, as well as Dr. Karoline Mortensen, Associate Professor of the Department of Health Sector Management and Policy at the University of Miami Business School, who discussed quality measures in MA plans. Dr. Jack Hoadley, Research Professor Emeritus at Georgetown University’s McCourt School of Public Policy and former Commissioner on the Medicare Payment Advisory Commission (MedPAC) also testified, speaking for himself and not on behalf of Georgetown or MedPAC.