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Medicare Watch

Medicare Watch articles are featured in a weekly newsletter that helps readers stay up-to-date on Medicare policy and advocacy developments, and learn about changes in Medicare benefits and rules.

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.

Read More »
a roll of bills from which spill out pills of many colors

Average Medicare Part D Premiums Inch Lower but Drug Affordability Still a Problem

This week, the Centers for Medicare & Medicaid Services (CMS)—the agency that oversees the Medicare program—announced that premiums for Medicare Part D, an optional benefit that provides prescription drug coverage, will be slightly lower for 2019. The average 2018 premium for basic coverage is $33.59, and the projected average for 2019 will be $32.50.

CMS suggests that increased competition and changes in cost sharing are the main reasons for the reduction. However, the drop may more likely reflect changes that Congress made earlier this year that shifted some of the costs for medications in the “donut hole”—a coverage gap in the program where costs for beneficiaries historically increased sharply—away from drug plans and onto manufacturers.

Read More »

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.

Read More »

Trump Administration Drug Pricing Proposals May Actually Raise Out-of-Pocket Costs for People with Medicare

Last week, the Medicare Rights Center submitted comments on a Request for Information (RFI) from the Department of Health and Human Services (HHS). This RFI asked for feedback on a host of potential changes that touted as ways to lower prescription drug costs for people with Medicare and Medicaid.

In May, the Trump Administration released a “blueprint” of various proposals in an attempt to bring down drug costs. Medicare Rights supports efforts to make prescription drugs more affordable. Many people with Medicare struggle to afford their medications, and Medicare affordability is one of the top issues on our national helpline every year. Something must be done to ensure the millions of people with Medicare have access to needed prescriptions.

Read More »

CMS Invites Additional Comments on Contested Medicaid Work Requirements

After a Federal Judge invalidated the previously approved plan by the Centers for Medicare & Medicaid (CMS) to require very low income parents and caregivers to show that they are working or engaged in other activities in order to qualify for Medicaid coverage in Kentucky, CMS re-released the rule and another one governing Mississippi for additional comments.

Read More »

Medicare: Strong and Built to Last

To launch our new series, we begin with “Medicare: Strong and Built to Last.” This fact sheet gives some basic statistics about the Medicare program, including who uses it, why it’s important, and its financial footing.

Read More »

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.

Read More »

Report Examines How Medigap Rules and Enrollment Vary Widely by State

This week, the Kaiser Family Foundation (KFF) released an issue brief analyzing the availability of, and enrollment in Medigaps across different states. One in four people in traditional Medicare had this private, supplemental health insurance in 2015. Medigaps help cover Medicare deductibles and cost-sharing, reduce the out-of-pocket burden associated with accessing care, and protect against high costs because of catastrophic illness or injury.

Read More »

Federal Court Decision Blocks Medicaid Work Requirement in Kentucky

In January, the Centers for Medicare & Medicaid Services (CMS) approved a Medicaid waiver in Kentucky that would allow the state to make participation in a work or “community engagement” program a condition for Medicaid eligibility. A group of advocates sued on behalf of Kentuckians who would be at risk of losing Medicaid coverage, and last month a federal judge put Kentucky’s Medicaid work requirement on hold. His decision called into question CMS’s attention to vital details about the Kentucky Medicaid waiver, including whether the waiver violates one of the primary purposes of the Medicaid statute—to provide health coverage.

Read More »

Kaiser Family Foundation Places Medicare Spending Trends in Historical Context

This week, the Kaiser Family Foundation released a new issue brief on Medicare spending. The brief analyzes the most recent historical and projected Medicare spending data published in the 2018 annual report of the Boards of Medicare Trustees and the 2018 Medicare baseline and projections from the Congressional Budget Office (CBO).

In 2017, Medicare spending accounted for 15% of the federal budget, and for 20% of total national health spending in 2016. It also accounted for 29% of spending on retail sales of prescription drugs, 25% of spending on hospital care, and 23% of spending on physician services.

Read More »

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.

a roll of bills from which spill out pills of many colors

Average Medicare Part D Premiums Inch Lower but Drug Affordability Still a Problem

This week, the Centers for Medicare & Medicaid Services (CMS)—the agency that oversees the Medicare program—announced that premiums for Medicare Part D, an optional benefit that provides prescription drug coverage, will be slightly lower for 2019. The average 2018 premium for basic coverage is $33.59, and the projected average for 2019 will be $32.50.

CMS suggests that increased competition and changes in cost sharing are the main reasons for the reduction. However, the drop may more likely reflect changes that Congress made earlier this year that shifted some of the costs for medications in the “donut hole”—a coverage gap in the program where costs for beneficiaries historically increased sharply—away from drug plans and onto manufacturers.

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.

Trump Administration Drug Pricing Proposals May Actually Raise Out-of-Pocket Costs for People with Medicare

Last week, the Medicare Rights Center submitted comments on a Request for Information (RFI) from the Department of Health and Human Services (HHS). This RFI asked for feedback on a host of potential changes that touted as ways to lower prescription drug costs for people with Medicare and Medicaid.

In May, the Trump Administration released a “blueprint” of various proposals in an attempt to bring down drug costs. Medicare Rights supports efforts to make prescription drugs more affordable. Many people with Medicare struggle to afford their medications, and Medicare affordability is one of the top issues on our national helpline every year. Something must be done to ensure the millions of people with Medicare have access to needed prescriptions.

CMS Invites Additional Comments on Contested Medicaid Work Requirements

After a Federal Judge invalidated the previously approved plan by the Centers for Medicare & Medicaid (CMS) to require very low income parents and caregivers to show that they are working or engaged in other activities in order to qualify for Medicaid coverage in Kentucky, CMS re-released the rule and another one governing Mississippi for additional comments.

Medicare: Strong and Built to Last

To launch our new series, we begin with “Medicare: Strong and Built to Last.” This fact sheet gives some basic statistics about the Medicare program, including who uses it, why it’s important, and its financial footing.

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.

Report Examines How Medigap Rules and Enrollment Vary Widely by State

This week, the Kaiser Family Foundation (KFF) released an issue brief analyzing the availability of, and enrollment in Medigaps across different states. One in four people in traditional Medicare had this private, supplemental health insurance in 2015. Medigaps help cover Medicare deductibles and cost-sharing, reduce the out-of-pocket burden associated with accessing care, and protect against high costs because of catastrophic illness or injury.

Federal Court Decision Blocks Medicaid Work Requirement in Kentucky

In January, the Centers for Medicare & Medicaid Services (CMS) approved a Medicaid waiver in Kentucky that would allow the state to make participation in a work or “community engagement” program a condition for Medicaid eligibility. A group of advocates sued on behalf of Kentuckians who would be at risk of losing Medicaid coverage, and last month a federal judge put Kentucky’s Medicaid work requirement on hold. His decision called into question CMS’s attention to vital details about the Kentucky Medicaid waiver, including whether the waiver violates one of the primary purposes of the Medicaid statute—to provide health coverage.

Kaiser Family Foundation Places Medicare Spending Trends in Historical Context

This week, the Kaiser Family Foundation released a new issue brief on Medicare spending. The brief analyzes the most recent historical and projected Medicare spending data published in the 2018 annual report of the Boards of Medicare Trustees and the 2018 Medicare baseline and projections from the Congressional Budget Office (CBO).

In 2017, Medicare spending accounted for 15% of the federal budget, and for 20% of total national health spending in 2016. It also accounted for 29% of spending on retail sales of prescription drugs, 25% of spending on hospital care, and 23% of spending on physician services.