Medicare Actuary: $141 Billion Medicare Doc Fix Bill Won’t Fix It For Long
A potential longer-term fix to a costly annual Medicare problem is actually not that permanent, according to a report from a federal actuary.
The Centers for Medicare and Medicaid Services’ Chief Medicare Actuary, the top authority on the program, has issued a report charging that a House-passed bill to amend Medicare’s Sustainable Growth Rate — a schedule that reduces physicians’ payments for Medicare customers annually — won’t be a permanent fix at all.
The SGR may officially reduce physician payments each year, but Congress annually passes “doc fix” legislation to avert the cuts to ensure that doctors don’t stop seeing Medicare patients altogether. The House of Representatives passed a longer-term fix several weeks ago with Democratic support, as some Republicans balked because cost increases were not fully offset with spending cuts.
The issue has starkly split even conservative groups. Boehner and some conservative advocates are touting the compromise bill as a real step forward on sorely-needed entitlement reform that will ultimately lower spending. Other conservative thinkers, however, have accused the establishment of reversing its position on paying for the changes to Medicare, as Boehner argued in 2009. (RELATED: GOP Leadership, WSJ Both Flip On Spending Battle Over Doc Fix)
The bill, which the Senate will consider next week, will increase the budget deficit by $141 billion over 10 years, according to the Congressional Budget Office.
The bill will increase net federal health care spending by $102.8 billion over the next decade, according to the actuary. That includes a $210 billion gross spending increase on Medicare, countered by higher Medicare premiums in Parts B and D that will bring in $55 billion more and cuts to Part A.
Even so, the actuary has charged that even with the billions in increased spending, the bill won’t be a permanent fix to the physician payment problem.
“We anticipate that physician payments rates under H.R. 2 would be lower than scheduled under the current SGR formula by 2048 and would continue to worsen thereafter,” the report concludes. ”Absent a change in the method or level of update by subsequent legislation, we expect access to Medicare-participating physicians to become a significant issue in the long term under H.R. 2.”
The conservative group Americans for Tax Reform, which supports the legislation, points to the billions in savings in different parts of Medicare. The actuary found that spending in Medicare Part B if the bill passes would be lower than both current law and an alternative projected baseline. There’s also another $400 billion in savings in Part A, according to the report — and while Medicare Part D isn’t included in the analysis, ATR argues that “you have to assume it’s in the hundreds of billions too.”
“The central claim conservative supporters have made is that this bill reduces the unfunded liabilities of the Medicare program,” ATR’s Ryan Ellis told The Daily Caller. “Now we have proof.”
“This is what entitlement reform looks like — the gains start small, but grow huge over time.”
The Heritage Foundation, which opposes the bill, says the report shows that the legislation isn’t worth the billions it will cost, according to an analysis from Heritage’s Paul Winfree.
“Rather than a permanent replacement to the Sustainable Growth rate, it is much more likely that the House doc fix will be a shorter term patch requiring another series of patchwork legislation just nine years from now,” Winfree wrote Friday.
BREAKING: New Mexico Gov Signs Bill To Protect You From Police
BREAKING: New Mexico Gov Abolishes Civil Asset Forfeiture
New Mexico Gov. Susana Martinez signed a bill to abolish civil asset forfeiture Friday.
She signed just before the noon deadline that would have pocket vetoed the legislation.
“As an attorney and career prosecutor, I understand how important it is that we ensure safeguards are in place to protect our constitutional rights,” Martinez said in a letter announcing her decision. “On balance, the changes made by this legislation improve the transparency and accountability of the forfeiture process and provide further protections to innocent property owners.”
Civil asset forfeiture is a practice where police can seize your property and keep it even if they don’t convict or charge you with a crime. Then, you must go through the difficult, and often unsuccessful process to get your property–whether it’s a vehicle, cash or your home–back from the police.
The new law makes two important changes:
1. Currently, when police seize property they can keep it even if you are innocent. Under the new law, police can still take property from you for a short period, but would need a conviction or a guilty plea in order to keep it.
2. The law changes the incentive structure for police. Under the new law, if police do get a guilty verdict and your property is forfeited, it goes to the state’s general fund rather than the police department’s budget. The difference at least adds a layer of bureaucracy and oversight between police and the funds they seize.
“It’s great that she signed it, and it’s really going to be a good thing for New Mexico,” Hal Stratton, former attorney general for New Mexico who has vocally supported the bill, told The Daily Caller News Foundation. “It was quite a collaborative effort. The fact that she is willing to step up and sign it is really a good thing.”
New Mexico’s state legislature passed the bill March 21 just hours before the session closed. If the bill had been vetoed it would likely not gotten attention again for two years because of New Mexico’s short legislative sessions.
“We’re thrilled,” Paul Gessing, president of the Rio Grande Foundation, which was co-founded by Stratton and has worked closely on the bill, told TheDCNF. “The right thing was done for all New Mexicans today.”
In the letter, Martinez addressed law enforcement’s fears that the loss of these funds would leave them less equipped to fight crime, particularly drug cartels.
“With the passage of this legislation, it is more critical than ever before that every county and municipality, as well as the state legislature, makes a stronger commitment to fully fund our law enforcement agencies so that they can continue undertaking complex investigations, protecting the public, and protecting themselves while doing so,” she said.
The effort drew support from groups on the right and left, including the American Civil Liberties Union. Those groups hope that this effort will start a domino effect in other states, which have been reluctant to make changes.
“This bipartisan legislative effort will preserve and strengthen public safety and crime-fighting efforts in New Mexico, and hopefully represents the beginning of a movement that will spark other states across the country to do the same,” Christine Leonard, executive director of the Coalition for Public Safety, said in a statement.
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Twitter Mocks 'Hillary's Big Announcement'
‘Condescending, Childish’: Marie Harf Gets In Facebook Argument Over Daily Caller Article
State Department acting spokeswoman Marie Harf got in a Facebook spat with a friend after he posted a Daily Caller article critical of her abilities.
The offending article was media reporter Al Weaver’s excellent report on comments by New York Times columnist David Brooks blasting Harf’s response to criticism. After Harf dismissed an op-ed by former Secretary of State Henry Kissinger as nothing but “big words and big thoughts,” Brooks snarked, “Are we in nursery school? We’re not, no polysyllabic words?”
“Team Obama bans polysyllabic words!!” gloated William M. Todd, a family friend of Harf’s. But Harf, who apparently has enough time to troll Facebook at 1 PM on a Friday afternoon, pounced:
Bill – I’m not sure how you could think this article accurately portrays me or how I view complicated foreign policy issues, given how long you’ve personally known me and my family. Does your hatred of this administration matter so much to you that it justifies posting a hurtful comment and a mean-spirited story about the daughter of someone you’ve known for years and used to call a friend? There’s a way to disagree with our policies without making it personal. Growing up in Ohio, that’s how I was taught to disagree with people. I hope your behavior isn’t an indication that’s changed.
A few of Todd’s other Facebook friends jumped to his defense. “Marie, your job performance has been highlighted by quite a few PR slips,” wrote one Rachel Mullen. “As an Ohioan, you should know that we don’t give someone a pass simply for being a Buckeye.” (VIDEO: State Department Spox Lashes Out At Reporters For *Gasp* Asking Questions)
But then Todd himself responded to the article, delivering a smackdown on Harf.
@ Marie. I have been very careful to never criticize you personally over your official comments. I have always and will always speak highly of you and your family — as my good friend from Florida, Jefferson Knight has indicated.
However, you are correct that I disagree with the foreign policies of this Administration and hope that they are capable of correction in the future.
In this particular instance, I am glad that you chimed in on the discussion. I certainly can understand why your Team would disagree with Henry Kissinger and George Schultz on policy matters. However, what is amazing to me was your condescending and, almost childish criticism of what I considered to be a well-reasoned and thoughtful op-ed on the current Middle East crisis.
I know you don’t agree with me, but for over 40 years, I have admired Mr. Kissinger as the keeper of the flame of a strong tradition of Western diplomacy stretching back over the centuries. He was always a brilliant scholar and his stellar service as Secretary of State proved that his theories worked in practice as well.
Despite our disagreements over the policies of this Administration, I have tried to avoid even discussing your role in communicating those mistaken ideas. The fact I departed from that restraint in this instance should tell you how disappointed about the Department’s response to the this Op-ed.
Harf pushed back twenty minutes later — with an essay-length response. Again, we must stress this is a federal employee during a workday afternoon, on taxpayer dime:
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