OBAMA'S STANCE
Obama's
website doesn't have any information dealing with medicare or medicaid directly. It only has information on the Affordable Care Act. So, here is a
good sum up of Obama's stance on Medicare. This is an article taken from
http://medicarenewsgroup.com/news/medicare-faqs/individual-faq?faqId=e7642be4-317f-490e-8dd0-43455d3a674a
"President Obama lays out
his plan for Medicare reform in his “Budget for Fiscal Year 2013.” The
proposal would mostly maintain Medicare in its current form, while implementing
structural payment reforms to encourage the utilization of high-value rather
than high-cost services. Thus, Obama focuses his Medicare reform proposal on
two main areas: (1) altering the current payment system, and (2) reducing fraud
and waste in the system. The Office of Management and Budget estimates that the
reforms in the president’s budget for Medicare, Medicaid, and other health
programs will save $364 billion over the next 10 years.
Premium Support
President Obama unequivocally
opposes any plan to turn Medicare into a voucher or “premium support” system.
In the president’s introduction to his fiscal year 2013 budget proposal, he
clearly articulated his opposition to replacing Medicare with a voucher system,
stating, “What I will not support are efforts to turn Medicare into a voucher
or Medicaid into a block grant. Doing so would weaken both programs and
break the promise that we have made to American seniors, people with
disabilities, and low-income families—a promise I am committed to keeping.”
Medicare Payment Reform
Obama’s proposal for Medicare
reform seeks to maintain the financial stability of Medicare in the long run by
initiating both general and specific payment reforms that would improve the
sustainability of Medicare. The intention of payment reform is to encourage the
appropriate use of health services by making new beneficiaries responsible for
payment for certain services.
Obama’s FY 2013 budget proposes
general payment reforms that would extend the solvency of the Hospital
Insurance Trust fund for up to two years, including:
·
Modifying
payments to certain providers in order to address payments that exceed patient
care costs.
·
Reducing
government payments to Medicare providers for beneficiaries’ nonpayment of
their deductibles and copayments.
·
Aligning
Medicare drug payment policies with Medicaid policies for low-income
beneficiaries.
·
Reducing the
federal subsidy of Medicare costs for beneficiaries with the highest incomes.
Obama’s payment reform proposals
also include more specific actions to incentive efficiency, such as:
·
Introducing a
modified Medicare Medical Insurance (Part B) deductible for copayments for home
health services that are not preceded by inpatient care services for new
beneficiaries beginning in 2017.
·
Implementing
changes to Medicare Supplement Insurance (Medigap) coverage plans and charging
a premium surcharge for those who choose Medigap plans beginning in 2017.
Research indicates that beneficiaries with Medigap plans that provide
first dollar coverage have less incentive to consider the costs; therefore, by
charging more for Medigap coverage, the administration hopes to give
beneficiaries an incentive to consider the costs of their health care services.
Obama also supports permanently
changing Medicare’s physician payment system. Currently, physician payments are
determined under a formula referred to as the Sustainable Growth Rate (SGR).
Since 2002, this formula has called for reductions in physician payment rates,
which Congress has had to override in order to prevent dramatic reductions to
physician reimbursements. The administration aims to work with Congress to fix
the SGR and to create a Medicare physician payment system that is more
predictable and permanent, because the failure to do so only prolongs long-run
structural budget issues.
Finally, the president’s budget
emphasizes containing health care costs through the use of expanded
preventative services under the Affordable Care Act (ACA), in order to address
the growing problem of chronic illness. Chronic diseases—such as heart disease,
cancer, strokes and diabetes—are a pervasive and costly health care issue in America ,
accounting for 75 percent of the nation’s health care spending. To better
contain the cost of chronic illness, Obama believes that health care must
emphasize wellness and encourage preventative screening to identify issues
early on. Accordingly, the ACA created the Prevention and Public Health Fund
(Fund), which is designed to create and expand the necessary infrastructure to prevent
disease or detect it early, and to manage conditions before they become
severe. As a result of certain provisions in the ACA, since 2011, 32.5
million Medicare beneficiaries have received at least one new free preventive
service, including screenings for cancer, diabetes, depression and blood
pressure.
Obama intends to continue to
support wellness and chronic illness prevention in 2013 by allocating $1.25
billion from the Fund for activities that will improve health outcomes and
reduce health care costs by increasing the availability of preventative
services, such as screenings and immunizations for both children and
adults. Furthermore, the budget creates a Comprehensive Chronic Disease
Prevention Program that will combine select chronic disease programs into one
main program. The hope is that this will “provide[LS1] States with additional flexibility to
address the leading causes of chronic disease and disability, while increasing
accountability and improving health outcomes through performance incentives.”
Lastly, Obama’s proposal seeks to
strengthen the authority of the Independent Payment Advisory Board (IPAB) to
reduce long-term drivers of Medicare cost growth.
Fraud Prevention
Obama’s Medicare reform proposals
focus heavily on reducing waste, fraud and abuse. In 2011, the Health Care
Fraud and Abuse Control Program (HCFAC) recovered nearly $4.1 billion in
taxpayer dollars in 2011 and $10.7 billion over the last three
years. Furthermore, the Health Care Fraud Prevention and Enforcement
Action Team (HEAT) has helped stop 150 defendants charged with approximately
$950 million in fraud, and increased the number of individuals charged with
criminal fraud from 797 in fiscal year 2008 to 1,430 in fiscal year 2011.
Going forward, the Department of
Health and Human Services will continue to focus on implementing ACA[LS3] anti-fraud provisions, in order to achieve
the administration’s goal of cutting the Medicare fee-for-service improper
payment rate in half by the end of 2012. The president’s 2013 budget invests
$610 million to implement activities that reduce Medicare payment error rates,
prevent fraud and abuse, target high-risk services and supplies, and enhance
civil and criminal enforcement. Specifically, Obama’s budget proposes the
following measures:
·
Authorizing
civil monetary penalties or other intermediate sanctions for providers who do
not update enrollment records.
·
Permitting
excluding individuals affiliated with entities sanctioned for fraudulent or
other prohibited actions from federal health care programs.
·
Affirming
Medicaid’s position as a payer of last resort when another entity is legally
liable to pay claims for beneficiaries.
·
Rescreening
1.5 million home health agencies, medical equipment suppliers, doctors,
hospitals and providers to ensure they are not defrauding taxpayers.
Medicare Beneficiary Age
Obama’s budget proposal contains
no mention of altering the age at which American citizens begin to receive
Medicare benefits, which is currently set at 65.
Insurance Exchanges
President Obama’s 2013 budget
proposal also allocates $76.4 billion to the Department of Health and Human
Services (HHS)—$300 million above HHS’ current 2012 funding level—so that the
department can focus on the administration’s priority of implementing the
Affordable Care Act. Specifically, HHS will use this money to help
states establish Affordable Insurance Exchanges and create cost-sharing and
assistance programs to make coverage affordable for all Americans."
So, here are the facts. Now it is
time to decide which plan will work better.


