Prescription drug protection is only one a part of Medicare, the federal authorities’s medical health insurance program for folks age 65 and over.
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Prescription drug protection is only one a part of Medicare, the federal authorities’s medical health insurance program for folks age 65 and over.
d3sign/Getty Pictures
The White Home launched President Biden’s $6.8 trillion proposed price range final week, itemizing his priorities for the upcoming fiscal yr. Amongst different issues, Biden singled out Medicare — the federal medical health insurance program for folks aged 65 or older. Republican leaders insist they will not be threatening cuts to Medicare in upcoming price range negotiations, however others within the social gathering have floated the thought of constructing adjustments over time to this system — together with profit cuts they are saying will probably be essential to maintain Medicare solvent.
NPR’s Michel Martin, as co-host of All Issues Thought of, sat down this week with veteran well being care journalist Julie Rovner, of Kaiser Well being Information, to get a greater sense of the place the controversy is headed over methods to fund Medicare, an costly, however widespread program. The next excerpt of their dialog has been edited for size and readability.
MARTIN: So, what’s the difficulty right here?
ROVNER: Medicare’s trustees say that within six years, the trust fund is going to run out of reserves, and so it will not be capable to pay all the present advantages. So mainly, to be able to convey down the price, you will have three choices: You may make the people who find themselves on this system pay extra, you may make taxpayers who assist help this system pay extra, or you may pay well being care suppliers — medical doctors and hospitals and all these people — much less.
Everyone considers any of these issues, “cuts,” though paying suppliers much less is usually only considered a cut to the providers. If the cuts get too massive, and the well being care suppliers say “We’ll stroll away from this system,” that is an issue too.
However Medicare may be very widespread, and I believe within the State of the Union, when the president stated he wasn’t going to do something to Medicare, folks form of slapped again and stated, “However Medicare goes to go broke if we do not do something.” So within the price range, Biden stated, nicely, listed below are a few issues that we might do, none of which have an effect on how a lot beneficiaries pay.
MARTIN: What are the highest traces of what President Biden’s proposing, with reference to Medicare?
ROVNER: It is really pretty small. Final yr, for the primary time, Medicare was given authorized permission to barter the worth of medication. There’s a brief listing of medication. This price range would make the listing longer, and it could have these negotiations occur sooner. It will additionally elevate a tax on very high-income earners — these incomes over $400,000. The Biden price range would elevate that Medicare tax from 3.8% to five% on these excessive earners.
MARTIN: Republicans have stated that they’ll stability the price range over the following decade, however will not contact Medicare. Is {that a} credible stance?
ROVNER: It’s, however provided that they go after Medicaid — the really bigger public medical health insurance program for folks with low incomes — and the subsidies on the Reasonably priced Care Act, which the president has now additionally stated he will not go after. It’s doable to stability the price range with out touching Medicare or Social Safety or elevating taxes, however you would need to lower a lot from the remainder of the price range. That is why we’ve not seen a Republican plan but. They’re nonetheless attempting to determine it out.
MARTIN: Senate Minority Chief Mitch McConnell has already stated publicly that Biden’s plan to extend the Medicare tax on excessive earners, “is not going to see the sunshine of day.” So what are we prone to see subsequent?
ROVNER: Nicely, sooner or later, you already know, the 2 events are going to have to come back collectively earlier than the Medicare belief fund runs out of cash. This isn’t the primary time we have been inside this shut interval the place the belief fund might run out of cash. It is occurred a number of occasions up to now. Ultimately, the events do get collectively and work out some technique to shore it up. And I am certain that can occur this time, too, however I think this yr goes to be extra of a combat main as much as the 2024 elections.
MARTIN: The talks over the debt ceiling are approaching. The leaders of each events have stated that Medicare is off the desk. However is it conceivable that Medicare will not be implicated sooner or later in these talks?
ROVNER: No. After all Medicare goes to be implicated sooner or later in these talks. To begin with, what Republican leaders say is just not essentially what all the Republican rank and file will do. That is true of the Democrats, too, so it is laborious to think about that Medicare will not be placed on the desk indirectly, form or type.
MARTIN: So, what’s going to you be being attentive to as these discussions proceed over the following couple of weeks and months?
ROVNER: One thing must be accomplished to Medicare, lest it run out of cash. So I believe that just about all the federal panoply of well being applications goes to be up for dialogue — and that is what I will be watching.
MARTIN: I am simply questioning, is that this the form of topic that the general public actually can deal with, can actually get galvanized round?
ROVNER: It could and it could actually’t. The trick is how this will get negotiated and the way it will get introduced to the general public as as to whether it should really have an effect on their well being care.
Julie Rovner is the Washington correspondent for KHN and host of “What The Well being?” — KHN’s weekly well being coverage information podcast. After practically eight years of hosting Weekend All Things Considered, Michele Martin is taking up a brand new internet hosting function on NPR’s Morning Version.
