Advocacy to Protect Social Insurance The Future of Medicare Advocacy to Protect Social Insurance Michael Burgess, NY StateWide Senior Action Council October 2012

Medicare Part D On March 23, 2010, President Obama signed comprehensive health reform, the Patient Protection and Affordable Care Act, into law. Effective dates for implementation of the act will continue through 2020. Changes will affect Medicare Part D prescription drug coverage and preventive services. New York StateWide Senior Action Council 1-800-333-4374 8/5/2019

Preventive Services Starting January 1, 2011, no deductible and Original Medicare pays 100 percent of the Medicare approved amount for the “Welcome to Medicare” physical AND for yearly wellness visits. The “Welcome to Medicare” and wellness visits cover specific services. If you are in a Medicare Advantage plan, deductibles and co-pays may apply. Check with your plan. New York StateWide Senior Action Council 1-800-333-4374 8/5/2019

CMS Strategies to Improve Quality and Reduce Costs Accountable Care Organizations Health Homes Financial Incentives to Reduce Hospital Readmissions Wellness initiatives Partnership for Patients, Care Transitions Programs Community First Choice – independent living Patient Safety, Reduce Medical Errors Reduce Medicare Fraud

Medicare Trustees Report Report in April 2012 Says Medicare Can Pay Full Benefits Until 2024; Costs Currently Exceed Revenues Each Year in Part A Part B and Part D are Self-Financed Report Says Social Security Can Pay Full Benefits Until 2033 Medicare “Funding Warning” as General Revenues Exceed 45% of Program Expenses

Federal Budget “Perfect Storm” Budget cuts of $1.2 trillion over ten years set to begin in January 2013 with half from domestic and half from defense programs; automatic 2% cut for Medicare to providers, not beneficiaries Bush era tax cuts for all incomes to expire on January 1, 2013 Obama supported payroll tax cut to expire on January 1, 2013 Debt ceiling increase will be needed by late 2012, early 2013

Demographics 44.3 million beneficiaries nationwide in 2010 79 million projected by 2030 2.815 million in New York State in 2010 58% women, 42% men 70% White, 12% African-American, 12% Hispanic 84% of beneficiaries are 65+ 16% are under 65 and disabled (420,000 in NYS)

Major Proposals for Savings from various interest groups Note: Stronger economic growth and employment produces greater revenues Raise eligibility age to 67 or higher Reduce reimbursement rates to providers Improve quality and coordination of care with wellness initiatives, reducing re-admissions, health homes, etc Require higher premiums for higher income beneficiaries Premium support (voucher) with hard cap on increases Raise Medicare payroll tax for all workers Negotiate drug prices like Veterans Administration

Independent Payment Advisory Board Enacted with Affordable Care Act Has power to recommend changes beginning in 2015 for cutting costs but not for changing eligibility, benefits or cost sharing for Part A and Part B IPAB recommendations take effect unless Congress passes alternatives Congress trying to repeal IPAB

Obama vs. Ryan GOP Budget Obama Proposals to Save Ryan GOP Budget Keep annual growth at no more than .5% Independent Payment Advisory Board (IPAB) Maintain Current Fee for Service and Medicare Advantage System Reform quality of care with Accountable Care Organizations; better care transitions; reduce hospital re-admissions; health homes Keep annual growth at no more than .5% Raise eligibility age to 67 Maintain traditional Medicare but force competition with private plans through an “exchange” starting in 2023 Provide premium support with beneficiaries paying more if costs are higher than plan support Repeals IPAB

Local Activities to Support Medicare Set up Town Hall Meeting on Medicare Invite candidates to service sites Letters to the editor Case stories of beneficiaries Coalition with provider organizations: home health, doctors, hospitals, nursing homes Coalition with unions in health care: Nursing Association, home health workers Restore the American Promise

Advocacy Organizations New York State Restore the American Promise National Committee to Preserve Social Security and Medicare (ncpssm.org) Alliance for Retired Americans (retiredamericans.org) AARP (aarp.org) National Council on Aging (ncoa.org) Families USA (familiesusa.org) New York StateWide Senior Action Council (nysenior.org)