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

2. 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 Changes will affect Medicare Part D prescription drug coverage and preventive services.
New York StateWide Senior Action Council
8/5/2019

3. 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
8/5/2019

4. 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

6. 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

7. 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

8. 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)

9. 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

10. 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

11. 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

12. 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

13. 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)