Prescription drug protection is only one a part of Medicare, the federal authorities’s medical insurance program for individuals age 65 and over.
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Prescription drug protection is only one a part of Medicare, the federal authorities’s medical insurance program for individuals age 65 and over.
d3sign/Getty Images
The White House launched President Biden’s $6.8 trillion proposed finances final week, itemizing his priorities for the upcoming fiscal yr. Among different issues, Biden singled out Medicare — the federal medical insurance program for individuals aged 65 or older. Republican leaders insist they will not be threatening cuts to Medicare in upcoming finances negotiations, however others within the social gathering have floated the thought of creating adjustments over time to this system — together with profit cuts they are saying might be essential to maintain Medicare solvent.
NPR’s Michel Martin, as co-host of All Things Considered, sat down this week with veteran well being care journalist Julie Rovner, of Kaiser Health News, to get a greater sense of the place the controversy is headed over tips on how to fund Medicare, an costly, however fashionable program. The following excerpt of their dialog has been edited for size and readability.
MARTIN: So, what’s the challenge right here?
ROVNER: Medicare’s trustees say that inside six years, the belief fund goes to expire of reserves, and so it will not be capable to pay the entire present advantages. So principally, to be able to deliver down the fee, you may have three choices: You could make the people who find themselves on this system pay extra, you can also 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.
Everybody considers any of these issues, “cuts,” though paying suppliers much less is often solely thought-about a minimize to the suppliers. If the cuts get too huge, and the well being care suppliers say “We’ll stroll away from this system,” that is an issue too.
But Medicare may be very fashionable, and I feel within the State of the Union, when the president mentioned he wasn’t going to do something to Medicare, individuals type of slapped again and mentioned, “But Medicare goes to go broke if we do not do something.” So within the finances, Biden mentioned, effectively, listed here are a few issues that we may 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 regard to Medicare?
ROVNER: It’s really pretty small. Last yr, for the primary time, Medicare was given authorized permission to barter the worth of medication. There is a brief listing of medication. This finances would make the listing longer, and it might have these negotiations occur quicker. It would additionally elevate a tax on very high-income earners — these incomes over $400,000. The Biden finances would elevate that Medicare tax from 3.8% to five% on these excessive earners.
MARTIN: Republicans have mentioned that they’ll steadiness the finances over the following decade, however will not contact Medicare. Is {that a} credible stance?
ROVNER: It is, however provided that they go after Medicaid — the really bigger public medical insurance program for individuals with low incomes — and the subsidies on the Affordable Care Act, which the president has now additionally mentioned he will not go after. It is feasible to steadiness the finances with out touching Medicare or Social Security or elevating taxes, however you would need to minimize a lot from the remainder of the finances. That’s why we have not seen a Republican plan but. They’re nonetheless making an attempt to determine it out.
MARTIN: Senate Minority Leader Mitch McConnell has already mentioned publicly that Biden’s plan to extend the Medicare tax on excessive earners, “won’t see the sunshine of day.” So what are we prone to see subsequent?
ROVNER: Well, in some unspecified time in the future, you recognize, the 2 events are going to have to come back collectively earlier than the Medicare belief fund runs out of cash. This is just not the primary time we have been inside this shut interval the place the belief fund may run out of cash. It’s occurred a number of occasions previously. Eventually, the events do get collectively and determine some method to shore it up. And I’m certain that can occur this time, too, however I believe this yr goes to be extra of a battle main as much as the 2024 elections.
MARTIN: The talks over the debt ceiling are approaching. The leaders of each events have mentioned that Medicare is off the desk. But is it conceivable that Medicare will not be implicated in some unspecified time in the future in these talks?
ROVNER: No. Of course Medicare goes to be implicated in some unspecified time in the future in these talks. First of all, what Republican leaders say is just not essentially what the entire Republican rank and file will do. That’s true of the Democrats, too, so it is laborious to think about that Medicare will not be placed on the desk indirectly, form or kind.
MARTIN: So, what is going to you be being attentive to as these discussions proceed over the following couple of weeks and months?
ROVNER: Something must be completed to Medicare, lest it run out of cash. So I feel that just about all the federal panoply of well being applications goes to be up for dialogue — and that is what I’ll be watching.
MARTIN: I’m simply questioning, is that this the sort of topic that the general public actually can concentrate on, can actually get galvanized round?
ROVNER: It can and it could’t. The trick is how this will get negotiated and the way it will get offered to the general public as as to if it would really have an effect on their well being care.
Julie Rovner is the Washington correspondent for KHN and host of “What The Health?” — KHN’s weekly well being coverage information podcast. After almost eight years of internet hosting Weekend All Things Considered, Michel Martin is taking over a brand new internet hosting position on NPR’s Morning Edition.