Dirty Penguin
Master Of Ceremony
Medicare | U.S. Congressman Paul Ryan
(emphasis mine)
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Recognizing the problems facing Medicare, the House-passed Budget:
Letting government break its promises to current seniors and to future generations is unacceptable. The reforms outlined in the budget passed by the House protect and preserve Medicare for those in and near retirement, while saving and strengthening this critical program so that future generations can count on it to be there when they retire.
- Strengthens health and retirement security by taking power away from government bureaucrats and empowering patients with control over their care.
- Repeals the new health care law’s unaccountable board of bureaucrats empowered to cut Medicare in ways that would jeopardize seniors’ access to care.
- Saves Medicare for current and future generations, with no disruptions for those in and near retirement.
- For younger workers, when they become eligible, Medicare will provide a premium-support payment and a list of guaranteed coverage options – including a traditional fee-for-service option – from which recipients can choose a plan that best suits their needs.
- Program growth would be determined by a competitive-bidding process – with choice and competition forcing providers to reduce costs and improve quality for seniors.
- Premium support, competitive bidding, and more assistance for those with lower incomes or greater health care needs will ensure guaranteed affordability for all seniors.
Beginning in 2024, for those workers born in 1959 or later, Medicare would offer them a choice of private plans competing alongside traditional fee-for-service option on a newly created Medicare Exchange. Medicare would provide a premium-support payment either to pay for or offset the premium of the plan chosen by the senior.
The Medicare Exchange would provide all seniors with a competitive marketplace where they could chose a plan the same way members of Congress do. All plans, including the traditional fee-for-service option, would participate in an annual competitive bidding process to determine the dollar amount of the federal contribution seniors would use to purchase the coverage that best serves their medical needs. Health care plans would compete for the right to serve Medicare beneficiaries.
The second-least expensive approved plan or fee-for-service Medicare, whichever is least expensive, would establish the benchmark that determines the premium-support amount for the plan chosen by the senior. If a senior chose a costlier plan than the benchmark plan, he or she would be responsible for paying the difference between the premium subsidy and the monthly premium. Conversely, if that senior chose a plan that cost less than the benchmark, he or she would be given a rebate for the difference. Private health plans would be required to cover at least the actuarial equivalent of the benefit package provided by fee-for-service Medicare.
Program growth would be determined by the competitive bidding process – with choice and competition forcing providers to reduce costs and improve quality for seniors. The competitive market for Medicare choices would foster innovation and quality while ensuring that the program is financially stable. As opposed to pegging the growth rate to a predetermined formula, competitive bidding offers the ideal means of harnessing the power of choice and competition to control costs, while also securing guaranteed affordability for patients. As a backup, the per capita cost once the program has begun could not exceed not exceed nominal GDP growth plus 0.5 percent. The President has repeatedly proposed empowering IPAB to hold Medicare growth to the same rate; the difference is that this budget proposes to use competition to control costs.
All health plans that participate in the Medicare Exchange, including the traditional Medicare option, would be required to offer insurance to all seniors – regardless of age and health status – thereby preventing insurers from cherry picking only the healthiest seniors for coverage under their plan. Additionally, the federal contribution to seniors’ health plans would be increased to account for a senior’s health status and age.
These reforms also ensure affordability by fixing the currently broken subsidy system and letting market competition work as a real check on widespread waste and skyrocketing health-care costs. Putting patients in charge of how their health care dollars are spent will force providers to compete against each other on price and quality. That’s how markets work: The customer is the ultimate guarantor of value.
Reform aimed to empower individuals — with a strengthened safety net for the poor and the sick — will not only ensure the fiscal sustainability of this program, the federal budget, and the U.S. economy. It will also guarantee that Medicare can fulfill the promise of health security for America’s seniors.
(emphasis mine)
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