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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.
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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 funds 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 funds negotiations, however others within the occasion have floated the thought of constructing adjustments over time to this system — together with profit cuts they are saying might be essential to hold Medicare solvent.
NPR’s Michel Martin, as co-host of All Issues Thought-about, 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 the right way to fund Medicare, an costly, however fashionable program. The next excerpt of their dialog has been edited for size and readability.
MARTIN: So, what’s the problem 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 all the present advantages. So mainly, to be able to deliver down the associated fee, you’ve got three choices: You can also make the people who find themselves on this system pay extra, you may make taxpayers who assist assist this system pay extra, or you may pay well being care suppliers — medical doctors and hospitals and all these of us — much less.
Everyone 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 large, and the well being care suppliers say “We’ll stroll away from this system,” that is an issue too.
However Medicare could be very fashionable, and I believe within the State of the Union, when the president mentioned he wasn’t going to do something to Medicare, folks type of slapped again and mentioned, “However Medicare goes to go broke if we do not do something.” So within the funds, Biden mentioned, properly, listed below 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 reference to Medicare?
ROVNER: It is really pretty small. Final yr, for the primary time, Medicare was given authorized permission to barter the value of medication. There’s a quick record of medication. This funds would make the record longer, and it will have these negotiations occur sooner. It will additionally elevate a tax on very high-income earners — these incomes over $400,000. The Biden funds would elevate that Medicare tax from 3.8% to five% on these excessive earners.
MARTIN: Republicans have mentioned that they’ll stability the funds over the subsequent 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 Inexpensive Care Act, which the president has now additionally mentioned he will not go after. It’s potential to stability the funds with out touching Medicare or Social Safety or elevating taxes, however you would need to minimize a lot from the remainder of the funds. That is why we have not seen a Republican plan but. They’re nonetheless attempting to determine it out.
MARTIN: Senate Minority Chief Mitch McConnell has already mentioned 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 may run out of cash. It is occurred a number of instances prior to now. Finally, the events do get collectively and work out some technique to shore it up. And I am certain that may occur this time, too, however I believe 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 mentioned that Medicare is off the desk. However is it conceivable that Medicare will not be implicated sooner or later in these talks?
ROVNER: No. In fact Medicare goes to be implicated sooner or later in these talks. To begin with, what Republican leaders say shouldn’t be essentially what all the Republican rank and file will do. That is true of the Democrats, too, so it is exhausting to think about that Medicare will not be placed on the desk ultimately, form or kind.
MARTIN: So, what’s going to you be being attentive to as these discussions proceed over the subsequent couple of weeks and months?
ROVNER: One thing must be carried out to Medicare, lest it run out of cash. So I believe that just about your entire federal panoply of well being packages goes to be up for dialogue — and that is what I will be watching.
MARTIN: I am simply questioning, is that this the sort of topic that the general public actually can give attention to, can actually get galvanized round?
ROVNER: It will possibly 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 Well being?” — KHN’s weekly well being coverage information podcast. After practically eight years of internet hosting Weekend All Issues Thought-about, Michele Martin is taking up a brand new internet hosting position on NPR’s Morning Version.
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