POL­ICY:

GOP isn’t alone in push­ing for Medi­care changes

Modern Healthcare - - Front Page - Rich Daly

CMS seeks to kick-start the push for ACOs with three ini­tia­tives

The de­sire for Medi­care ben­e­fits has trumped con­cerns about Medi­care costs for decades. Now con­gres­sional Repub­li­cans are bet­ting that his­toric debt and deficits have changed the equa­tion, and Democrats are ready to call their bluff.

Yet even as Democrats are step­ping up at­tacks on a Repub­li­can deficit-re­duc­tion plan that would over­haul Medi­care, at least some are con­ced­ing that sig­nif­i­cant changes are needed to bol­ster the pro­gram’s long-term vi­a­bil­ity and the fed­eral gov­ern­ment’s fis­cal bal­ance.

The par­ties will face off over the is­sue this week as the Se­nate is ex­pected to hold its first vote on a Repub­li­can bud­get plan that in­cludes con­tro­ver­sial plans to transform Medi­care from an open-ended en­ti­tle­ment to a sys­tem of in­di­vid­ual pay­ments for pri­vate in­surance cov­er­age.

“The Repub­li­can bud­get, pure and sim­ple, would pull out the rug from un­der se­niors to fi­nance tax cuts for bil­lion­aires,” Sen. Sher­rod Brown (D-Ohio) said at a news con­fer­ence last week about the $2 tril­lion in tax cuts in the House bud­get.

But some form of change is needed in the pro­gram, if only to keep it from fu­el­ing ev­er­larger deficits, noted Democrats such as House Demo­cratic leader Nancy Pelosi. In an ap­pear­ance on CNBC’s “The Call” last week, Pelosi (D-Calif.) said the nation must put ev­ery­thing on the ta­ble to re­duce the deficit. When pressed if that in­cluded Medi­care, she said yes.

HHS Sec­re­tary Kath­leen Se­be­lius, dur­ing a rare ap­pear­ance at a Capi­tol Hill news con­fer­ence, agreed that cuts to Medi­care are needed. She touted Pres­i­dent Barack Obama’s deficitre­duc­tion “frame­work” in­tro­duced in April, which also in­cluded Medi­care cuts. Al­though Obama’s plan is vaguely sketched, with many of its Medi­care cuts to be de­ter­mined by the health­care law’s In­de­pen­dent Pay­ment Ad­vi­sory Board, it would cut Medi­care by $340 bil­lion over 10 years.

“The ap­proach that Democrats in Congress and the pres­i­dent want to take is to im­prove Medi­care, and it’s al­ready un­der way thanks to last year’s health­care law,” Se­be­lius said May 19.

The calls for Medi­care changes by se­nior Democrats—who gen­er­ally are seen as its most re­li­able de­fend­ers—has per­suaded health­care provider ad­vo­cates to take se­ri­ously the calls of lead­ers of both po­lit­i­cal par­ties for bol­ster­ing its long-term fis­cal out­look as the key to rein­ing in grow­ing fed­eral deficits.

“There’s not just smoke, there’s real fire

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