Re­mak­ing Medi­care

Bi­par­ti­san Ryan-Wy­den plan gets cool re­cep­tion

Modern Healthcare - - THE WEEK IN HEALTHCARE - Jes­sica Zig­mond

As con­gres­sional lead­ers wran­gled over a host of spend­ing is­sues last week, two fed­eral law­mak­ers man­aged to re­lease a bi­par­ti­san pro­posal to re­struc­ture the Medi­care pro­gram.

House Bud­get Com­mit­tee Chair­man Paul Ryan (R-wis.) and Sen. Ron Wy­den (D-ore.) to­gether in­tro­duced a plan for the fed­eral health­care pro­gram that start­ing in 2022 would of­fer Amer­ica’s se­niors a choice among Medi­care-ap­proved pri­vate plans and the tra­di­tional Medi­care plan. Any pri­vate plan that par­tic­i­pates in the pro­gram would have to pro­vide at least as com­pre­hen­sive a ben­e­fit as tra­di­tional feefor-ser­vice Medi­care, and Amer­i­cans who are at or above age 55 to­day would not see changes in their ben­e­fit struc­ture, ac­cord­ing to a summary of the pro­posal. In­stead, they would have the op­tion of switch­ing to a pri­vate plan af­ter the Medi­care ex­change is es­tab­lished. That mar­ket­place is in­tended to sup­plant the Medi­care Ad­van­tage pro­gram.

The “premium sup­port” model al­lows pri­vate plans to com­pete with tra­di­tional Medi­care based on their abil­ity to pro­vide cov­er­age at an af­ford­able cost. In this new struc­ture, premium-sup­port lev­els will be de­ter­mined by the cost of the sec­ond­low­est-cost plan, as well as tra­di­tional Medi­care.

The Obama ad­min­is­tra­tion was quick to crit­i­cize the pro­posal, com­par­ing it with Ryan’s plan in April to pri­va­tize Medi­care.


Wy­den, left, and Ryan pro­pose let­ting se­niors choose be­tween pri­vate plans and tra­di­tional Medi­care.

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