The 2020 General Election will be critical for a number of programs and Medicare is high up the ladder among them. Medicare represents 15 percent of the national budget. With the national deficit reaching an all-time high, it’s possible that Medicare—possibly cuts or reforms—could be on the table for changes post 2020.
Tricia Neuman, senior vice president of the Kaiser Family Foundation, said “Voters need to think about who they want to be making decisions about the future of Medicare.”
Congress has always taken steps to keep the program financially sound probably because Medicare, along with Social Security, has long been seen as must-haves.
Medicare is extremely popular, so popular that the drawback is politicians are often afraid to make necessary changes to make it stronger. They fear that any calls for change could be misinterpreted by their constituents as opposition to it. Insiders have described pushing for reforms to Medicare at Congress is like tip-toeing around land mines.
But Medicare experts say while Medicare is strong, politicians need to look at the root causes of rising program costs and get costs manageable so that it can continue to be robust and available for generations.
Keali’i Lopez, state director AARP Hawai’i says “within six years, Medicare’s Part A (hospital) trust fund is projected to run short of funds needed to pay full hospital benefits, primarily due to rising health care costs, rapidly increasing prescription drug prices, new technology, and increased enrollment.”
Lowering cost and improving efficiency are even more crucial as the number of Medicare beneficiaries grow. In 2030, it is expected to be 80 million. Currently, enrollees are just over 60 million.
Medicare experts say a big reason for rising costs is attributable to pharmaceutical companies having free reign to set their own prices with little to no accountability or transparency.
Recently the House of Representatives has passed the Elijah E. Cummings Lower Drug Costs Now Act (HR 3), which would tackle prescription drug costs. It would require the federal government to negotiate the prices of some high-cost drugs on behalf of Medicare and use the savings to fund dental, vision and hearing benefits.
This bill actually addresses most of the complaints Medicare beneficiaries express. The program is clearly popular, but the common criticism is that Medicare doesn’t cover drug costs adequately and that Original Medicare does not cover dental, vision, and hearing benefits.
Seniors with chronic and major health problems are simply unable to pay for needed drugs.
The Elijah E. Cummings Lower Drug Costs Now Act (HR 3) identifies Medicare beneficiaries needs. While it is a step in the right direction, perhaps another bill must also be worked on to address the overall systemic problems of health care’s fast rise in costs (faster rate than inflation).
The boldest among reforms floating around is Medicare-for-All, which just 10 years ago seemed to be a political pipe dream. Now it has been gaining rapid support in recent years.
What are Medicare beneficiaries main concern
According to an EHealth survey there is overwhelming content with Medicare among beneficiaries—nearly nine out of 10 people who are 80 years old or older say they’re satisfied or very satisfied with Medicare. That’s compared to 79% of people age 71 to 79, 71% of people 65-70 and 69% of those under 65.
While the same EHealth survey shows overwhelming content, it also found people with higher incomes are happier 81% of respondents making between $50,000 and $75,000 are either satisfied or very satisfied. That’s compared to 67% of those with an annual income below $25,000.
The EHealth survey also highlights areas of worry for beneficiaries:
that their benefits will be cut (more than two-thirds ex-
that fewer doctors will take Medicare (more than half)
almost all beneficiaries were concerned that they will no longer be able to afford coverage
What do Medicare beneficiaries found most important in choosing a plan?
monthly premiums (one-third looked for affordability in premiums)
low out-of-pocket costs (31%) • having their preferred doctor in the plan’s network (20%)
• getting adequate and affordable drug coverage (12%)
out-of-pocket costs (top concern for younger Medicare beneficiaries)
Medicare specialists say that new recipients and near retirees approaching 65 (age to qualify for enrollment, besides the disabled) should be armed with as much knowledge of the different plans Medicare offers. When choosing a plan, a recipient should look at both short-term and long-term needs based on their unique health and income needs.
Beneficiaries should also be mindful that Medicare plans can and should be changed based on their current needs. Beneficiaries who expect major procedures and surgeries ahead of time (a year or so) should examine their current policy. If there is another one that will save money, they should switch to it as far ahead as possible before that major procedure. Beneficiaries must consider that there are set periods annually when these changes to plans are accepted.
Medicare can be complex. But with working knowledge of the programs, beneficiaries can maximize their benefits. Taking that extra step to study your options is well worth it.