Entitled to Know

Ask Mary Jane, NCPSSM Contributor: Mary Jane Yarrington, Senior Policy Analyst

Ask Mary Jane, NCPSSM Contributor: Mary Jane Yarrington, Senior Policy Analyst

Ask Mary Jane, NCPSSM Contributor: Mary Jane Yarrington, Senior Policy Analyst

Apparently the Centers for Medicare and Medicaid Services has.
A new GAO report investigates CMS audits of private insurance providers offering Medicare Advantage plans. These private MA plans will collect billions in government subsidies while also charging $1000 more per beneficiary to provide the same coverage already provided by Medicare.

This latest GAO report finds:

“CMS has not met the statutory requirement to audit the financial records of at least one-third of the participating MA organizations for contract years 2001-2005, nor has it done so yet for the contract year 2006 bid submissions.”

Even worse, the audits that CMS has performed turned up $34 million dollars which Medicare beneficiaries should have received in additional benefits, lower co-payments or lower premiums. Good news for seniors, right? Think again.

In other words, private MA insurers get to keep another $34 million of our taxpayer dollars, because CMS won’t enforce its own contracts with the insurance industry.

Welcome to the world of privatized Medicare.

Only in Washington could a 14% increase in prescription drug premiums for seniors be "spun" to sound like good news. That’s CMS’s strategy in announcing next year’s Part D premium hike. The administration’s logic goes something like this: since Part D isn’t costing as much as we first predicted seniors shouldn’t really mind double-digit premium hikes.

Here are the basics on the 2008 Part D premium: starting January 1 seniors’ average Part D premium for basic coverage will increase from about $22 this year to $25 next year. What CMS doesn't tell you is that in addition to this premium hike, beneficiaries will also face higher deductibles and a growing “doughnut hole” which will remain unchecked as long as healthcare costs continue to skyrocket.

By 2014, the Medicare's Trustees expect monthly Part D premiums to increase to $64.26 , the deductible to rise 75% to $457, and the $2,850 “doughnut hole” to become a yawning gap of almost $4,983.75.

CMS is also quick to remind everyone that if seniors don’t want to pay more they can just go shopping for another plan. As if choosing a drug plan for each of the first two years hasn’t been confusing enough!

72 years ago today President Franklin D. Roosevelt signed the Social Security Act. Today, nearly 50 million seniors, the disabled, and survivors receive Social Security benefits and for many it will make the difference between living independently or in poverty.

No other government program in American history can claim the successes achieved by Social Security. Period. Attacks and misleading predictions about sustainability have been leveled against the program since its creation and still, Social Security checks go out on time and as promised. Whether you’re 72 or 22, it appears Social Security is poised to play an even larger role in your life.

A new report by the Center for American Progress details the decline in pensions, personal savings and median incomes, which increase the importance of the only, guaranteed retirement income…Social Security. These are especially important facts for our younger workers who have been told repeatedly that “Social Security won’t be there for you”.

What nonsense.

Here’s a great source for some historical perspective. “The Battle for Social Security—From FDR’s Vision to Bush’s Gamble”. Author Nancy Altman says Social Security’s most important champion has always been the American people.

“Through its many challenges, Social Security has always emerged victorious,because Americans have remained committed to this essential program. The large majority of Americans have supported Social Security because it embodies the best of American values, including reward for work, compassion, fairness, foresight, and prudent, conservative management. This unflagging support has permitted Social Security to eradicate much of the economic insecurity of the past and to transform society.”

Kudos to Sen. Hillary Clinton for being the first presidential candidate to remind everyone about the continuing privatization threat to Social Security. Here is her answer to a pension question posed at the August 7th Democratic Candidates Forum in Chicago:

While the Iraq war, healthcare and the economy have dominated presidential talking points so far, we certainly hope more candidates will remember that it wasn’t that long ago when Social Security was literally under attack by those who’ve never believed in the value of social insurance.

The privatization Social Security and Medicare is a core values debate which we hope more presidential candidates will take on in their campaigns.

MSNBC has video of the Chicago forum and the New York Times has the full transcript.

There were a lot of cheers in our office last night and celebrations today as families nationwide get the news of last night's House vote in support of the Children’s Health and Medicare Protection (CHAMP) Act. Incredibly is was still a largely partisan vote with most Republicans and a few conservative Democrats voting against it. Here's a link to the roll call vote and last night's reaction from our President/CEO, Barbara Kennelly.

“While everyone in Washington claims to care about seniors and children, tonight’s vote in the House forced members of Congress to prove it. A majority has chosen to return America’s healthcare priorities where they belong…on American families.

Government subsidies to private insurers providing Medicare Advantage have created a gaping hole that is draining the Medicare trust fund and imposing unfair costs on millions of beneficiaries across the nation. These outrageous overpayments were proposed by the insurance industry and passed into law by their allies in Congress, 4 years ago. That mistake was corrected in the House tonight.

By eliminating these government subsidies, private Medicare plans will have to compete on a level playing field with traditional Medicare. We’ve been told for decades industry can provide seniors cheaper and more efficient healthcare…this House bill gives insurers the chance to prove it.”

But the battle is far from over. The Senate's SCHIP legislation is still being debated on the floor and it does not include any of the House provisions to eliminate billions in government subsidies to private insurers. The Conference on these two very different bills will be very interesting indeed.