Entitled to Know

Medicare’s chief actuary testified in the House today following last week’s release of the Social Security and Medicare Trustees Report. Ways and Means Health Subcommittee Chairman Pete Stark highlighted some of the back-and-forth in a News Release issued at the conclusion of today’s event:

“When Secretary Leavitt appeared before the Subcommittee earlier this year, he made alarmist statements about the future of Medicare and told us to ‘call the government actuary’. Well, we did,” stated Chairman Stark, “and the Medicare Chief Actuary made it clear time and time again today that overpayments to private plans are a serious drain on Medicare’s financing that undermine the program’s financial health and raise costs for all beneficiaries. I think Secretary Leavitt is the one who needs to talk to his actuary.”

In today’s Ways and Means Health Subcommittee hearing on the 2008 Medicare Trustees report, Centers for Medicare & Medicaid Services Chief Actuary Rick Foster made several important statements.

** Foster said that overpayments to private Medicare Advantage (MA) plans shorten the solvency of the Part A Trust Fund:

“If the law were changed such that benchmarks were set at fee-for-service rates, then it would extend the solvency of the Medicare Trust Fund by about 18 months.”

** He also indicated that overpayments increase premiums for all 44 million seniors and people with disabilities – even though almost 80 percent of Medicare beneficiaries are not enrolled in private plans:

“As of 2009, the additional premium associated with higher [MA] benchmarks is about $3 a month.”

** When directly asked if Medicare advantage ever costs less than fee-for-service, Foster flatly said:

“No, not under current law.”

** Foster also stated that hitting the “45 percent trigger” does not mean there is a crisis with the Medicare Trust Funds:

“Despite the title, the Medicare Funding Warning should not be interpreted as a finding that Medicare funding is inadequate.”

**When asked about the arbitrary nature of the nature of the trigger, he stated:

“I’m not aware of any specific technical rationale for it.”

** Foster confirmed that the 2008 Trustees report would not have triggered the “Medicare Finance Warning” had payment rates between traditional fee-for-service Medicare and Medicare Advantage plans been equalized:

“If [benchmarks were set at fee-for-service rates] as in the CHAMP Act, the trigger would not have been tripped in this report. General revenues would not have crossed the 45% threshold until 2016 rather than 2014.”

** When discussing the financial future of Medicare, it is important to remember that health projections are notoriously unreliable. For example, small changes in assumptions or experience with respect to productivity, utilization and other variables, can produce substantially different estimates. In discussing this volatility, the Chief Actuary warned against putting too much stock in long-term estimates:

“We should never kid ourselves or place too much reliance on what are inherently uncertain projections.”


Our Analysis of the 2008 Trustees Report can be found here and more details on Medicare Advantage Plans and the outrageous industry subsidies they depend on is linked here.