NAHC Signs Onto Congressional Letter Outlining Aims to Protect Medicare Beneficiaries During SGR Negotiations
Senior Groups Join in Opposing Home Health and Hospice Copays
March 3, 2014 09:10 AM
The National Association for Home Care & Hospice (NAHC) joined with two dozen other prominent aging and beneficiary advocacy groups in sending a letter to leaders in both the House and Senate outlining their aims for a successful reform to the flawed Medicare physician payment formula, known as the “sustainable growth rate” or SGR, currently being debated in Congress.
The letter states that the signatories “hope [congressional negotiators] will continue to make progress toward a Medicare physician payment policy that will stabilize payments and improve incentives for greater quality and efficiency. Nonetheless, we remain deeply concerned about issues critical to the well-being of people with Medicare that your committees have yet to collectively address.”
Specifically, the letter outlines goals that all signatories agree must shape the SGR negotiations, while detailing their rationale.
Those goals include:
Protect people with Medicare from higher health care costs
“A legislative proposal to repeal and replace the SGR must not be paid for by shifting added health care costs to people with Medicare. Proposals such as further income-relating Medicare Part B and Part D premiums, prohibiting or taxing comprehensive Medigap coverage, adding a home health copayment, increasing brand name copayments for Extra Help enrollees, or otherwise redistributing the burden of Medicare cost sharing through increased deductibles, coinsurances or copayments should not be adopted as offsets to pay for a permanent SGR solution…
Congress must not make Medicare unaffordable for beneficiaries, jeopardize access to needed care, or worsen the already tenuous economic circumstances facing most people with Medicare. National polling consistently demonstrates that most Americans oppose reducing Medicare spending to reduce the deficit. For instance, in a March 2013 CBS News Poll, 80% of respondents opposed cutting Medicare. We anticipate that cuts to Medicare benefits would be similarly unpopular in the context of physician payment reform.”
Make the Qualified Individual (QI) program permanent
“We are very concerned that a permanent SGR solution could significantly diminish the prospects for continued bipartisan agreements on the extension of the QI benefit.
The QI program is essential to the financial stability of people with Medicare living on fixed incomes. The QI benefit pays Medicare Part B premiums, amounting to $104.90 per month, for individuals with incomes between 120% to 135% of the federal poverty level (FPL)—about $13,800 to $15,500 per year—and less than $7,080 in assets. In 2011, 520,000 older adults and people with disabilities were enrolled in the QI program.1 According to a recent analysis, Medicare beneficiaries with incomes between 101% and 150% FPL spend more than one quarter (26.1%) of their income on out-of-pocket health care costs, more than any other income group.2 This stark reality makes the QI benefit that much more important.
In December, the Senate Finance Committee voted on a SGR reform package that only extended the QI program through 2018. We believe this represents a grave error, and we urge you to make the QI program permanent.”
The letter also outlines several ways to pay for the SGR fix that would not fall on Medicare beneficiaries. The letter suggests that Congress utilize unspent Overseas Contingency Operations (OCO) funds and adopt proposals to ensure that the Medicare program and beneficiaries are receiving the best possible price for prescription drugs, including restoring Medicare drug rebates for low-income beneficiaries.
SGR negotiations will be coming to a head at the end of March – coinciding with NAHC’s March on Washington. All NAHC members and supporters are encouraged to join with their peers and colleagues at this year’s March on Washington.
To read the full letter, please click here.
For more information on the March on Washington, please click here.