Medicare Part B Premiums for Some Beneficiaries Could Increase Without Congressional Action
NAHC Attends Press Conference Highlighting Need for Legislation to Prevent Steep Increase in Medicare Premiums; Opposes Home Health Copays or Payment Cuts to Offset Cost
October 14, 2015 09:36 AM
Democratic lawmakers in the U.S. House of Representatives, led by Minority Leader Nancy Pelosi (D-CA), held a press conference last week to highlight the need for Congress to pass legislation by October 15 to prevent a steep increase in Medicare Part B premiums for certain beneficiaries. Premiums could increase by approximately 50 percent for more than 15 million individuals, or 30 percent of Medicare beneficiaries, starting next year. The 30 percent of Medicare beneficiaries potentially affected would include individuals who are eligible for both Medicare and Medicaid, individuals with incomes over $85,000 annually, new enrollees, and those who do not receive Social Security.
Federal law protects 70 percent of Medicare beneficiaries from any Medicare premium increase that exceeds the annual increase in an individual’s Social Security benefits, through what is known as a “hold harmless” provision. However, federal law does not provide the same protection to the 30 percent of Medicare beneficiaries listed above. According to the Medicare trustees report released in July, the standard premium for affected beneficiaries would increase from $105 to $159 per month, and the annual deductible would rise from $147 to $223 in 2015. Medicare beneficiaries with incomes over $85,000 already pay more than the standard premium and would face even larger increases in their premiums.
In addition to the beneficiaries who would be affected, state Medicaid programs are concerned about the potential increase in premiums because they are responsible for paying the Medicare premiums of low-income individuals eligible for both Medicare and Medicaid. Congressional inaction would effectively shift costs from the federal government to state Medicaid programs that are already facing budget challenges.
Minority Leader Pelosi said she has been working on a compromise with Speaker John Boehner, but that so far he has refused to act to prevent the increase in premiums. “For the past month, on a regular basis, we have been reaching out to Republicans to tell them the deadline is racing toward us,” Minority Leader Pelosi said at the press conference. “We thought we were close to a solution, but when that didn’t happen, we had to go public.”
Following the press conference, Speaker Boehner’s staff reportedly said that he is only considering legislation that fully offsets its cost, which is estimated to be as much as $7.5 billion. At this point, there is no announced agreement on how to offset that cost.
The National Association for Home Care & Hospice (NAHC) attended the press conference, as Medicare Part B covers some home health services and the potential premium increase could affect certain Medicare home health beneficiaries. While NAHC supports a compromise to prevent the steep increase in Medicare premiums, NAHC opposes any offset that would impose home health copays or include payment rate cuts. Home health copays would be a “sick tax” on our most vulnerable seniors, and additional payment rate cuts on top of those that have already been implemented would directly impact access to care for Medicare home health beneficiaries. Contact your congressional delegation using NAHC’s Legislative Action Center (click here), and ask them to oppose any home health copays or payment cuts to offset the cost of this or any other legislation.