Sickest Medicare Patients May Be Greatly Affected by the Super Committee

September 30, 2011

The “Super Committee” in Congress is tasked with finding $1.2 trillion worth of savings by November 23. If its members fail to do so, automatic spending cuts will kick in, taking that amount evenly from domestic and military spending. With only two out of the six meetings the committee has held thus far having been public, observers’ apprehension is growing. The few things that have trickled out include tax reform, as well as Medicare and Medicaid cuts. When it comes to spending cuts, both Democrats and Republicans seem to find common ground on the topic of “dual-eligibles,” the sickest and most costly patients. The term refers to people who are eligible for medical coverage under both Medicare and Medicaid; these patients make up about 16% of Medicare beneficiaries, yet make up about 27% of the program’s total spending. Right now, a possible solution being considered is forcing these patients into managed care, which currently about 100,000 of the 9 million dual patients are enrolled in. Whatever the Super Committee decides to do, the repercussions will be felt throughout the senior community and beyond. “With many states already cutting back on Medicaid, managed care plans for dual-eligibles could endanger the quality of care on which some of America's most vulnerable citizens depend,” warned Barbara J. Easterling, President of the Alliance.

 

New on our Web Site: the Alliance’s 10-Year Anniversary Report

Visit http://bit.ly/pjVbXy for the Alliance’s 10-Year Anniversary report, which includes highlights of achievements since the Alliance’s launch in 2001. That web site also contains the latest video footage and material from our 2011 Legislative Conference. For pictures of the Iowa Alliance Quad Cities affiliate members - with their redistricted new U.S. Representative, David Loebsack (D) - go to http://bit.ly/qkDdhq.

Study Shows Medicare Advantage Increases Medicare Spending

In 2004, the Medicare program began to adjust its payments to private plans for enrollees’ health status. As a result, a plan would receive a higher “risk-adjusted” payment for a recipient with diabetes or heart disease than for an otherwise identical person without these conditions. For the National Bureau of Economic Research report, How Does Risk Selection Respond to Risk Adjustment? Evidence for the Medicare Advantage Program [ http://bit.ly/ovW0n1 ], researchers studied individual-level data for 55,000 people in the Medicare Current Beneficiary Survey from 1994 to 2006. The authors were able to show that the private Medicare Advantage (MA) program has increased total Medicare spending, and transferred Medicare resources from the relatively sick to the relatively healthy. For example, before risk-adjustment began in 2004, switching from fee-for-service Medicare to Medicare Advantage increased average individual Medicare spending by $1,800. The authors calculated that using risk adjustment formulas on the population that enrolled before 2004 would have reduced MA overpayments by more than $800 a person. But when the reimbursement formula changed, so did the pattern of enrollment in Medicare Advantage plans. After 2004, switching from fee-for-service to Medicare Advantage increased Medicare spending by approximately $3,000 per person. The pattern suggests that Medicare Advantage plans invest more resources in their relatively healthy enrollees, perhaps to differentially retain them.

 

Attempts to Rig the 2012 Elections Suspected

According to an editorial by Harold Meyerson in The Washington Post, [ http://wapo.st/neaKFL ], ever since the Republicans gained power in the 2010 elections, they have made it increasingly difficult for minority, poor and young voters to participate in elections. Tactics include voter identification requirements, which can amount to a poll tax if the ID is not free. “There is no evidence that widespread voter impersonation is taking place in Pennsylvania,” said Pennsylvania Alliance President Jean Friday, and Alliance members have been e-mailing Pennsylvania state senators about voter ID requirements there. Another proposal in Pennsylvania has emerged that will change the practice of giving all the electoral votes to the candidate who wins the popular vote. This has been the practice in all past presidential campaigns, as well as in 47 other states. State Senate Majority Leader Dominic Pileggi is pushing a plan that will give the candidate the number of electoral votes equal to the number of districts he wins. This re-working of the Electoral College, along with Pennsylvania redrawing its district lines, will give the GOP a majority of 12 districts. That means President Obama could still win the popular vote in Pennsylvania by carrying the urban areas, such as Philadelphia, but lose the majority of the Electoral College votes. A number of other swing states are thinking of adopting this system as well. To combat these and similar efforts, the Lawyers’ Committee has created the interactive “Map of Shame” at www.mapofshame.com or www.lawyerscommittee.org. In addition to highlighting the states with voter suppression legislation, the Lawyers’ Committee has created a tool to provide details about the changes.

 

Illinois Alliance Holds its State Convention

The Illinois Alliance convention was held last Friday at a UAW center in Ottawa, IL. Barbara Franklin was re-elected state President.  Other officers elected: Homer K. Spaulding, re-elected as Executive Vice President; Katie Jordan, re-elected as Treasurer; and Jane Russell, Secretary. Speakers included Ms. Easterling and Kris Sadur of Rep. Jan Schakowsky’s office. Terri Gendel, Director of Benefits and Advocacy at AgeOptions, spoke about their Senior Medicare Patrol, a national program to stop Medicare Fraud. To learn more, go to http://bit.ly/gkTfyn.

 

Something on Your Mind? Write Letter, Win Pen!

Is there something you want retirees in your community to know about?  Take a moment to write a letter to the editor, and if it is published, the Alliance will send you a free, union-made “Retirees with the Write Stuff” pen. “Letters to the editor are free and are often widely read,” said Alliance Secretary-Treasurer Ruben Burks, “with the deep-pocketed business interests we are up against, it’s nice to have an option that doesn’t cost money.” Most recently, Dorothy Asbury, Janice Ayres, Charlie Balban, Joseph Boffa, Jo Etta Brown, Sam Burnett, Robert Connett, Homer Craig, Billy Feitlinger, Tony Fransetta, Barbara Franklin, Judy Jobes, Gerald Lotierzo, Beatrice Lumpkin, Nick Makrinos, Reggie Marselus, Steve Skvara, William Stevens, Bill Wallace, and Guy Watson contributed to their local papers. If you have had a letter published lately, please email aracommunications@retiredamericans.org.


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