In response, the GOP is doubling down on the idea that today’s seniors won’t be affected. That’s partly true. Ryan’s plan to convert Medicare into a limited insurance subsidy, the most controversial aspect of the budget, wouldn’t take effect until 2022.
But the proposal would also repeal last year’s health care law, which means reopening a coverage gap in Medicare’s prescription-drug benefit that the statute closed. The gap, commonly called the “doughnut hole,” requires seniors to pay 100 percent of any prescription costs after the annual total reaches $2,840 and until it hits $4,550. Those who spend more or less have at least three-quarters of the costs covered. Under the 2010 health law, Medicare will pay 7 percent of the cost of generic drugs and 50 percent on name-brand pharmaceuticals; by 2020, the doughnut hole will be closed.
If Congress were to pass Ryan’s plan and repeal the law, as House Republicans want, the 3 million to 4 million seniors left in the doughnut hole each year would immediately face significant out-of-pocket costs. They and all other Medicare beneficiaries would also lose access to a host of preventative-care benefits in the health care law, including free wellness visits to physicians, mammograms, colonoscopies, and programs to help smokers quit.Perhaps more jolting, the Republican budget would cut spending on Medicaid—health care for the poor—much of which goes to long-term care for the elderly. Some 9 million seniors qualify for both Medicare and Medicaid benefits, and about two-thirds of all nursing-home residents are covered by Medicaid. The GOP budget proposes cutting some $744 billion from Medicaid over 10 years by turning the system into block grants that limit federal contributions and give states more choice in structuring benefits. No one knows exactly which Medicaid services states would choose to cut back, but senior citizens account for a disproportionate share of Medicaid outlays and would almost certainly bear some of the burden.
“We know that two-thirds of the dollars in Medicaid go to people who are disabled or over 65, so this is the big funder of long-term care in this country,” said David Certner, AARP’s legislative-policy director. “We also know this could have an impact on home- and community-based care, which is the kind of care individuals prefer the most [and] often the ones that will be cut first.”
Ah, but big Republican donors often own nursing home chains, so I’m sure it’ll all work out!
I would add that as soon as there are actual people on the Ryan voucher plan, the Repubs will begin screaming bloody murder about the unfairness of those on traditional Medicare getting all that government help while others suffer. Those on trad Medicare will be referred to as leeches, greedy geezers, suckers on the government teets, and any other number of Repub negative terms for anyone helped by the social safety net.
If Obama puts into effect “changes” to Medicare and/or SocSec it will mean the death of the Democratic Party. And, as of now, what Obama and the ConservaDems will do or are thinking about doing is totally undefined and undeclared* — and that’s how Obama works: in secret, behind closed doors, making covert agreements.
I don’t know what the Neolib, Corporatist, Free-Market loving branch of the party will call itself; it may well try to keep the name and work to continue to scam the voters. But the progs and libs and Democratic base voters will be gone.
Where they’ll go…completely up in the air as of now.
*When Congressional Dems, who are big supporters of Obama, say anything about not changing Medicare, there’s usually some kind of weasel wording involved. Such as: We will never change Medicare to a voucher plan. Wellllll…what might they change it to? Older retirement age? Higher co-pays?
Another aside: I just completed choosing my Medigap plan. I’d been looking at Medicare Advantage plans here in NJ and had been trying to find out what and how things were covered. It reminded me all over again how difficult it is to get any usable information out of health insurance company representatives.
In trying to figure what my costs would be between Medigap, which picks up the 20% Medicare doesn’t cover and with a Part D prescription plan, and a Medicare Adv plan with co-pays for doctors, prescriptions, etc., but with vision and dental, I kept running into vague answers to almost every question. Were my endocrinologist administered shots needed for the annual thyroid cancer checkup, a nuke medicine scan using radiaoactive iodine to see where there might be stray thyroid, possibly cancerous, cells in my body, I would be told any number of things: depends on your doctor, ask your doctor, get us the diagnostic code and we can possibly check, we can’t tell until we get the doctor’s billing, ask Medicare, ask the insurance company. Round and round.
I finally nailed down that these shots, administered by a doctor, were covered by Part B — 98% certain. Ah, that 2% could be expensive however…. And I could not get a definitive answer from the Med Adv carrier.
Then came how lab work, other diagnostic tests were covered. Under Medigap, 100%, no worries. Under Med Adv, depends. It would be between $35 and $125 for each test, if it’s covered….
I was hoping Med Adv would work for one year – well, the rest of this year, at least. I was hoping that with the lower monthly rate I could pay down what I owe on my hospitalization from last summer. But, it was just too dicey.
I ended up choosing AARP Medigap with 100% coverage and an RX plan which doesn’t cover Armour Thyroid pills and one of my nasal sprays (which is generic even!, but I’ve been through so many and this one works). Any name brand drug is a $35 co-pay for 30 days, generic $7 for 30 days. To get 90 day fills, I have to use their mail order service — at no difference for name brand and a minor saving for generics. Some local drug stores have some generics for less than the co-pay within the plan. Go figure.
Since there are financial penalties for not taking the prescription plan when one begins Medicare, I chose the cheapest plan available since none covered the Armour Thyroid.
As of 2011, my monthly Medicare costs will be almost exactly $300 a month, one-fourth of what my individual plan cost last year (it would be higher this year). Plus, there will be the uncovered prescriptions and the co-pays. But, still, this so much better than individual insurance.
Given that currently insurers don’t want to cover seniors without their being on Medicare, I can’t imagine how far that Ryan voucher will go toward coverage.
Hard times ahead, I fear.
Last night I woke up and caught the last 40 minutes of a The American Experience about the CCC, FDR’s Civilian Conservation Corps.
I actually had tears about how ineffectual our current Dem president and Congress Dems are in the face of our worst economic downturn since the Great Depression and how much FDR did with for the people of the time, for genuine hope for the people, for our environment and national part infrastructure, for feeding, clothing and educating young men, black and white (albeit in separate camps after the first were integrated.
It may have even helped us to succeed in WWII. It was run by the Army, whose leaders at first were resistant to what FDR wanted them to do, but apparently the men who came out of the CCC were up to speed almost immediately in the regular military.
What a terrible thing to lose such an opporunity to help people, help the nation, all because of the Neolib Corporatists and their free-market obsessions. Well, that and knowing where the money is….
It can be watched online at PBS.
You can count on it like the sun rising in the east . . . any plan from our corporately co-opted congress critters will fuck everyone no matter what it says.
Oh and BTW, the way out of the Great Depression wasn’t war, it was practically full employment. Unfortunately, war is the only thing that conservatives support. They hate paying working men and women anything, but if a bunch of middle class Americans are going to die in the process they consider it a wash and are all for it.