Posts Tagged ‘medicare

27
Aug
14

Medicare Is Not Destroying The Budget? Thanks, ObamaCare

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David Leonhardt: Medicare: Not Such A Budget-Buster Anymore

You’re looking at the biggest story involving the federal budget and a crucial one for the future of the American economy. Every year for the last six years in a row, the Congressional Budget Office has reduced its estimate for how much the federal government will need to spend on Medicare in coming years. The latest reduction came in a report from the budget office on Wednesday morning. The changes are big. The difference between the current estimate for Medicare’s 2019 budget and the estimate for the 2019 budget four years ago is about $95 billion dollars. That sum is greater than the government is expected to spend that year on unemployment insurance, welfare and Amtrak — combined. It’s equal to about one-fifth of the expected Pentagon budget in 2019. Widely discussed policy changes, like raising the estate tax, would generate just a tiny fraction of the budget savings relative to the recent changes in Medicare’s spending estimates.

In more concrete terms, the reduced estimates mean that the federal government’s long-term budget deficit is considerably less severe than commonly thought just a few years ago. The reduced estimates are also an indication of what’s happening in the overall health care system. Even as more people are getting access to health insurance, the costs of caring for individual patients is growing at a super-slow rate. That means that health care, which has eaten into salary gains for years and driven up debt and bankruptcies, may be starting to stabilize as a share of national spending. The Affordable Care Act, in particular, made significant reductions to Medicare’s spending on hospitals and private Medicare plans, to help subsidize insurance coverage for low- and middle-income Americans.

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08
Aug
14

ObamaCare: Helping Millions? ✓ Strengthening Medicare? ✓

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Alex Wayne: Medicare Reduces Payments For 2015 Hospital Admissions

Medicare, the U.S. program for the elderly and disabled, said payments for hospital admissions would fall $756 million next year as penalties stiffen for patients who return too early. Payments for inpatient services at about 3,400 acute-care hospitals will be cut about 0.6 percent in 2015, the Centers for Medicare and Medicaid Services said in a regulatory filing,

including reductions in funding for hospitals who provide care for many low-income patients, those with too many patients who contract infections while admitted and higher penalties for readmissions within 30 days. The Obama administration has applauded reduced Medicare spending for hospital admissions, a trend encouraged by the Patient Protection and Affordable Care Act that has added 13 years to the life of Medicare’s key trust fund.

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Tony Carrk: Conservatives Want You To Pay More For The Health Plan You Like

The Affordable Care Act, or ACA, is working: The uninsured rate has fallen dramatically since the law went into effect. Newly released data published in The New England Journal of Medicine show that 10.3 million adults gained coverage during the first open enrollment period. According to a recent Commonwealth Fund survey, 60 percent of those with new coverage said they used their coverage to go to the doctor or hospital or to fill a prescription; 62 percent of those people said they would not have been able to do so without their new coverage. Moreover, of those who were looking for a doctor, two-thirds said they were able to get an appointment within two weeks. People are happy with their coverage. Overall, 78 percent of those surveyed said they were either somewhat

satisfied or very satisfied with their new coverage. This is about the same rate as those reported by both people who were previously insured and by those who newly gained coverage. Even 74 percent of self-identified Republicans reported being satisfied with their coverage. The ACA has not only led to millions of Americans getting health care coverage, but it has also benefited the country as a whole. Earlier this month, the nonpartisan Congressional Budget Office, or CBO, reported that the ACA is helping slow the growth rate of health care costs, which has positive consequences for the federal budget. It is also helping strengthen the solvency of Medicare.

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The New England Journal Of Medicine: Health Reform And Changes In Health Insurance Coverage In 2014

In this analysis of nationally representative survey data from January 2012 through June 2014, we found a significant decline in the uninsured rate among nonelderly adults that coincided with the initial open-enrollment period under the ACA. These changes remained highly significant after adjustment for potential confounders such as employment, demographic characteristics, and income. As compared with the baseline trend, the uninsured rate declined by 5.2 percentage points by the second quarter of 2014, a 26% relative decline from the 2012–2013 period. Combined with 2014 Census estimates of 198 million adults 18 to 64 years of age, this corresponds to 10.3 million adults gaining coverage, although depending on the model and confidence intervals,

our sensitivity analyses imply a wide range from 7.3 to 17.2 million adults. Absolute gains were largest among young adults and Hispanics, two groups with high uninsured rates at baseline. We found evidence that within the first 6 months of gaining insurance, more adults reported having a personal doctor and fewer had difficulties paying for medical care — even though the latter measure asked about the prior 12 months. These results are consistent with studies of previous insurance expansions that have shown that gains in coverage can lead to rapid improvements in access. In conclusion, we found that the number of Americans without health insurance declined significantly since the ACA open-enrollment period began in October 2013.

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06
Aug
14

Rise and Shine

On This Day: President Obama greets a young supporter at a campaign rally for gubernatorial candidate Creigh Deeds in Tyson’s Corner Va., on Aug. 6, 2009 (Photo by Pete Souza)

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Today (All Times Eastern)

10:0: The President delivers remarks and participates in Session One of the U.S.-Africa Leaders Summit at the State Department: Investing in Africa’s Future.

12:30: Participates in Session Two: Peace and Regional Stability

2:30: Participates in Session Three: Governing the Next Generation

5:0: Holds a press conference, State Department

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10:0: First Lady Michelle Obama, in partnership with former First Lady Laura Bush and the Bush Institute, will host a day-long spouses symposium at the Kennedy Center focused on the impact of investments in education, health, and public-private partnerships.

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Jonathan Cohn: Obamacare’s Impact On The Uninsured, State By State: Where Officials Wanted It To Work, It Did

Need another reminder of why Obamacare’s impact depends heavily on the state where you live? Gallup has one for you. On Tuesday, the organization published a state-by-state breakdown of how the law has affected the rate of uninsurance, at least according to its polling. Arkansas seemed to make the most progress: In that state, by Gallup’s reckoning, the ranks of the uninsured fell by 10.1 percentage points. Next was Kentucky, at 8.5 percentage points. The states that made the most headway covering the uninsured,

according to Gallup, are states in which officials decided to build their own insurance marketplaces and to make all low-income people eligible for Medicaid, as the Affordable Care Act originally envisioned. The Medicaid expansion is obviously the big factor here, because it meant many more people (into the millions, in the largest states) became eligible for government-subsidized insurance. But it’s safe to assume that the states that undertook both steps were also the ones that put the most thought and effort into promoting the program.

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Michelle Jamrisko: Services In U.S. Expand At Fastest Pace Since 2005

Service industries such as builders and retailers grew in July at the fastest pace since December 2005, signaling the U.S. economy was hitting its stride entering the second half of 2014. The Institute for Supply Management’s non-manufacturing index increased to 58.7, exceeding the highest estimate in a Bloomberg survey of economists, from the prior month’s 56, the Tempe, Arizona-based group’s report showed today. Readings greater than 50 indicate expansion. The median estimate in the Bloomberg survey called for 56.5.

Prospects for the world’s largest economy are improving as the group’s orders index reached an almost nine-year high, reflecting broad-based gains. Combined with another report showing factory bookings are also jumping, the pickup in demand raises the odds the job market will extend its recent progress. “We’re seeing numbers that we haven’t seen since well before the financial crisis and recession, and they seem to be more sustained,” said Terry Sheehan, an economist at Stone & McCarthy Research Associates in Princeton, New Jersey, whose ISM index projection of 57 was among the highest in the Bloomberg survey. The strengthening is “pretty much across the board for business activity, new orders and employment.”

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Shobhana Chandra: Trade Gap Shrinks To Five-Month Low As U.S. Imports Drop

The trade deficit in the U.S. unexpectedly narrowed in June, reflecting the biggest drop in imports in a year as the economy moved closer to energy independence. The gap shrank 7 percent to $41.5 billion, the smallest since January, from May’s $44.7 billion, Commerce Department figures showed today in Washington. The median forecast in a Bloomberg survey of 66 economists called for a deficit of $44.8 billion. The drop in purchases of foreign goods included declines in autos and cellular phones, while petroleum imports were the lowest in more than three years.

Demand for goods made overseas will probably rebound in coming months, helped by growing household spending and business investment. Exports were little changed at a record, a sign markets overseas will represent less growth for American factories as Europe’s economy struggles to pick up and geopolitical tensions mount. “Imports are going to bounce back because of the strength of the U.S. consumer,” said Jay Bryson, global economist at Wells Fargo Securities LLC in Charlotte, North Carolina. “The U.S. is doing better than most advanced countries.”

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Roberto A. Ferdman: Why Immigrants Are The Best Thing That Happened To Medicare

America’s growing immigrant population might not be all that bad for the country’s health-care system. In fact, it’s probably playing an important role in helping to keep it afloat. U.S. immigrants’ net contribution to Medicare’s Hospital Insurance Trust Fund, the program’s core funding source, was $183 billion between 1996 and 2011. US-born Americans? Negative $69 billion, according to a new report by the Partnership for the New American Economy, an immigration advocacy group. That means that immigrants have been pumping a lot more money in than they take out, while the rest of the population has been doing just the opposite. On a per person basis, immigrants contributed $62 more per person to the trust fund than the U.S.-born, and claim $172 less in benefits.

By the institute’s estimates, the cash contributed by immigrants over the 16-year span was more than a mere inconsequential boost. “Our analysis indicates that non-citizen immigrants, a group that includes both authorized and unauthorized immigrants, played a particularly large role subsidizing the care of the U.S.-born population,” the report says. The net $183 billion contribution was enough to ensure the prolonged buoyancy of Medicare trust fund, which according to the most recent projection will remain solvent through 2030.

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On This Day

President Obama carries a cake into the Oval Office for a birthday party for Phil Schiliro, assistant to the president for legislative affairs, on Aug. 6, 2009 (Photo by Pete Souza)

President Obama waits to speak at a campaign rally for gubernatorial candidate Creigh Deeds in Tyson’s Corner Va., on Aug. 6, 2009 (Photo by Pete Souza)

President Obama waits backstage to speak at a reception in Tyson’s Corner Va., for gubernatorial candidate Creigh Deeds, on Aug. 6, 2009 (Photo by Pete Souza)

 President Obama speaks at a campaign rally for gubernatorial candidate Creigh Deeds in Tyson’s Corner Va., on Aug. 6, 2009 (Photo by Pete Souza)

President Obama shakes hands at a reception in Tyson’s Corner Va., for gubernatorial candidate Creigh Deeds, on Aug. 6, 2009 (Photo by Pete Souza)

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President Obama walks into the Oval Office with newly confirmed Supreme Court Justice Elena Kagan, Aug. 6, 2010 (Photo by Pete Souza)

President Obama signs Elena Kagan’s commission in the Oval Office, before a reception in the East Room celebrating her confirmation to the Supreme Court, Aug. 6, 2010 (Photo by Pete Souza)

President Obama visits with Supreme Court Justice Ruth Bader Ginsburg and newly confirmed Supreme Court Justice Elena Kagan in the Blue Room of the White House, prior to Kagan’s confirmation reception in the East Room, Aug. 6, 2010 (Photo by Pete Souza)

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President Obama is briefed on the tragedy in Afghanistan by Defense Secretary Leon Panetta, Adm. Mike Mullen, Chairman of the Joint Chiefs of Staff, National Security Advisor Tom Donilon, Chief of Staff Bill Daley, and national security staff, at Camp David, Aug. 6, 2011 (Photo by Pete Souza)

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Members of the press document President Obama during the Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012 signing ceremony in the Oval Office, Aug. 6, 2012. (Official White House Photo by Sonya N. Hebert)

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President Obama takes the stage to deliver remarks on housing and home ownership at Desert Vista High School in Phoenix, Ariz., Aug. 6, 2013 (Photo by Pete Souza)

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President Obama joins Jay Leno for a taping of the “The Tonight Show with Jay Leno” in Burbank, Calif., Aug. 6, 2013 (Photo by Pete Souza)

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04
Aug
14

ObamaCare: Helping Medicare Function Efficiently

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Sara Kliff: The Amazing News Buried Inside A 283-Page Medicare Report

This is arguably the most unexpected piece of news in the new Medicare Trustees report: the government’s hospital insurance program might be spending less money to cover more beneficiaries than it did a year ago. Medicare’s hospital insurance program — known to wonks as Medicare Part A — spent $266.8 billion covering 50.3 million people in 2012. In 2013, the the same program spent $266.2 billion to cover 51.9 million people. what’s definitely clear — and what’s driving this trend — is that Medicare is spending significantly less per person than they did two years ago.

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And this report expects that trend to continue for another two years going forward. By 2015, the Medicare Trustees’ Report projects that the program will spend less per person on hospital care than it did in 2008. This doesn’t happen much in health care: not just slower growth, but the actual dollar amount spent on a given type of care dropping. The Affordable Care Act, for example, penalizes preventable readmissions — times when seniors turn up at the hospital a second time after something goes wrong during their first visit. Readmissions have been falling pretty steadily for the last few years, and those reductions could be showing up in the lower per-person spending.

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30
Jul
14

ObamaCare: Making Medicare Stronger For Future Generations

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White House: Medicare Trustees Report Shows Significant Improvements For Seniors And Taxpayers

Today’s annual report from the Medicare program’s Boards of Trustees brings good news about the program’s financial future: Its Trust Fund will last four more years, to 2030, and projected Part B premiums for 2015 will not increase for the second year in a row. As we celebrate Medicare’s 49th birthday this week, we will recommit to ensuring that the program continues providing health and economic security for the nation’s elderly and people with disabilities through the 21st century and beyond. Today’s news shows that we are on the right track, and we are optimistic that the promising results we’ve seen in recent years can continue into the future. In 2009, the Trustees projected the Hospital Insurance Trust Fund would not be able to pay its bills in 2017 – just three years from now. Today’s new date is 2030, 13 years later than that projection – an improvement that is thanks in part to reforms in the Affordable Care Act (Chart 1).

The law implemented changes to promote value-based payments, reduce waste and fraud, and strengthen the program’s benefits. These changes, for example, have reduced hospital spending on preventable readmissions, helping to lower hospital costs, which constitute a significant portion of trust fund spending. Lower Medicare spending means lower cost sharing and lower premiums for Medicare beneficiaries. For the second year in a row, premiums in Part B are projected to stay the same in 2015 as in 2013 and 2014. This means seniors are expected to keep more of their annual Social Security cost of living adjustment. In fact, the last six years have seen some of the slowest premium growth in the program’s history. Moreover, the Affordable Care Act has saved millions of beneficiaries over $10 billion in prescription drug costs by improving prescription drug benefits and closing the “donut hole.”

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Sahil Kapur: Obamacare Will Help Medicare Remain Solvent Even Longer, Trustees Report Says

The Medicare insurance trust fund will be solvent until 2030, four years longer than projected last year, according to a trustees report released Monday. The trustees report chalked up the new projection to the recent slowdown in health spending growth and various cost-saving reforms enacted under Obamacare. “In recent years U.S. national health expenditure (NHE) growth has slowed relative to previous historical patterns,” the report read.

It added: “The Board assumes that the various cost-reduction measures … will occur as the Affordable Care Act requires.” (Obamacare has been credited in recent years with extending the life of Medicare beyond 2016, the year it was projected to go in the red prior to the ACA’s enactment.)

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Amy Goldstein: Medicare Finances Improve Partly Due To ACA, Hospital Expenses, Trustee Report Says

Medicare’s financial stability has been strengthened by the Affordable Care Act and other forces that have been subduing health-care spending, according to a new official forecast that says the fund covering the program’s hospital costs will remain solvent until 2030 — four years later than expected a year ago. The trustees’ forecast said that the trust fund that pays for hospital care — Medicare Part A — has been strengthened significantly,

with the date when it is predicted to start running short of money extended by 14 years since the Affordable Care Act was enacted in 2010. The report also predicted that the insurance premiums that older Americans pay for the portion of Medicare that covers doctors’ visits and other outpatient care would probably remain the same for a third year in a row.

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11
Jul
14

ObamaCare: Preserving Medicare For Future Generations

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Mother Jones: Medicare Just Keeps Producing Great Budget News

Medicare has been a bastion of good news lately. Every year, the CBO reduces its baseline estimate of Medicare costs, which have dropped by more than $1,000 since 2010. It is clear that the Medicare savings provisions in the ACA, such as reductions in provider payment updates and Medicare Advantage payments, have played a major role. In addition to scheduled reductions in Medicare’s more formulaic payment rates, providers may be tightening their belts and looking to deliver care more efficiently in response to financial incentives included in the ACA, and it is possible that these changes are having a bigger effect than expected.

For example, CMS recently reported that hospital readmission rates dropped by 130,000 between January 2012 and August 2013. It is also possible that hospitals and other providers are using data and other analytic tools more successfully to track utilization and spending and to reduce excess costs. Another more straightforward factor is that several expensive and popular brand-name drugs have gone off patent in recent years, which has helped to keep Medicare drug spending in check.

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