If President Obama’s rhetoric on domestic policy can be said to
have a coherent theme, it involves his desire to use government to
create a level playing field in which no single segment of the
electorate enjoys unfair advantages or suffers disproportionate
disadvantages in the pursuit of happiness. He is particularly
concerned, he tells us, that the “rich” pay their fair share while
poor and minority Americans receive their just due. Somehow,
though, every policy decision made by his administration seems to
tilt the playing field against the latter.
The latest example of this curious phenomenon can be found in
the recent
announcement by the Centers for Medicare and Medicaid Services
(CMS) that it plans to cut an extra 2.2 percent from the Medicare
Advantage (MA) program. This new cut, which came as a surprise to
everyone except Obama’s health care commissars, will be added to
the $200 billion in cuts Obamacare has already mandated for MA.
What does this have to with low-income and minority seniors? The
administration’s new Medicare cuts will come directly out of their
pockets.
MA is a health coverage vehicle created for seniors as part of
the Medicare Modernization Act of 2003. It permits private health
plans to provide Medicare coverage to seniors and requires these
carriers to compete with one another for the business of retired
Americans looking for an affordable alternative to traditional
fee-for-service Medicare. One of the ways in which MA plans compete
is by offering comprehensive coverage that requires low
out-of-pocket expenses, a feature that would obviously appeal to
anyone on a modest fixed income.
It will come as no surprise, then, that every serious study of
MA has shown the program to be increasingly popular among
low-income and minority seniors. Unfortunately, the Obama
administration’s surprise rate cuts amount to an old fashioned
bait-and-switch. The MA plans are already taking a huge hit
pursuant to Obamacare’s $200 billion cut, and they will be unable
to absorb these newest slashes in the program without passing at
least some of the costs to the patients in the form of increased
co-pays and deductibles.
And it is by no means an exaggeration to say that these extra
out-of-pocket costs will hit the seniors who can least afford them.
America’s Health Insurance Plans (AHIP), a trade group to which
many MA carriers belong, recently issued a
report confirming that reality: “Sixty-one (61) percent of all
minority (nonwhite) beneficiaries enrolled in Medicare Advantage in
2011 had incomes of $20,000 or less; 59 percent of African-American
and 75 percent of Hispanic Medicare Advantage beneficiaries had
incomes of $20,000 or less.”
Considering the percentage of Hispanic beneficiaries that will
be affected, it is not surprising that the CMS announcement
elicited a quick and unfavorable response from Senator Marco Rubio.
And last Friday, a bipartisan group of more than 90 House members
joined Georgia Democrat John Barrow and Louisiana Republican Bill
Cassidy in
demanding that CMS abandon the cuts: “This reduction in funding
will leave many vulnerable seniors with fewer benefits, higher
out-of-pocket costs, and in some cases the loss of their current MA
coverage.”
It will indeed. As AHIP reminds us, “The Congressional Budget
Office projects that the reform law’s payment cuts alone will
result in three million fewer people enrolled in Medicare
Advantage.” The group goes on to point out that Obamacare is
already expected to increase the out-of-pocket expenses endured by
MA enrollees: “Actuaries at Oliver Wyman estimate that the health
insurance tax will result in seniors facing $220 in higher
out-of-pocket costs and reduced benefits next year and $3,500 in
additional costs over the next ten years.”
Why is an administration allegedly committed to “fairness” and
preventing the evil Republicans from “ending Medicare as we know
it” proposing such Draconian cuts? In addition to the President’s
absurd belief that he can fix Medicare’s gigantic unfunded
liability by such cuts, there is his capitalism “problem.” That MA
has made successful use of free market competition is anathema to
his socialistic view of economics and undermines his primary
justification for imposing a government-run health care system on
the country.
So, Medicare Advantage has to be slowly throttled to death,
regardless of the harm done to the most vulnerable people in our
society. If low-income seniors must pay higher Medicare
deductibles, that’s just the breaks. If African-American and
Hispanic seniors are herded back to traditional Medicare against
their will, so be it. Obama’s CMS bureaucrats don’t put it that
way, of course. Their announcement suggests they feel for their
victims: “We appreciate that plans are facing several legislatively
mandated changes affecting payment for 2014.”
They will, of course, “solicit comment on ways to modify
requirements to improve opportunities for administrative
efficiencies while improving delivery of care.” But, in the end,
they will respond to such comments just as they responded to the
avalanche of protests they received concerning the contraception
mandate — they will disregard them. Obama and his apparatchiks
believe they own the playing field, and they plan to tilt it until
the nation has been fundamentally transformed.
Photo: WhiteHouse.gov
