Medicare Blog

how did the 2003 medicare bill assist the private sector?

by Ms. Kianna Gibson DDS Published 2 years ago Updated 1 year ago
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In a 54-44 vote, the Senate approves the most sweeping changes to Medicare in the program's 38-year history. The $400 billion bill adds a prescription drug benefit to Medicare and encourages private-sector competition. The bill's passage is seen as a key political victory for President Bush.

Full Answer

What is the Medicare Modernization Act of 2003?

Today the President signed into law the historic Medicare Prescription Drug, Improvement, and Modernization Act of 2003, which will help to create a modern Medicare system, allow for the biggest improvements in senior health care in nearly 40 years, and provide seniors with prescription drug benefits and more choices in health care.

What is Title 1 of the Medicare Prescription Drug Improvement Act 2003?

Medicare Prescription Drug, Improvement, and Modernization Act of 2003 - Title I: Medicare Prescription Drug Benefit (Sec. 101) Amends title XVIII (Medicare) of the Social Security Act (SSA) to add a new part D (Voluntary Prescription Drug Benefit Program).

How many summaries are there for the Medicare Prescription Drug Improvement Act?

There are 3 summaries for H.R.1. Bill summaries are authored by CRS. Medicare Prescription Drug, Improvement, and Modernization Act of 2003 - Title I: Medicare Prescription Drug Benefit (Sec. 101) Amends title XVIII (Medicare) of the Social Security Act (SSA) to add a new part D (Voluntary Prescription Drug Benefit Program).

What's in Bush's Medicare reform bill?

WASHINGTON (CNN) -- President Bush on Monday signed into law landmark Medicare reform legislation that includes prescription drug benefits and has sparked a bitter fight between opponents and supporters.

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What are the implications of the Medicare Modernization Act of 2003?

The 2003 Medicare Modernization Act (MMA) is considered one of the biggest overhauls of the Medicare program. It established prescription drug coverage and the modern Medicare Advantage program, among other provisions. It also created premium adjustments for low-income and wealthy beneficiaries.

What was the impact of the Medicare prescription drug and Improvement Act of 2003?

Today the President signed into law the historic Medicare Prescription Drug, Improvement, and Modernization Act of 2003, which will help to create a modern Medicare system, allow for the biggest improvements in senior health care in nearly 40 years, and provide seniors with prescription drug benefits and more choices ...

What was the biggest change to Medicare brought about by the 2003 Medicare Modernization Act?

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 was enacted in November 2003 and became effective on January 1, 2006. Two major changes occurred. A prescription drug benefit is now available for seniors and younger persons with disabilities who are covered by Medicare.

What Medicare plan did the Medicare Modernization Act of 2003 add and what does this plan cover?

On December 8, 2003, President George W. Bush (R) signed the Medicare Prescription Drug, Improvement, and Modernization Act (P.L. 108–173), which authorizes Medicare coverage of outpatient prescription drugs as well as a host of other changes to the program.

What was the impact of the Medicare Prescription Drug Improvement and Modernization Act quizlet?

What was the impact of the Medicare Prescription Drug Improvement and Modernization Act? The Act created Medicare Part D, the drug prescription program.

What came out of the Medicare Prescription Drug Improvement and Modernization Act?

Since the enactment of Medicare Prescription Drug, Improvement, and Modernization Act in 2003, only insurance companies administering Medicare prescription drug program, not Medicare, have the legal right to negotiate drug prices directly from drug manufacturers.

What was the impact of the Durham Humphrey Amendment?

This amendment established the distinction between so-called legend (prescription) drugs and over the counter (nonprescription) drugs. The amendment also authorized the taking of prescriptions verbally, rather than in writing, and the refilling of prescriptions.

Why was Medicare Part D established?

Medicare Part D, also called the Medicare prescription drug benefit, is an optional United States federal-government program to help Medicare beneficiaries pay for self-administered prescription drugs. Part D was enacted as part of the Medicare Modernization Act of 2003 and went into effect on January 1, 2006.

When was Medicare Part D implemented?

January 1, 2006In 2003 the Medicare Modernization Act created a drug benefit for seniors called Part D. The benefit went into effect on January 1, 2006.

What did President Bush do for Medicare?

Improved the quality of health care for Medicare beneficiaries by adding preventive screening programs to help diagnose illnesses earlier. Increased competition and choices by stabilizing and expanding private plan options through the Medicare Advantage program, and increased enrollment to nearly 10 million Americans.

Why did the states sue the federal government over the passage of the Affordable Care Act?

Why did states sue the federal government over the passage of the Affordable Care Act? a. States questioned the constitutionality of requiring individuals to purchase healthcare insurance.

What does MMA stand for in Medicare?

The Medicare Modernization Act (MMA) included three polices to limit the financial. risks that Part D prescription drug plans (PDPs) must bear.

Why did opponents try to stop the bill?

Why opponents tried to stop the bill. Those who refused to vote for the bill saw it as a sweetheart deal for drug-makers and insurers. Medicare wouldn't be able to bargain for better prices with pharmaceutical companies, but would be sending many more customers their way.

What is the purpose of the XVIII Act?

Official Title: An act to amend title XVIII of the Social Security Act to provide for a voluntary prescription drug benefit under the medicare program and to strengthen and improve the medicare program, and for other purposes .

What items were reduced in the 2005 Medicare payment?

Provides that for 2005 the payment amount for certain items, oxygen and oxygen equipment, standard wheelchairs, nebulizers, diabetic lancets and testing strips, hospital beds and air mattresses, will be reduced.

What is the federal income tax rate for 2004?

Provides that starting April 1, 2004 through September 30, 2004, payment will be based on a 62.5 percent Federal amount and a 37.5 percent local amount, and that starting October 1, 2004, payment will be based on a 75 percent Federal amount and a 25 percent local amount.

What is a FEHBP?

Requires the Secretary to apply such coordination requirements to described Rx plans, which include Medicaid programs and group health plans and the Federal Employees Health Benefit Program (FEHBP), in the same manner as such requirements apply to a State Pharmaceutical Assistance Program.

Abstract

Context: Twenty-five years ago, private insurance plans were introduced into the Medicare program with the stated dual aims of (1) giving beneficiaries a choice of health insurance plans beyond the fee-for-service Medicare program and (2) transferring to the Medicare program the efficiencies and cost savings achieved by managed care in the private sector..

Trailing the Private Sector, 1985–1997

The reason that Medicare expanded to include risk-based private plans was to share the gains realized from managed care in other settings.

Failed Attempt at Savings: 1997–2003

The BBA's goals with respect to Medicare Advantage can be summarized in the following question: Could Medicare Advantage be reformed so that Medicare could participate in the managed care dividend enjoyed by private employers? In the latter half of the 1990s, Republicans (the new congressional majority), centrist Democrats, and some policymakers began to look to Medicare as a source for reducing the deficit ( Oberlander 2003 ).

Medicare Spends Its Way out of Trouble: 2003–2010

The 2003 Medicare Modernization and Improvement Act (MMA) established a larger role for private health plans in Medicare largely based on a shift away from a focus on cost containment and regulation and toward the “accommodation” of private interests (e.g., the pharmaceutical and insurance industries) and an ideological preference for market-based solutions that stemmed from the Republican control of both the executive and legislative branches of government ( Oberlander 2007 ).

Achieving MA's promise? 2010 and Beyond

The ACA, signed into law by President Obama in March 2010, included another major restructuring of the MA program and significant cuts in MA plan payments. Specifically, for 2011, the payment benchmarks against which plans bid are frozen at 2010 levels.

Acknowledgments

The authors gratefully acknowledge funding from the National Institutes on Aging through P01 AG032952, The Role of Private Plans in Medicare. Joseph Newhouse wishes to disclose that he is a director of and holds equity in Aetna, which sells Medicare Advantage plans.

Endnotes

1 Excellent quantitative summaries of the Part C experience are available from the Medicare Payment Advisory Commission (MedPAC), through its annual reports ( http://www.medpac.gov ), and from other researchers (e.g., see Gold 2005, 2007, 2009; Zarabozo and Harrison 2009 ).

What is the President's action on Medicare?

Today the President signed into law the historic Medicare Prescription Drug, Improvement, and Modernization Act of 2003, which will help to create a modern Medicare system, allow for the biggest improvements in senior health care in nearly 40 years, and provide seniors with prescription drug benefits ...

How many seniors are covered by Medicare?

For the first time in Medicare's history, a prescription drug benefit will be offered to all 40 million seniors and disabled Americans in Medicare to help them afford the cost of their medicines.

How much money would a senior save with no drug coverage?

Seniors with no drug coverage and monthly drug costs of $200 would save more than $1,700 on drug costs each year. Seniors with no drug coverage and monthly drug costs of $800 would save nearly $5,900 on drug costs each year.

How much does Medicare cover for seniors?

Seniors would be protected again high out-of-pocket costs with Medicare covering 95% of drug costs over $3,600 per year. Low-income seniors will receive additional help paying for their medicines. A $600 annual subsidy would be added to their drug discount card.

What percentage of Medicare subsidy is required by the Trustees?

For the first time ever, the legislation will require the Medicare Trustees to analyze the combined fiscal status of the Medicare Trust Funds and warn Congress and the President when Medicare's general fund subsidy exceeds 45 percent.

Will seniors have more choices in health care?

Seniors will have more choices in health care-including the same kinds of choices that members of Congress and other federal employees enjoy today. Seniors will be able to choose the health care plan that best fits their needs-instead of having that choice made by the government.

Can seniors get Medicare?

Seniors can choose to stay in traditional Medicare and still get prescription drug coverage. Or, they can choose a new Medicare-approved private plan where the drug benefit is integrated into broader medical coverage, including disease management programs and protections against high out-of-pocket medical spending.

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