How radical are the changes to Medicare under the Trump administration?
This post is coauthored by Lawrence J. Wedekind. The Trump administration is making fundamental changes to the Medicare program. These reforms are every bit as radical as the changes we have seen in federal policy governing employer-provided coverage and the market for individual insurance.
What are the harmful changes to Medicaid under the Trump administration?
Trump Administration’s Harmful Changes t... President Trump has made clear that his goal remains to repeal the Affordable Care Act (ACA), including its expansion of Medicaid to low-income adults, and to impose rigid caps on the federal government’s Medicaid spending.
What changes can the Trump administration make to Obamacare?
More recently, the Trump administration told states that they could apply for waivers to make more substantial changes to their Obamacare marketplaces, including altering the rules for who is eligible for federal help paying monthly premiums. These premium subsidies are essential to keeping Obamacare functioning, experts say.
What has the Trump administration done for health care?
Along with chipping away at the landmark Affordable Care Act, the Trump administration has made a historic and controversial change to Medicaid, allowing states to require many participants who gained coverage through Obamacare to work or lose their benefits. Another major focus of the President: the cost of drugs.
When will CMS change the star rating?
Additionally, CMS adopted a series of changes in the March 31, 2020, Interim Final Rule with Comment Period (CMS-1744-IFC) for the 2021 and 2022 Star Ratings to accommodate challenges arising from the COVID-19 public health emergency.
Does Medicare have telehealth?
The Centers for Medicare & Medicaid Services today finalized requirements that will increase access to telehealth for seniors in Medicare Advantage (MA) plans , expand the types of supplemental benefits available for beneficiaries with an MA plan who have chronic diseases, provide support for more MA options for beneficiaries in rural communities, and expand access to MA for patients with End Stage Renal Disease (ESRD). Together, the changes advance President Trump’s Executive Orders on Protecting and Improving Medicare for Our Nation’s Seniors and Advancing American Kidney Health as well as several of the CMS strategic initiatives.
Can ESRD be covered by Medicare?
Today’s rule gives beneficiaries with ESRD more coverage choices in the Medicare program. Previously, beneficiaries with ESRD were only allowed to enroll in MA plans in limited circumstances.
What are Trump's changes to contraceptive coverage mandate?
The first one would allow non-profit and for-profit employers, including publicly traded companies, to receive an exemption based on their religious beliefs. The second would let all but public companies obtain an exemption based on moral objections.
What did Trump do to weaken the Affordable Care Act?
Trump made his first move to weaken the Affordable Care Act only hours after his inauguration, signing an executive order directing agencies to interpret regulations as loosely as possible and to minimize the financial burden of the law through waivers, exemptions or delays.
Why are premium subsidies important?
These premium subsidies are essential to keeping Obamacare functioning, experts say . Trump officials say their moves are aimed at providing greater access to more affordable health insurance options. They are particularly concerned about younger Americans and those who earn too much to qualify for federal subsidies.
How many states have imposed work requirements on Medicaid recipients?
So far, eight states have received permission to do so, and more applications are under review.
How many people signed up for the Affordable Care Act in 2019?
Some 8.4 million people signed up on the federal exchange for 2019. Still, that’s down from roughly 9.2 million who picked plans for 2017. Much of the drop stems from fewer new consumers selecting policies. The Trump administration plans to make even more changes to the Affordable Care Act for the coming year.
How much did the drug price increase in 2019?
Companies do appear to be tempering their hikes in 2019, however. The average increase was 6.3%, down from nearly 9% a year ago, taking into account different dosages of the same drug.
Has Trump repealed Obamacare?
President Donald Trump hasn’t fulfilled his campaign promise to repeal Obamacare outright, but he’s fundamentally reshaped the debate over health care in America in myriad ways during his two years in office. Along with chipping away at the landmark Affordable Care Act, the Trump administration has made a historic and controversial change ...
1. Pay doctors a flat fee
One of the more controversial changes to Medicare, this move would pay doctors who accept Medicare a flat fee. Medicare providers currently charge patients based on the level of care received during their appointment, but this proposal would change that. Instead, it would pay doctors a flat fee no matter what kind of appointment the patient had.
2. Add step therapy protocol to Medicare Advantage drug plans
Another controversial move of the administration is to add step therapy protocol to Medicare Advantage drug plans. Step therapy protocol means patients would need to try cheaper versions of medication before trying more expensive versions. Drugs under the step therapy protocol are usually physician-administered drugs covered under Part B.
3. Limit payments to doctor offices on hospital grounds
Medicare pays more for patients seen by a doctor whose office is located in a hospital or hospital-owned facility. Medicare’s proposal is to pay a flat fee for “site-neutral” appointments, meaning Medicare would pay the same amount no matter where a patient is seen.
4. Increase accountability for Accountable Care Organizations
Medicare Accountable Care Organizations (ACOs) were established by the Affordable Care Act. ACOs are composed of groups of doctors, hospitals, and other healthcare providers who voluntarily work together to coordinate patient care and reduce healthcare costs.
How did Obamacare change the Medicaid program?
Obamacare fundamentally changed the Medicaid program by allowing states to add non-disabled, non-aged adults to their Medicaid rolls. The law also favored these “expansion adults” over such traditional populations as the elderly, people with disabilities, children, and pregnant women.
What is the Trump administration's final rule on health insurance?
The rule allows employers to establish accounts that their workers can use to purchase individual health insurance policies.
Why is Obamacare portable?
Because workers will own their insurance policies, their coverage will be portable, moving with them from job to job. The Trump administration moved to allow states to make innovative reforms as well. Section 1332 of the Obamacare statute permits states to obtain waivers from some of the law’s restrictions.
How much will the premiums fall in 2020?
Premiums are estimated to fall by 5.9% to 19.8% in these states.
How did conservatives block the expansion of the federal role in health care?
Conservatives blocked this expansion of the federal role in health care by demonstrating that through regulatory relief, states could lower health care premiums, protect the poor and sick, and stabilize private markets—all without spending a single new federal taxpayer dime.
When did the IRS stop imposing penalties on the uninsured?
In December of that year, Congress did enact a tax reform bill that eliminated the tax penalty on the uninsured. That change, effective January 2019, meant that Americans who were priced out of the individual health insurance market by Obamacare would no longer face IRS penalties.
Did Congress leave Obamacare?
Aside from this measure of relief, however, Congress chose to leave Obamacare largely intact. Some in both political parties favored doubling down on the law, seeking tens of billions in additional federal “bailout” payments to insurers that sell through health care exchanges.
What is Trump's record on Medicare?
Trump is building on a three-year record of success, particularly in stewardship of the Medicare Advantage program. His administration has promoted regulatory flexibility that has unleashed market forces in Medicare Advantage, which will secure better care and savings for seniors, as well as savings for taxpayers.
What is the administration doing to improve Medicare?
The administration is doing all in its power under existing law to improve Medicare for beneficiaries and taxpayers. Congress must build on what the president has begun and make further reforms.
What is the President's executive order on Medicare?
President Donald Trump is making an ambitious move to build on a string of regulatory relief actions that “protect and improve” Medicare, the federal health care program that serves approximately 60 million senior and disabled persons. The president’s executive order, issued Thursday, is yet another step following a roadmap that’s leading ...
When will Medicare be insolvent?
The initial indicator of trouble is the deteriorating state of the traditional Medicare hospitalization program (Part A), which faces insolvency as early as 2026, meaning that the program will not be able to pay for all of its promised hospital benefits.
What is Section 3 of the Medicare Supplemental Benefits Act?
Importantly, Section 3 of the order envisions a rule change in the provision of Medicare Advantage supplemental benefits that would “allow Medicare beneficiaries to share more directly in the savings of the program,” including “cash or monetary rebates” that would encourage seniors to seek and secure “high value” care.
What is Trump's goal with Medicaid?
President Trump has made clear that his goal remains to repeal the Affordable Care Act (ACA), including its expansion of Medicaid to low-income adults, and to impose rigid caps on the federal government’s Medicaid spending. While Congress considered and rejected a series ...
When will DHS reject Medicaid?
Beginning February 24, 2020, DHS immigration officials will be able to reject immigration applicants if they have received, or are judged likely to receive in the future, any of an array of benefits, including Medicaid. Timing for the DoS implementation of the policy has not yet been announced.
How does a block grant waiver affect health insurance?
States with block grant waivers could deny coverage for prescription drugs, allow states to impose higher copayments on people in poverty , and waive standards for managed care plans (which many states use to provide Medicaid coverage).
How many people in Arkansas lost medicaid in 2018?
In Arkansas, over 18,000 Medicaid beneficiaries — almost 1 in 4 subject to the new rules — lost coverage in 2018 as a result.
How many children would lose Medicaid in 10 years?
After ten years, more than 300,000 children would lose comprehensive coverage ...
What would happen if the poverty line was lowered?
By lowering the poverty line, that proposal would ultimately cut billions of dollars from federal health programs and cause millions of people to lose their eligibility for, or receive less help from, these programs. Many programs, including Medicaid and CHIP, use the poverty line to determine eligibility and benefits, and the cuts to these programs — and the numbers of people losing assistance altogether or receiving less help — would increase with each passing year. After ten years, more than 300,000 children would lose comprehensive coverage through Medicaid and CHIP, as would more than 250,000 adults covered through the ACA Medicaid expansion. Some pregnant women, low-income parents in non-expansion states, and people receiving family planning services through Medicaid would also lose coverage.
What would happen if the federal government capped funding?
Moreover, capped federal funding would shift financial risk to states, with federal funding cuts most likely to occur when states can least absorb them — such as during recessions, public health emergencies, and other times when states face both high demand for coverage and strain on other parts of their budgets.
