Is Medicare's hospital insurance trust fund going insolvent?
Even as America's balkanized health care system struggles to deal with the pandemic, the coronavirus lurks behind another looming crisis. Medicare's Hospital Insurance Trust Fund is projected to become insolvent in 2024 or 2026 — just three to five years from now. Yet you probably haven't heard about that.
When will the Medicare trust fund be depleted?
In the 2020 Medicare Trustees report, the actuaries projected that assets in the Part A trust fund will be depleted in 2026, just five years from now (Figure 3). A more recent projection from the Congressional Budget Office also estimated depletion of the HI trust fund in 2026.
What is the hospital insurance trust fund?
The Hospital Insurance trust fund provides financing for only one part of Medicare, and therefore represents only one part of Medicare’s financial picture.
What does Medicare insolvency really mean?
What Medicare Insolvency Really Means Current insolvency projections mean that the trust fund could pay 90% of Part A bills once the depletion date is breached. The bills would be paid, but with delay. And it's possible that a risk of lower payments to hospitals and other health care providers might limit access to some of their services.
How long will the Medicare trust fund last?
In the 2022 Medicare Trustees report, the trustees projected that assets in the Part A trust fund will be depleted in 2028, six years from now. This is a modest improvement from the projection in the 2021 Medicare Trustees report, when the depletion date was projected to be 2026.
Is the Medicare trust fund insolvent?
The 2021 Medicare Trustees Report projects that, under intermediate assumptions, the HI trust fund will become insolvent in 2026, the same year as estimated in the prior three years' reports. Medicare is a federal insurance program that pays for covered health care services of qualified beneficiaries.
What happens if Medicare trust runs out?
It will have money to pay for health care. Instead, it is projected to become insolvent. Insolvency means that Medicare may not have the funds to pay 100% of its expenses. Insolvency can sometimes lead to bankruptcy, but in the case of Medicare, Congress is likely to intervene and acquire the necessary funding.
What is the prediction for Medicare solvency in the United States?
According to recent projections, the Medicare Hospital Insurance (HI) Trust Fund, absent congressional action, will become insolvent in 2026 and no longer be able to fully cover the cost of beneficiaries' hospital bills.
What will happen to Medicare in 2026?
According to a new report from Medicare's board of trustees, Medicare's insurance trust fund that pays hospitals is expected to run out of money in 2026 (the same projection as last year). The report states that in 2020, Medicare covered 62.6 million people, 54.1 million aged 65 and older, and 8.5 million disabled.
Is Medicare going to run out?
A report from Medicare's trustees in April 2020 estimated that the program's Part A trust fund, which subsidizes hospital and other inpatient care, would begin to run out of money in 2026.
What is the future of Medicare?
After a 9 percent increase from 2021 to 2022, enrollment in the Medicare Advantage (MA) program is expected to surpass 50 percent of the eligible Medicare population within the next year. At its current rate of growth, MA is on track to reach 69 percent of the Medicare population by the end of 2030.
Does Medicare fund Social Security?
For Social Security, the OASI Trust Fund pays retirement and survivors benefits and the DI Trust Fund pays disability benefits. For Medicare, the HI Trust Fund pays for Part A inpatient hospital and related care.
What happens when Social Security runs out of money?
Reduced Benefits If no changes are made before the fund runs out, the most likely result will be a reduction in the benefits that are paid out. If the only funds available to Social Security in 2033 are the current wage taxes being paid in, the administration would still be able to pay around 75% of promised benefits.
Is the future of Social Security at risk?
According to the 2022 annual report of the Social Security Board of Trustees, the surplus in the trust funds that disburse retirement, disability and other Social Security benefits will be depleted by 2035. That's one year later than the trustees projected in their 2021 report.
How does insolvency affect hospitals?
The short-term impact of insolvency would directly affect hospitals, health systems and other industry stakeholders more so than Medicare beneficiaries. “If the trust fund does go insolvent, there are real consequences to how hospitals get paid, how post- acute care providers get paid,” Blum said.
What happens when Medicare is depleted?
When the fund is depleted of assets, Medicare may be able to cover only 90% of its expenditures via incoming revenue. Insolvency thus could lead to delays in payments to providers and adversely affect patient access. Hospital revenues and revenue cycle processes could be significantly affected if the trust fund used to make Medicare Part A payments ...
What percentage of Medicare expenditures will be covered by payroll taxes in 2020?
A 2020 report from the Medicare Boards of Trustees estimates that with no money in the trust fund, incoming payroll taxes would cover only 90% of Medicare expenditures. “What it means is that providers would be delayed in getting their payments,” Uccello said.
Does Medicare revenue decrease?
Medicare revenue likely would not decrease for providers, according to Blum’s model, which assumes MA plans pay the same as Medicare fee-for-service (FFS). “The real impact happens to Medicare beneficiaries,” Blum said.
Does Medicare Advantage get paid through the trust fund?
Health plans that participate in Medicare Advantage (MA) also get paid through the fund. No statutory mechanism exists to guide payment policy if the fund becomes insolvent. “The law is silent as to what happens when the trust fund runs out,” Blum said. “There’s no playbook that would describe the operational procedures.
When will the HI trust fund be depleted?
To give a recent example of how such factors play into solvency projections, in January 2020, prior to the outbreak of the COVID-19 pandemic, CBO projected that the HI trust fund would be depleted in 2025.
How many years has the HI trust fund been depleted?
In the 30 years prior to 2021, the HI trust fund has come within five years of depletion only twice – in 1996 and again in 1997 (Figure 4). At that time, Congress enacted legislation to reduce Medicare spending obligations to improve the fiscal outlook of the trust fund.
How is Medicare solvency measured?
Medicare solvency is measured by the level of assets in the Part A trust fund. In years when annual income to the trust fund exceeds benefits spending, the asset level increases, and when annual spending exceeds income, the asset level decreases. This matters because when spending exceeds income and the assets are fully depleted, ...
How much would Medicare increase over 75 years?
Over a longer 75-year timeframe, the Medicare Trustees estimated that it would take an increase of 0.76% of taxable payroll over the 75-year period, or a 16% reduction in benefits each year over the next 75 years, to bring the HI trust fund into balance.
How much of Medicare will be covered in 2026?
Based on data from Medicare’s actuaries, in 2026, Medicare will be able to cover 94% of Part A benefits spending with revenues plus the small amount of assets remaining at the beginning of the year, and just under 90% with revenues alone in 2027 through 2029.
Where does Medicare get its money from?
Funding for Medicare comes primarily from general revenues, payroll tax revenues, and premiums paid by beneficiaries (Figure 1). Other sources include taxes on Social Security benefits, payments from states, and interest. The different parts of Medicare are funded in varying ways.
How much of the federal budget is Medicare?
Medicare spending often plays a major role in federal health policy and budget discussions, since it accounts for 21% of national health care spending and 12% of the federal budget. Recent attention has focused on one specific measure of Medicare’s financial condition – the solvency of the Medicare Hospital Insurance (HI) trust fund, ...
When will the HI Trust Fund become insolvent?
In April, using pre-COVID-19 data, the Trustees of Social Security and Medicare projected that the HI Trust Fund would become insolvent in 2026 — meaning that Medicare Part A claims submitted by providers would not be fully reimbursed.
How much is Medicare Part A advance?
Between $65 billion and $92 billion in advance payments were made to Medicare Part A providers that draw upon the HI Trust Fund. This increased claims on the Trust Fund in 2020 and lowers them for 2021 — assuming they are paid back in 2021.
Dive Brief
While the coronavirus pandemic has significantly affected short-term spending in Medicare, it shouldn't have a large impact on the financial status of the program's trust funds after 2024, according to the Medicare Board of Trustees' annual report to Congress.
Dive Insight
Though the pandemic has injected volatility into most aspects of healthcare spending since early 2020, the long-term financial status of the trust funds backing Medicare funding hasn't really changed from past estimates, according to the new report.
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How long does it take for Medicare to become insolvent?
But now even those gimmicks have run their course. Estimates suggest the Medicare trust fund will become officially insolvent within five years —and could face a cash flow crunch even sooner.
When did Medicare Part A become a condition of Social Security?
In 1993, an administrative ruling by the Clinton administration—one that did not even go through notice-and-comment rulemaking—forced all individuals to enroll in Medicare Part A as a condition of applying for Social Security. This policy makes little sense, for several reasons.
What does it mean when seniors pay to Medigap?
Every dollar seniors pay to a Medigap insurer allows an organization like AARP to take their share of the cut (a.k.a. “ kickbacks ”) in the process. Fewer dollars running through insurance companies means less overhead and profits for the insurers—and more dollars back in seniors’ pockets.
How much money does Washington spend on Medicare?
According to the Congressional Budget Office, the national debt has roughly tripled since 2007 and is projected to rise such that, by the end of the coming decade, Washington will spend nearly $1 trillion per year just to pay the interest on our bills. Medicare itself has been effectively insolvent for several years.
When will seniors' per capita income increase?
Projections from the Kaiser Family Foundation demonstrate the rationale for expanding means testing further. According to Kaiser, between 2016 and 2035, per capita income for seniors will rise the greatest for those in the top quartile of income.
Does Medicare have a cap on out of pocket costs?
Because the traditional Medicare benefits provided by law do not include a cap on out-of-pocket costs, roughly nine in 10 seniors have some type of “insurance” to provide such a catastrophic cap. Otherwise they could face medical bills totaling tens of thousands of dollars (or more) in the case of a medical emergency.
Can Republicans reform Medicare?
To be clear: Republicans can—and should—explore more comprehensive Medicare reforms, including a premium support program that would place private plans and traditional Medicare on a level playing field to attract and enroll seniors.
