Health Policy

HLTH 5120 Healthy Policy Issue

Premium support system will gradually be known as Medicare, Beginning in 2022, individuals turning 65 as well as younger, disabled individuals becoming eligible for Medicare would only have access to health coverage through private insurance plans, rather than through the current government-run Medicare program, traditional Medicare, or under a Medicare Advantage plan.

Under the new premium support system, Medicare beneficiaries would be entitled to payment from the federal government to help defray premiums and other health care costs under the plan. The government would make payments directly to private health plans on behalf of Medicare eligible enrollees, rather than pay hospitals, physicians, and other medical providers directly for the services provided to their Medicare- eligible patients, as is currently the case. If the government payments to plans on behalf of enrollees were insufficient to cover premiums and/or other costs, beneficiaries would be responsible for additional costs. In other words, Medicare would no longer provide coverage for medical care, but instead provide a “subsidy” toward the purchase of a private health insurance plan.

Pros

Choice: Starting 2022, a new Medicare program will begin offering seniors a choice among Medicare-approved private plans and the traditional Medicare plan much like the choice of plans members of Congress have.

Seniors will be provided with simple, easy-to-understand information about the plans that are available in their areas during their annual open-enrollment period, explaining options and prices, and they will be told exactly how their current plan compares to the next-lowest-cost option.

Cons

The proposal would gradually raise the age of Medicare eligibility from 65 to 67 beginning in 2022

This proposal would re-open the Part D coverage gap, in which beneficiaries are responsible for paying all of their prescription drugs costs. Over time, prescription...