Why Medicare politics are heating up : Shots


Prescription drug protection is only one a part of Medicare, the federal authorities’s medical insurance program for individuals age 65 and over.

d3sign/Getty Pictures

conceal caption

toggle caption

d3sign/Getty Pictures

Prescription drug protection is only one a part of Medicare, the federal authorities’s medical insurance program for individuals age 65 and over.

d3sign/Getty Pictures

The White Home launched President Biden’s $6.8 trillion proposed funds final week, itemizing his priorities for the upcoming fiscal 12 months. Amongst different issues, Biden singled out Medicare — the federal medical insurance program for individuals aged 65 or older. Republican leaders insist they will not be threatening cuts to Medicare in upcoming funds negotiations, however others within the celebration have floated the thought of creating adjustments over time to this system — together with profit cuts they are saying shall be essential to maintain Medicare solvent.

NPR’s Michel Martin, as co-host of All Issues Thought of, sat down this week with veteran well being care journalist Julie Rovner, of Kaiser Well being Information, to get a greater sense of the place the talk is headed over how one can fund Medicare, an costly, however in style program. The next excerpt of their dialog has been edited for size and readability.

MARTIN: So, what’s the difficulty right here?

ROVNER: Medicare’s trustees say that inside six years, the belief fund goes to expire of reserves, and so it will not have the ability to pay all the present advantages. So principally, with the intention to deliver down the fee, you’ve got three choices: You can also make the people who find themselves on this system pay extra, you may make taxpayers who assist help this system pay extra, or you’ll be able to pay well being care suppliers — medical doctors and hospitals and all these of us — much less.

Everyone considers any of these issues, “cuts,” though paying suppliers much less is often solely thought-about a minimize to the suppliers. If the cuts get too large, and the well being care suppliers say “We’ll stroll away from this system,” that is an issue too.

However Medicare may be very in style, and I feel within the State of the Union, when the president mentioned he wasn’t going to do something to Medicare, individuals kind of slapped again and mentioned, “However Medicare goes to go broke if we do not do something.” So within the funds, Biden mentioned, effectively, listed below are a few issues that we might do, none of which have an effect on how a lot beneficiaries pay.

MARTIN: What are the highest traces of what President Biden’s proposing, with reference to Medicare?

ROVNER: It is really pretty small. Final 12 months, for the primary time, Medicare was given authorized permission to barter the worth of medicine. There’s a brief listing of medicine. This funds would make the listing longer, and it might have these negotiations occur sooner. It could additionally elevate a tax on very high-income earners — these incomes over $400,000. The Biden funds would elevate that Medicare tax from 3.8% to five% on these excessive earners.

MARTIN: Republicans have mentioned that they will steadiness the funds over the subsequent decade, however will not contact Medicare. Is {that a} credible stance?

ROVNER: It’s, however provided that they go after Medicaid — the really bigger public medical insurance program for individuals with low incomes — and the subsidies on the Inexpensive Care Act, which the president has now additionally mentioned he will not go after. It’s attainable to steadiness the funds with out touching Medicare or Social Safety or elevating taxes, however you would need to minimize a lot from the remainder of the funds. That is why we’ve not seen a Republican plan but. They’re nonetheless attempting to determine it out.

MARTIN: Senate Minority Chief Mitch McConnell has already mentioned publicly that Biden’s plan to extend the Medicare tax on excessive earners, “won’t see the sunshine of day.” So what are we prone to see subsequent?

ROVNER: Effectively, in some unspecified time in the future, you understand, the 2 events are going to have to come back collectively earlier than the Medicare belief fund runs out of cash. This isn’t the primary time we have been inside this shut interval the place the belief fund might run out of cash. It is occurred a number of instances previously. Finally, the events do get collectively and work out some approach to shore it up. And I am positive that may occur this time, too, however I think this 12 months goes to be extra of a struggle main as much as the 2024 elections.

MARTIN: The talks over the debt ceiling are approaching. The leaders of each events have mentioned that Medicare is off the desk. However is it conceivable that Medicare will not be implicated in some unspecified time in the future in these talks?

ROVNER: No. After all Medicare goes to be implicated in some unspecified time in the future in these talks. To begin with, what Republican leaders say shouldn’t be essentially what all the Republican rank and file will do. That is true of the Democrats, too, so it is exhausting to think about that Medicare will not be placed on the desk indirectly, form or kind.

MARTIN: So, what is going to you be listening to as these discussions proceed over the subsequent couple of weeks and months?

ROVNER: One thing must be achieved to Medicare, lest it run out of cash. So I feel that just about your entire federal panoply of well being packages goes to be up for dialogue — and that is what I will be watching.

MARTIN: I am simply questioning, is that this the sort of topic that the general public actually can deal with, can actually get galvanized round?

ROVNER: It will possibly and it might’t. The trick is how this will get negotiated and the way it will get offered to the general public as as to whether it is going to really have an effect on their well being care.

Julie Rovner is the Washington correspondent for KHN and host of “What The Well being?” — KHN’s weekly well being coverage information podcast. After practically eight years of internet hosting Weekend All Issues Thought of, Michele Martin is taking over a brand new internet hosting function on NPR’s Morning Version.