The 1st Session of the 116th Congress featured the introduction of the Medicare For All Act Of 2019 (H.R. 1384) in the House of Representatives by Pramila Jayapal (D-WA). The bill had 107 Democrat co-sponsors. It calls for transforming the Medicare program into a single payer system that would be implemented over a two-year period beginning after the bill is signed into law. Beneficiaries could keep their current health insurance coverage during the two-year transition period, but would lose it once the Medicare plan began. Individuals automatically would be enrolled in the program at the time of birth in the U.S. Coverage would include inpatient and outpatient hospital care; ambulatory services; primary and preventive care (also chronic care); prescription drugs; biologics; medical devices; mental health and substance abuse treatment services; laboratory and diagnostic services; maternity care; dental and vision care; and long-term care. Health plans and employers still could provide additional benefits not covered by the Act. No co-payments, premiums, deductibles, or similar charges would be imposed.
It cannot be expected that a piece of legislation this broad will be passed and enacted anytime soon. Many vested interests stand to be affected quite dramatically. They include: providers, insurance companies, pharmaceutical firms, medical device manufacturers, and individuals who are satisfied with their present coverage. Figuring out how to pay for benefits is another challenging aspect that has serious ramifications for the nation’s tax structure.
The Medical Device Tax As A Means Of Offsetting Health Care Costs
When the Patient Protection and Affordable Care Act (ACA) became law nine years ago this month, it was anticipated that new taxes would help to offset some of its costs. One example is a medical device tax. This 2.3% federal excise levy on the medical device industry has been suspended and delayed since the law was enacted. More recently, the tax was delayed retroactively and will not go into effect until January 1, 2020. Senators Pat Toomey (R-PA) and Amy Klobuchar (D-MN) have introduced legislation (S. 692) to repeal this tax permanently. The bill currently has 25 bipartisan cosponsors.
A Bipartisan Approach To Reducing Health Care Cost Growth
Barring any overnight developments that produce cures for major causes of mortality, such as heart disease and cancer, due to a steady growth in the overall population of the U.S. and accelerating increases in the number and proportion of the aged, health care costs will continue to increase. Recent years have witnessed considerable amounts of dissention and polarization in the political arena. Thus, it always is refreshing whenever spurts of bipartisanship occur. On March 1, eight prominent health economists from the Brookings Institution and the American Enterprise Institute, organizations seldom aligned ideologically, sent Lamar Alexander (R-TN), Chairman of the Senate Committee on Health, Education, Labor, and Pensions (HELP), a list of 13 recommendations for the government to reduce the growth in health care costs. Recommendations include: passing legislation to expand mandatory bundled-payment programs and to end surprise out-of-network billing; and increasing Medicare payments for primary-care services and reducing them for other services.
Curtailing Fraud In Government Health Programs
Every year, billions of dollars in outlays and government program complexity combine to result in a susceptibility to improper payments, including fraud. Although there are no reliable estimates of fraud in Medicare, in fiscal year 2017 improper payments were estimated at about $52 billion, according to the Government Accountability Office (GAO). On February 25 of this year, the House passed H.R. 525, the Health Care Fraud Prevention Task Force Act, by voice vote. The bill would create the Health Care Fraud Prevention Task Force, a public-private partnership that would identify nationwide health care waste, fraud, and abuse and would supersede the Health Care Fraud Prevention Partnership (HFPP), which currently is operated by the Centers for Medicare & Medicaid Services (CMS). The newly established task force would contract with a third party to detect and prevent health care fraud through information sharing; streamline analytical tools and data; and provide a forum for government and industry experts to exchange successful anti-fraud practices. The task force also would be required to submit a report every two years to Congress showing any progress and cost savings attributable to the partnership.
More Articles from TRENDS March 2019
COSTS ASSOCIATED WITH NONADHERENCE
Suggests how factors affecting both caregivers and patients can result in nonadherence to treatment interventions. Read More
PRESIDENT’S CORNER—ASAHP MEMBER FOCUS
Curt Lox, Dean, Brooks College of Health Professions at the University of North Florida, is featured in this issue of TRENDS. Read More
FEDERAL BUDGET RELEASE AND PROPOSED LEGISLATION
The Trump Administration released its proposed federal budget for FY 2020 and legislation is introduced in Congress involving higher education. Read More
DEVELOPMENTS IN HIGHER EDUCATION
Describes: Senate and House hearings on reauthorizing the Higher Education Act (HEA), a proposal from the White House to reform the HEA, negotiated rulemaking by the U.S. Department of Education, and a judicial ruling on final regulations pertaining to borrower defense to repayment regulations. Read More
QUICK STAT (SHORT, TIMELY, AND TOPICAL)
Selected Estimates Based On The National Health Interview Survey, January To September 2018
Electronic Health Behaviors Among U.S. Adults With Chronic Disease
Use Of Toilet Seats To Detect Chronic Heart Failure
Medical And Health Data Wearable Read More
AVAILABLE RESOURCES ACCESSIBLE ELECTRONICALLY
Emerging Technologies To Support An Aging Population
School Success: An Opportunity For Population Health
CARE Act Implementation: Progress And Promise Read More
IMPACT OF MARIJUANA LAWS ON HEALTH AND LABOR SUPPLY
Provides information about the effects of state medical marijuana laws on the health and labor supply of adults age 51 and older, with a focus on individuals with medical conditions that may respond positively to treatment involving marijuana. Read More
GLOBAL SYNDEMIC OF OBESITY, UNDERNUTRITION, AND CLIMATE CHANGE
Refers to a proposed rationale for international-level policy interventions that have the potential to mitigate harmful health consequences associated with these three problems. Read More