- Medicare Platform: Principles to Improve Medicare for All Beneficiaries Now and In the Future
- Medicare IS Under Attack, and In Danger of "Withering on the Vine"
- Moving Forward with COVID-19 and Medicare: Podcast with Judy Stein
- Medicare is a Success: Preserving a Sound Program for Future Generations
- Private Medicare: Too Much For Taxpayers, Too Little For Beneficiaries
- More Information
- Articles & Updates
Medicare Platform: Principles to Improve Medicare for All Beneficiaries Now and In the Future
- Improve Consumer Protections and Quality Coverage
- Cap out-of-pocket costs in traditional Medicare[1]
- Require Medigap plans to be available to everyone in traditional Medicare, regardless of pre-existing conditions and age
- Ensure parity between Medicare Advantage (MA) and traditional Medicare
- Ensure all benefits in Medicare Advantage are also available in traditional Medicare, such as the waiver of 3-day prior hospital stay requirement for skilled nursing home care, coverage for home health aides, certain oral health, vision, and audiology services
- Ensure payment in traditional Medicare is at least as much per enrollee as in Medicare Advantage[2]
- Simplify enrollment in traditional Medicare, Part D and Medigap, and ease transitions from other insurances to Medicare
- Improve consumer protections in Medicare Advantage
- Ensure parity between mental health and physical health coverage
- Ensure the Medicare appeals system is cost-effective and fair for beneficiaries
- Ensure access to timely, meaningful decision-making, and written determinations at all levels of appeal
- Add a meaningful appeals process for hospice coverage[6]
2. Reduce Ongoing Barriers to Care
- Eliminate the harm of so-called hospital “Observation Status” when a person is actually in the hospital
- Eliminate the 3-day prior inpatient hospitalization requirement for skilled nursing facility coverage or, at least, count all time in the hospital towards the 3-day prior hospital requirement
- Ensure access to home health coverage is actually available for all beneficiaries who meet coverage criteria; ensure access to legally authorized home health aides; resolve conflicts between payment models and coverage laws[7]
- Ensure access to quality skilled nursing facility care
- Require adequate staffing ratios, provider payments subject to a medical loss ratio, and adequate oversight and enforcement
- Ensure beneficiaries with longer-term, chronic, and/or debilitating conditions have full access to skilled nursing, therapy and related care needed to maintain their conditions or slow decline, as is required by law
3. Improve Traditional Medicare
- Ensure traditional Medicare is comprehensive, simple to navigate, and affordable
- Add oral health, audiology, and vision coverage for all beneficiaries in traditional Medicare
- Increase low-income protections and reduce cost-sharing
- Add coverage for long-term care
- As in HR 3,[8] ensure savings achieved through drug negotiations, or by other means, are reinvested into the Medicare program
Improve and simplify Medicare. Don’t privatize or cut it.
Build it better. Then expand access for generations to come.
[1] In 2016, the average person with Medicare coverage spent $5,460 out of their own pocket for health care (Kaiser Family Foundation, 2019).
[2] On average, MA plans are still being overpaid due, in part, to manipulation of risk adjusted payment and a broken quality bonus payment system; see, e.g., https://medicareadvocacy.org/medicare-advantage-continues-to-drive-up-medicare-costs, https://medicareadvocacy.org/support-traditional-medicare-by-leveling-the-playing-field-with-medicare-advantage/, http://www.medpac.gov/docs/default-source/reports/jun19_ch8_medpac_reporttocongress_sec.pdf.
[3] See, e.g., https://medicareadvocacy.org/center-comments-on-medicare-advantage-and-part-d-transformation-ideas/.
[4] See, e.g., discussion of reversing MA network adequacy changes in recent final Part C & D rule at: https://medicareadvocacy.org/final-rule-for-medicare-parts-c-and-d-includes-weakened-standards-for-medicare-advantage-networks/.
[5] See, comments to proposed Part C & D rule at: https://medicareadvocacy.org/wp-content/uploads/2020/04/CMA-CD-Comments-2020.pdf.
[6] For example, establish an expedited appeals process for hospice coverage issues similar to one currently in regulations for untimely discharges from skilled nursing facilities, home health and hospice – see 42 CFR §405.1200, et seq.
[7] For example, consider lifting or expanding the current statutory cap on outlier payments (claimed for individuals with significant resource needs) from 2.5% of total Medicare home health payments, and 10% of expenditures to any singular home health agency. These caps inappropriately limit access to necessary services under the guise of controlling fraud.
[8] H.R.3 – Elijah E. Cummings Lower Drug Costs Now Act (passed House of Representatives 12/12/19).
Medicare IS Under Attack, and In Danger of “Withering on the Vine“
In 1995 Newt Gingrich predicted that privatization efforts would lead Medicare to wither on the vine. He said it was unwise to get rid of Medicare right away, but envisioned a time when it would no longer exist because beneficiaries would move to private insurance plans.
Well … that’s what’s happening. Not just by happenstance, but rather according to a determined, strategic plan. The plan has included the following:
- Government subsidies to private plans, renamed “Medicare Advantage,” ranging from 14% – 2% above traditional Medicare per-beneficiary costs;
- Additional benefits added to private Medicare Advantage, benefits that weren’t added, and aren’t allowed, in traditional Medicare;
- Part D prescription drug coverage wrapped into Medicare Advantage, but not into traditional Medicare;
- Increases in traditional Medicare Part B premiums, especially for the middle class;
- Limits on access to Medigap insurance to supplement traditional Medicare and on benefits for those who can obtain a Medigap policy.
It didn’t take a crystal ball. It took a vision, planning and persistence.
The Center for Medicare Advocacy also has vision, planning and persistence. We do all we can to keep Medicare focused on the needs of older and disabled people, not the insurance industry. We speak out with expertise and with the stories of real people.
With your support, we’ll keep insisting that Medicare is fully present for the families that rely on it – now and in the future. We’re ready to keep Medicare from withering on the vine.
Moving Forward with COVID-19 and Medicare: Podcast with Judy Stein
Center for Medicare Advocacy Executive Director Judy Stein joins journalist Mark Miller on retirementrevised.com to discuss what the pandemic is teaching us about ways to improve Medicare.
“The crisis has put a bright spotlight on weaknesses in many of the systems designed to protect Americans from risks. But older people are more susceptible to serious illness and death from the virus. The problems in Medicare were evident before the pandemic, and now they are becoming even more clear.”
Medicare is a Success: Preserving a Sound Program for Future Generations
The Medicare program is a success story. It was designed and enacted in 1965 as a social insurance program because private companies failed to insure older people. It was intended to provide basic coverage through one health insurance system, with a defined set of benefits. Reforms to Medicare should honor and maintain its core values to ensure its continued success for future generations.
As stated by Nancy-Ann DeParle, a former Administrator of the Health Care Financing Administration (HCFA, now CMS):
Few programs in the history of the United States have brought as much benefit to society as Medicare. Since its enactment in 1965, Medicare has provided access to quality health care for those Americans least likely to be attractive to private insurers – those over age 65, disabled, or with end stage renal disease. Medicare has also prevented many Americans from slipping into poverty. The elderly’s poverty rate has declined dramatically since Medicare was enacted – from 29 percent in 1966 to 10.5 percent in 1995. Medicare also provides security across generations: it has given American families assurance that they will not have to bear the full burden of health care costs of their elderly or disabled parents or relatives at the expense of their young families. (Preface, A Profile of Medicare, May 1998.)
Core Values That Should be Addressed in Any Medicare Reform Plan
- Medicare should continue to be a national health insurance program, not a set of independent private plans and payment options.
- Medicare should include a mandatory, secure set of defined benefits.
- Medicare should continue to provide one community of interests among the healthy and frail, rich and poor. It should not separate beneficiaries into separate groups with distinct and varying interests by creating multiple cost-sharing levels, benefit options, and delivery systems that differ depending upon the ability to pay or an individual’s health.
- Medicare should provide equal access to appropriate and high quality health services for all beneficiaries, including those with chronic, long-term, and mental health conditions.
- Private Medicare plans should be carefully monitored by CMS to ensure they provide full Medicare coverage and rights to their enrollees.
- Medicare should provide an accessible, meaningful appeals process that guarantees due process to all beneficiaries. Medicare coverage decision-makers, at all levels, should be independent from CMS and should be required to make coverage decisions based on the law and regulations.
Conclusion
The public should listen carefully to the many proposals being considered that would dramatically change Medicare under the guise of reform, modernization, and deficit reduction. Many of these proposals would abandon Medicare’s core values and increase expensive privatization. Medicare can be strengthened and preserved for future generations if an informed public demands it.
Private Medicare: Too Much For Taxpayers, Too Little For Beneficiaries
When Medicare was created in 1965 over 50% of everyone 65 or older had no health insurance. Private insurance failed to meet their needs. Medicare, on the other hand, is a success. It increased the number of insured older adults to 95%. In 1972 Medicare coverage was extended to people with significant disabilities. But Medicare’s success in providing access to health care for millions of people is in danger. Ironically, the threat comes from private insurance plans. Funded by windfall subsidies from taxpayer dollars, privatization is jeopardizing the cost-effective, dependable Medicare program.
Since 2003 the number and costs of private Medicare plans have increased exponentially as a result of the design of Medicare Part D and “Medicare Advantage”. Unlike plans to privatize Social Security, which were debated and largely rejected by lay people and professionals alike, the privatization of Medicare is well underway and has occurred largely without public knowledge or discussion. Medicare privatization and the billions of dollars being spent to subsidize private plans threaten the future of Medicare and the health and economic security the Medicare public program has provided for America’s older and disabled people and their families.
Medicare wasn’t broken, but because of the ever-increasing private Medicare options, it is breaking. The myriad private plans are creating confusion and barriers to care for real people. The Center for Medicare Advocacy is contacted everyday by people who were inappropriately marketed to; people who did not understand what they were getting into, people who have been unable to get the health care services they need from their Medicare Advantage (MA) plan, and people who are “locked into” their MA plan. Further, the Center gets calls for help from people who thought they had MA “on top of” their regular Medicare and/or Medigap and are surprised to find out that is not true when the service or provider they need is not covered by their MA plan.
Medicare privatization costs taxpayers approximately billions of dollars every year, while it hurts many people with Medicare and strangles the traditional Medicare program. Consider these stories from just a few of the Center’s clients:
- Mrs. P is a 67 year old woman who was diagnosed with ALS three years ago. She contacted the Center for help because her private Medicare plan cut off all her home care, saying she was “stable” and no longer needed home health services. CMS said the coverage decision was up to the plan and would not intervene. The Center for Medicare Advocacy filed a case in federal court seeking continued coverage for Mrs. P. The Court ordered Medicare to cover Mrs. P.’s home care; she was therefore able to stay at home with the health care she needs. Without Medicare coverage and this necessary home care, Mrs. P. would have been forced to enter a nursing home.
- A Congressman called the Center to obtain help for a constituent who he met at a local town hall meeting. Mr. B and his wife were members of a Medicare Advantage plan in Connecticut. They went to Florida for vacation where Mrs. B fell and was sent to the hospital to treat her injuries. Tests at the hospital showed that, unbeknownst to Mrs. B, she had a brain tumor. Doctors determined she needed treatment immediately. Because Mr. B is frail himself and the couple’s daughter in Utah is a nurse, they decided to go there for Mrs. B’s chemotherapy. Upon receiving the chemotherapy, however, Mrs. B had a life threatening reaction that resulted in her being in the Intensive Care Unit for days. She ultimately died. The hospital bill came to $100,000 and was completely denied by the Medicare Advantage plan because Mrs. B was “out of network”. The Center appealed. Finally, after an administrative hearing most of the bill was paid in recognition that the care received after Mrs. B’s reaction to treatment was emergency services.
- Mrs. W called us with a Medicare Advantage (MA) problem. She went from a hospital to a nursing home and was being billed for $13,000 because the nursing home was out of her MA plan’s network. She had been told by both the hospital and nursing home staff that original Medicare would cover her nursing home stay, even though she had an MA plan. This is not true. The beneficiary herself is extremely confused and was unable to answer any of the Center attorney’s questions.
- The Center has a case pending for an individual who is in an MA plan in Connecticut and went out of network for doctor’s services. He was billed $5,000 for these services. This individual is functionally illiterate and did not understand that he could only see providers in the plan’s network when he signed up for the MA plan. He says he did not receive any booklets or anything in writing from the MA plan regarding the network’s providers. Even if he did, he likely wouldn’t have been able to read the information or comprehend the concept of a network.
- A Center attorney received a call from a woman with significant MA concerns. She and her husband were visited by an MA marketing representative for a Private Fee For Service Plan (PFFS). He came door to door and was absolutely not invited. The woman told our attorney that both she and her husband suffer from brain injuries and previous strokes and that they were both distressed when the agent came into their home. He told them that he wanted to talk to them about a “new kind of Medicare.” She said that she listened but did not understand and that he gave too much information too fast. She said she filled out the form he had and said yes to all of his questions just to get him to leave her home; this all happened in January, 2007.
When the woman called the marketing representative to disenroll the representative told her to just send a letter to the plan and that would effectuate disenrollment. She did so in January but had not been disenrolled when she contacted the Center six months later. During that time, she and her husband needed and received medical services, for which they were billed and sent to collection. The husband requires injections from an oncologist which cost $3000 each; he needed three during this period. Other services received during the period included doctors’ visits, a hospital CT scan, neurologist visits, and endocrinologist visits.
- Mr. N, one of the Center’s clients had traditional Medicare along with a Medigap supplemental policy. He was approached by an MA plan while at his dialysis unit, which is now a marketing violation. He was told that the MA plan and the Medigap policy together would cover all his expenses. Mrs. N called the Center because they are now receiving bills for the balance of what the MA plan did not cover. When she contacted the Medigap representative, he told her that because she now is in an MA plan, the Medigap won’t cover the balance. Mrs. N then called the MA plan to disenroll because she is worse off than before joining the MA. They told her she couldn’t disenroll at this time.
The Center is working to retroactively disenroll Mr. N from the MA plan based upon the misinformation that he was given by the marketing representative. Hopefully, if the retroactive MA disenrollment is granted, the Medigap policy will provide retroactive coverage for the past bills.
- A Center attorney received a call from the daughter of a beneficiary who speaks very little English. Apparently an agent from an MA plan in Hartford, CT came door-to-door without being invited (which is a marketing violation), visited this woman’s mother and got her to sign an application. The representative told the mother that everything would be “free”. The daughter called the plan and was able to get her mother disenrolled. But, Social Security is still deducting the monthly premium for the MA plan from her mother’s Social Security check so she called the Center to get help with the premium problems. Her mother needs the money.
- The Center was contacted by the daughter of a woman who signed up for an MA plan. Apparently representatives from the MA plan called and asked if they could come to the mother’s home. She, and the daughter, visited with the representatives and made it very clear that what they were looking for 100% coverage of the mother’s dialysis treatments. The representatives told them that if she signed up her dialysis treatments would be covered 100%. It soon became clear to the mother and daughter that the plan only covers 80% of dialysis treatments, the same as traditional Medicare. In addition, it became clear that the plan never should have offered to sign her up in the first place because she has ESRD which precludes her from signing up for this plan.
- Another gentleman called the Center. He was visited by an MA plan and was told that the plan was “free” – which it is not. He received a letter from Social Security stating that $46.00 would be deducted from his Social Security check. This is how he found out that the plan was not “free.””
“Medicare Advantage” is starving the successful traditional Medicare program and hurting beneficiaries. Studies by MedPAC, the Congressional Budget Office, and the Commonwealth Fund and numerous scholars confirm that taxpayers are spending between 12% – 19% more on private plans than it would cost to serve the same people in the traditional Medicare program. Meanwhile, private Medicare has proven far less able to provide secure health insurance and a wide choice of doctors and other health care providers for older people and people with disabilities.
Medicare was enacted in 1965 because private industry failed to insure more than 50% of older people. It would be ironic if privatization condemned Medicare now, returning older and disabled people to the vagaries of the private, for-profit insurance industry.
The solution for the Medicare crisis is not to increase the eligibility age or decrease benefits, but to stop privatizing it at the expense of older people and taxpayers.
Judith Stein
Center for Medicare Advocacy, Inc.
October 15, 2008
More Information
- Medicare Matters: A Video Timeline About Medicare from Kaiser Family Foundation
- Medicare Facts & Fiction – Lessons to Combat Medicare Spin
- Real Solutions for Medicare Reform
- Medicare Matters: 50 Insights for Medicare’s 50th Anniversary
Articles & Updates
- President Biden’s Prescription for Medicare Solvency
- Implementation of Medicare Drug Bill Proceeds – This Progress Must be Defended
- Center for Medicare Advocacy Statement on Recent Medicare Advantage Payment Policies and Proposals
- Critical Provisions of Medicare Drug Bill Already Taking Effect
- Medicare Provisions in Year-End Spending Bill
- Center for Medicare Advocacy Weighs in on IRA Implementation
- Provisions of Recently Passed Medicare Drug Bill in Effect Next Month – January 2023
- Additional New Medicare Coverage News – Hearing Aids and Oral Health
- President Biden Signs Inflation Reduction Act into Law – Includes Critical Medicare Prescription Drug Provisions
- Senate Passes Historic Reconciliation Bill, House Vote Imminent
- Senate Poised to Vote on Important Bill with Valuable Medicare Drug Provisions
- Release of Parity Principles to Optimize Medicare Coverage of Substance Use Disorder and Mental Health Care
- 2022 Medicare Trustees Report
- A Special Alert about Medicare’s Future | Don’t Let Traditional Medicare “Wither on the Vine*”
- Senate Finance Committee Holds Hearing on Medicare Solvency
- CMA Statement on Medicare Financing
- Study Published in Health Affairs Finds that Medicare Advantage Quality Bonus Program Has Not Improved Quality
- Build Back Better Act: House and Senate Nursing Home Provisions Compared
- Pass Build Back Better — Seize the Moment to Protect Nursing Home Residents
- Landscape of Medicare Advantage (MA) and Part D Plans in 2022
- CMA Statement | But for Critical Hearing Benefit, Medicare is Left Behind in Build Back Better Framework
- Joint Advocates’ Statement: | Add Dental Coverage to Medicare, Not Vouchers
- Analysis Provides Options for Containing the Cost of a New Medicare Dental, Hearing, and Vision Benefit
- Congress Continues to Negotiate Potential Historic Expansion of Medicare – The Time to Act Is Now
- Reminder | Tell Congress Now is the Time to Improve Medicare
- Congress Begins Debate About Adding Dental, Hearing and Vision Benefits to Medicare – Now is the Time to Act
- Medicare is at a Crossroads – Time to Dispel Myths Hindering an Historic Expansion of Benefits
- Congress Sets the Stage for Important Medicare Improvements
- Advocates Call on Congress to Improve Medicare
- Medicare Team Now Complete – Time to Improve the Program for Beneficiaries
- Medicare and Revenue – Looking Back, Looking Forward
- Changes to Health Coverage Must Include Medicare Improvements
- Policy-Makers Should Review Overpayments to Medicare Advantage when Considering Medicare Fiscal Solvency
- Medicare and the Dilemma of “Choice”
- Study Finds Cost-Sharing Increases Can be Deadly
- Commonwealth Fund Issues Series of Articles Addressing Medicare’s Fiscal Solvency – Introductory Statement by Marilyn Moon
- Center for Medicare Advocacy and Medicare Rights Center Urge Biden Administration to Take Immediate Action on Key Issues Facing Medicare Beneficiaries
- Advocates Urge Biden Administration to Take Immediate Action on Key Issues Facing Medicare Beneficiaries
- Biden Administration Withdraws Harmful Rule Re: Dropping Medicare Part A Coverage
- Consumer Groups Sign on to Letter Asking Acting HHS Secretary to Suspend Geo Direct Contracting Demo
- A New Administration Begins During a “Winter of Peril and Possibility”
- COVID Relief and Omnibus Package: Overview of Medicare Provisions
- Affordable Care Act: Millions Have Benefited Despite Sabotage
- Center for Medicare Advocacy Issues Transition Memorandum: Medicare Improvements for the Biden Administration
- Center for Medicare Advocacy Submits Memorandum: Medicare Improvements Biden Administration Can Make Immediately
- Center for Medicare Advocacy Urges Incoming Administration to Suspend Direct Contracting Demonstration
- Center for Medicare Advocacy Comments on Harmful Proposed Rule that Would Automatically Expire Regulations Governing Medicare and Other Important Programs
- Comments on HHS “Regulations Rule”
- Strengthen Medicare to Build Back Better
- Center for Medicare Advocacy’s Statement on Supreme Court ACA Oral Argument
- Five Days until the Affordable Care Act is in Front of the Supreme Court
- Dismantling the Affordable Care Act Would Harm Medicare and Medicare Beneficiaries
- Dismantling the Affordable Care Act Would Harm Medicare and Medicare Beneficiaries
- Dismantling the ACA Would Harm Medicare and Medicare Beneficiaries | Highlight on Preventive Services
- Supreme Court Nomination Could Have Devastating Consequences for the Affordable Care Act and Medicare
- Candidates: Don’t Forget Medicare
- Medicare’s Finances – Challenges and Solutions
- With Next COVID Relief Bill Stalled, President Trump Issues Directives of Questionable Authority and Threatens Social Security and Medicare
- Improve Medicare for All Beneficiaries
- Real Medicare Matters
- Podcast with Judy Stein: Moving Forward with COVID-19 and Medicare
- Medicare Trustees Report: Projections Similar to Last Year, and Savings Are Available
- Decisive Win for Affordable Care Act: Supreme Court Rules Sabotage Attempt Illegal
- Fact-Checking the State of the Union Speech Regarding Health Care
- Administration Encourages States to Block Grant Medicaid
- Supreme Court Allows Harmful “Public Charge” Immigration Rule to Continue – For Now
- Court Decision Could Lead to the Demise of the Entire Affordable Care Act
- House Passes Historic Medicare Expansion Bill – H.R. 3
- House to Vote on Historic Medicare Bill Next Week
- Medicare is Being Privatized. Where is the Outcry?
- Potential Impacts of New Medicare Payment Models On Skilled Nursing Facility and Home Health Care
- CMS Administrator Seema Verma Testifies on Health Care Sabotage Before House Subcommittee
- Center for Medicare Advocacy Board President Judith Feder Testifies at Drug Pricing Hearing
- Center for Medicare Advocacy Analysis of President’s Medicare Executive Order:
- More People Went Without Health Insurance in United States in 2018
- Support Traditional Medicare by Leveling the Playing Field with Medicare Advantage
- Administration’s “Public Charge” Rule Would Result in Millions Losing Access to Health Care and Other Necessary Services
- Short-term Health Plans: Goldmines for Insurance Companies, Junk for Enrollees
- Court Hearing Next Week in Case that Threatens the Affordable Care Act – Act Now
- More Health Care Sabotage: “Censorship” of the Affordable Care Act
- Center Comments on Direct Contracting
- Trump Administration Proposes to Gut Health Care Rights, Particularly Targeting LGBTQ People
- A First Step in an Important National Discussion: Congressional Committee Holds Hearing on “Medicare for All”
- Medicare Trustees Issue 2019 Report: Medicare is Not Going Broke
- Health Care Sabotage News: Court Strikes Blow for Health Care; Advocates File Amicus Brief in Texas ACA Case
- Trump Administration Works to Undermine the Affordable Care Act – Yet Again
- Home Infusion Therapy Services
- Improve and Expand Medicare: CMS Should Provide Objective Information About Medicare Options
- Improve and Expand Medicare: Create Parity Between Medicare Advantage and Traditional Medicare
- Improve and Expand Medicare: Cover Long-Term Services and Supports (LTSS)
- Center Submits Comments on Proposed Medicare Prescription Drug Rule
- ACA and Health Care Sabotage Continue
- Improve and Expand Medicare: Add an Out-of-Pocket Cap
- Improve and Expand Medicare: Oral Health
- Improve and Expand Medicare: Ensure Medigap Access
- Medicare Platform:
- Texas Lawsuit Sabotage of the Affordable Health Care Act
- Texas Affordable Care Act Decision Flawed, ACA is Still the Law of the Land
- Health Care Sabotage Continues as ACA Open Enrollment Comes to an End
- Health Care Sabotage: Administration Doubles Down on States’ Ability to Undermine ACA
- ACA Open Enrollment Ends December 15th
- Health Care Prominent in Mid-Term Elections – How will the New, Divided Congress React?
- Make Sure Medicare Matters – Cast Your Vote Today
- Don’t Fall for the Distraction: The President’s Prescription Drug Proposal is Much Ado About Much Too Little
- Campaign Codewords from the National Committee to Preserve Social Security and Medicare
- Health Care Sabotage: Administration Issues New Guidance Making it Easier to Ignore ACA Rules
- Make Sure Medicare Matters this Election – Vote on November 6!
- We Need Your Voice – Don’t Let Traditional Medicare Wither on the Vine!
- President’s Medicare Op-Ed is Untrue
- Medicare Matters for Young Americans: Expect It, Protect It!
- Health Care Sabotage: Expanded “Short-Term, Limited-Duration Insurance” is Here
- Center Launches SaveMedicareNow Initiative Ahead of Mid-Term Elections
- 2018 Will Determine the Future of Medicare
- More Health Care Sabotage: Inadequate Funding for Navigators
- MedPAC Discusses Requiring a Three-Day Hospital Stay for All Post-Acute Care, Threatening Access to Care
- Health Care Sabotage: Association Health Plans Are Here
- Health Care Sabotage Continues: New Pre-Existing Conditions Legislation Not What It Seems; GAO Critical of HHS ACA Enrollment Actions
- The Center for Medicare Advocacy Submits Comments Opposing Kentucky’s Medicaid Work Requirements
- Health Care Sabotage – Slandering a Program Which Has Widely Expanded Access and Coverage
- Major Health Care Sabotage: HHS Issues Final Rule on Short-Term Limited-Duration Insurance
- Health Care Sabotage: Poll Shows Voters are Watching
- Now Can We Call it Sabotage?
- Health Care Sabotage – Navigators Face another Round of Cuts
- Health Care Sabotage: Impact of Sabotage on the Exchanges
- Health Care Sabotage: Another Attempt at ACA Repeal
- ACA Repeal – Again: A Bad Deal for Older Adults and People with Disabilities
- Tipping the Scales Toward Medicare Advantage (at the Expense of Medicare)
- Another Week, More Health Care Sabotage
- Health Care Sabotage: DOJ Won’t Defend the Affordable Care Act
- Medicare Trustees Report: Stop Overpaying Private Plans & Underfunding Medicare
- More Health Care Sabotage May Be Coming Soon if Short-Term Plans are Allowed
- Advocates Raise Concerns About Inaccuracies and Bias in Draft MEDICARE & YOU Handbook
- Health Care Sabotage: Graham-Cassidy Redux?
- Health Care Sabotage: More on Short-Term Limited-Duration “Junk” Plans
- CMS Issues Request for Information on “Direct Provider Contracting:” Beneficiary Advocates Take Note
- If it Looks Like Health Care Sabotage and it Sounds Like Health Care Sabotage…
- The Sabotage of Health Care Continues – Center Comments on “Junk Plans”
- Choose Medicare Act Introduced – Improving Medicare, Moving Toward Universal Coverage
- The Sabotage of Health Care Continues – Important News
- Congress Poised to Vote for Harmful Balanced Budget Amendment
- This Week in Health Care Sabotage
- Eighth Anniversary of the Affordable Care Act
- This Week in Healthcare Sabotage: Administration Wants Older People to Pay More
- Bill to Control Medicare Prescription Drug Costs Introduced
- A Big Week In Health Care Sabotage
- This Week in Healthcare Sabotage
- Health Care Sabotage Continues
- President’s Budget Targets Key Health Care Programs; Millions at Risk if Implemented
- Center for Medicare Advocacy Statement on the Health Extenders in the Budget Agreement
- State of the Union Speech Touches on Health Care Issues
- How to Listen to Tonight’s State of the Union Address
- Remember People with Medicare in Renewed Spending Bill Debates
- People with Medicare Largely Forgotten in Spending Bill Debate
- Health Care Sabotage Continues
- Remembering Martin Luther King in 2018
- CMA Alert – Tax Cuts will Hurt, Not Help; Sherman Fairness Hearing Set; “Homebound” Settlement Objections Due; More
- Advocacy Organizations Opposed to Congressional Tax Plan
- CMA Alert – SNF Enforcement Halted; Know Your Medicare Appeals; Ultimate Health Care Sabotage; More
- CMA Alert – The REST of the Tax Cut Plan; “Jimmo” Improvement Standard Update; QMB News; Enrollment Periods End Soon
- Help Stop the Devastating Tax Bills. Call Congress Now!
- More than 40 Organizations Join Together in Opposition to Senate’s Tax Cuts & Jobs Act
- Tax Bill Talking Points and Action Steps
- House Passes Damaging Tax Bill, Health Advocates Urge Senate to Rethink Their Plan
- Alert – Tax Cut Harm Just Got Worse; This Week in Sabotage; CMS Pushing MA Plans; SNF Deregulation
- Tax Cut Bill Just Got Worse. Health Care at Risk.
- Alert – Spotlight on Medicare Home Health Care; Tax Cuts Set Stage for Medicare/Medicaid Cuts; ACA News
- Joint Statement from Center for Medicare Advocacy and Medicare Rights Center on the Tax Cuts and Jobs Act
- CMA Alert – It’s Enrollment Season; CMS Reissues HH Booklet; “Homebound” Case Settlement; More
- Federal Judge Fails to Protect Affordable Care Act Subsidies
- CMA Alert – Remember You CAN Choose Original Medicare; Equitable Relief; This Week’s Sabotage News
- CMA Alert, October 18, 2017 – Nursing Home Rights Roundup; ACA Stabilization; More
- Statement from the Center for Medicare Advocacy on Trump Administration’s ACA Actions
- CMA Alert – Open Enrollment Tips; ACA Sabotage; More
- Statement from Center for Medicare Advocacy on Latest ACA Repeal Effort
- Senate Holds Single Hearing on Bill to Strip Coverage from Millions – Act Now
- Graham-Cassidy: It’s Just Worse
- Leading Medicare Advocates Voice Opposition to Graham-Cassidy Bill
- URGENT: ACA Repeal Effort Renewed Through Graham-Cassidy Bill. This is Not a Drill – Action Needed!
- Moving Forward: Let’s Improve Medicare
- CMA Alert – Congress Returns, Still Threatening Health Care; ACA Sabotage; More
- The Medicare Rights Center and the Center for Medicare Advocacy Develop New Partnership with Support from The Retirement Research Foundation
- CMA Alert – Joint Replacement Model Undermines Care; OTC Hearing Aids Legislation Passed; More
- CMA Alert – Critical Issue Roundup: MA Overpayment; HH Payment; Observation; More
- Center for Medicare Advocacy Statement on Senate Failure to Pass ACA Repeal
- CMA Alert – Still Fighting for Health Care as Medicare’s Anniversary Nears; New Fraud Warning
- Senate Votes to Continue Attack on Health Care
- CMA Alert – Senate Health Bill, Again; Medicare Trustees Report; HH CoPs; More
- Health Repeal Myths & Facts: The Fight Continues
- Congress Leaves for the July 4th Recess, Health Care Repeal Remains a Threat – Continue to Make Your Voice Heard
- Health Care Repeal Vote Postponed But the Fight is Not Over
- Health Care Repeal Vote Postponed – But Keep the Pressure On
- Real People Will be Harmed by House & Senate Health Repeal Bills
- Senate Releases Draft of Bill to Undermine Health Coverage: Stop the “Better Care Reconciliation Act”
- Senate Plans to Vote to Gut Health Care Next Week – Act Now to Stop These Cuts!
- The Senate is Secretly Working to Gut Health Care – Bill Could Pass Soon!
- Health Care is Under Assault – CBO Score for AHCA, Trump Budget and ACA Sabotage
- More Than 75 National Organizations Urge U.S. Senate to Defend Medicare and Medicaid
- Senate Must Reject Health Bill Passed by the House
- House Passes American Health Care Act – Not American in Spirit or Health Care in Substance
- ACA Repeal Bill Keeps Getting Worse – Congress Must Reject It Today
- House Poised to Vote on Bill Gutting the Affordable Care Act and Medicaid, and Undermining Medicare – Act Now
- The Affordable Care Act in 2017: Myths and Facts
- CBO Report Confirms ACA Repeal Legislation Will Reduce Health Coverage, Care and Undermine Medicare
- Statement: CBO Report Confirms ACA Repeal Legislation Will Reduce Health Coverage, Care and Undermine Medicare
- Medicaid is Essential for Millions of Medicare Beneficiaries
- American Health Care Act (AHCA): A Repeal and Regress Plan
- 100 National Organizations Urge Congress to Reject Radical Changes to Medicaid
- Health Savings Accounts and Medicare Beneficiaries
- President Trump’s Address to Congress Brings No New News on Health
- Back to the Future: High Risk Pools Annotated Bibliography
- Repealing Medicaid Expansion Could Lead to Thousands of Deaths in the U.S. Annually
- House Republicans Present Outline of Plan that Would Gut Health Coverage
- The Center for Medicare Advocacy Comments on the Confirmation Hearing of Seema Verma
- Affordable Care Act Replacement Proposals – Concerns and Resources
- Center for Medicare Advocacy Statement on the Confirmation of Rep. Tom Price as Secretary of Health and Human Services
- New Study: Uninsured Rates for Older Adults will Increase if ACA is Repealed or Medicare Eligibility Age is Raised
- Issue Brief: Nursing Home Residents in Jeopardy if Medicaid Becomes a Block Grant
- Opening Salvo on ACA Replacement Falls Short
- HHS Nominee Price Faced Senate HELP Committee Today – Unanswered Questions Remain
- Fact-Checking the Confirmation Hearing of Secretary of Health and Human Services Nominee Tom Price
- Five Medicare Questions Senators Need to Ask Secretary of Health and Human Services Nominee Tom Price at Next Wednesday’s Confirmation Hearing
- Advocates Warn Congress of Dangerous Consequences of ACA Repeal and Delay for Seniors and People with Disabilities
- What’s at Stake In the Fight to Sustain Medicare, Medicaid and the Affordable Care Act (ACA)
- “Cures” Act Tips the Scales Even Further in Favor of Medicare Advantage Over Traditional Medicare
- Reports Highlight Devastating Effects of Repealing the Affordable Care Act and Turning Medicaid into Block Grants
- Protect Our Health Care: It’s All Connected – ACA, Medicaid and Medicare are All Under Threat
- Plenty of Sensible Changes to Help and Preserve Medicare
- Medicare is not “Going Broke”
- The Rush to Destroy Medicare as We Know It
- 10 Things To Be Thankful For, From the Center for Medicare Advocacy
- Truth: Obamacare Helps Medicare
- An Open Letter to CMS About Fraud
- Medicare Affordability and Enrollment Act: Important Protection Introduced for Beneficiaries
- Kaiser Family Foundation Issue BriefTurning Medicare Into a Premium Support System: Frequently Asked Questions
- Democratic and Republican Party Platforms: Side-by-Side Comparison of Issues Important to Medicare Beneficiaries
- Proper Use of Electronic Health Records Could Enhance Patient Care
- President Calls On Congress to Add a Public Option to the Affordable Care Act
- Center for Medicare Advocacy Submits Comments on Proposed MACRA Rule
- Center Comments on Proposed Rules for Medicare Skilled Nursing Facilities
- Yet Again, Value-Based Purchasing Did Not Improve Quality
- Solution to Medicare Part B Cost Increases? Look at “Outpatient” Observation Status
- Center Submits Comments to CMS Proposal Concerning Medicare Advantage Value-Based Insurance Design Model
- Reports of Import – Trustees and Kaiser Family Foundation
- Supreme Court Victory for the Affordable Care Act and Access to Healthcare
- Bundling Payments for Post-Acute Care
- Center Attorneys Meet with Senate Finance Committee Staff Members About Changes to Medicare Appeals Process
- Senate Finance Committee Holds Hearing on Medicare Appeals Backlog – Proposed Solutions Are of Great Concern
- Congress Passes “Doc Fix” – Senate Unable to Improve the Bill for Medicare Beneficiaries
- Medicare Myths vs. Facts – “Doc Fix” Edition
- Observation Status Bills Reintroduced in Both the House and the Senate (H.R. 1571/S. 843)
- “Doc Fix” Package Passed by House Takes Too Much from Beneficiaries with Too Little In Return
- Analysis of SGR Legislation From the Center for Medicare Advocacy
- No Way to Celebrate Medicare’s 50th: Proposed Congressional Budgets Offer More of the Same, Less for Medicare and Beneficiaries
- Ongoing “Doc Fix” Negotiations
- The President’s Proposed FY 2016 Budget: The Impact on Medicare
- Medicaid-Medicare Dual Eligible Updates
- Center Executive Director Judith Stein Testifies Before House Energy & Commerce Committee about Medicare Advantage Plans
- The President’s Proposed FY 2015 Budget: The Impact on Medicare
- Replacing the Broken Medicare Physician Payment Formula: At What Cost for People with Medicare?
- Medicare Prescription Drug Rebate Debate
- Caution: Home Health Episode Payment Caps
- Happy Birthday, Medicare!
- The Medicare Improvements for Patients and Providers Act: Improving Enrollment in the Medicare Savings Program Five Years Later
- New Report: Immigrants and Immigration Reform are Good for Medicare
- Good News: Trustees Project Longer Medicare Solvency
- Center for Medicare Advocacy Submits Joint Testimony to Congress on Medicare Reform Proposals
- CMS Addresses Observation Status Again… And Again, No Help for Beneficiaries
- Debunking Medicare Myths: Drug Rebates for Dual Eligibles
- Medicare’s Future: Letting the Affordable Care Act Work, While Learning From the Past
- Privatization: Not Right for Medicaid, Not Right for Medicare
- Medicare Paid $5.1 Billion to SNFs that Did Not Provide Care-Planning and Discharge-Planning (February 2013 OIG Report)
- The Impact of the President’s Budget on People Who Depend on Medicare and Social Security
- Medicare Benefit Redesign: Proposals to Restructure Could Hurt More than Help
- Happy Anniversary, Affordable Care Act
- Medicare Advantage “Cuts?” Don’t Believe it.
- Medicare and Mental Health
- Protect Medicare: Reject Paul Ryan’s Budget Proposal
- Honor Women’s History Month: Preserve a Strong Medicare Program
- Center for Medicare Advocacy Testifies on Medicare Redesign
- Translating DC-Speak: What Deficit Proposals Mean for Medicare Beneficiaries
- Nursing Home Enforcement by United States Attorneys: What Happened to the Regulatory System?
- Study Shows High Cost-Sharing Significantly Harms Family Health and Finances
- Medicare Facts and Fiction: Costs and Spending Edition
- Notes from the Cliff: The Deal and Its Impact on Medicare
- Putting a Donut Hole Back in Medicare: Proposals to Increase Medigap Costs Put Vulnerable Beneficiaries at Risk
- Warning: Medicare Payment Limits Are Bad for Health!
- Special Report – Independence of Medicare Administrative Law Judges Threatened by Office of Inspector General’s Recommendations
- Annual Medicare Payment Limits for Home Health – Even Worse Than Co-Pays for Beneficiaries
- Raising the Medicare Eligibility Age: A Costly and Dangerous Proposal
- Deficit Reduction and Medicare: Save Money Without Harming Beneficiaries
- The Affordable Care Act Moves Forward: What’s Up for 2013
- Medicare and ACA Facts and Updates; Jimmo Update
- CMA in Action: Judith Stein Testifies in Congress on the Ryan Plan to End Medicare
- Making Sense of Medicare’s Preventive Service Benefits
- Medicaid, Long Term Care and the Ryan Budget
- How the Ryan Budget (and Republican Platform) Would Hurt Current Nursing Home Residents
- We Don’t Need the Ryan Plan − Medicare Is Not Going Broke
- Center for Medicare Advocacy Director Judith Stein Refutes Claims that ACA Hurts Medicare
- The $700 Billion Medicare Myth
- Organizations Unite to Urge Caution in Demonstration Programs Serving Low-Income Medicare Beneficiaries
- House Votes for 33rd Time to Repeal Health Reform
- Good News for Medicare: Supreme Court Upholds Affordable Care Act
- Supreme Court Upholds Health Care Reform, Including Improvements to Medicare
- Champions for Medicare Beneficiaries Applaud Supreme Court Ruling
- Cut Through the Rhetoric: Questions to Ask After the Supreme Court ACA Decision
- MedPAC Reviews Blending Medicare and Medicaid
- A Reporter’s Checklist for the Impending Obamacare Ruling
- Center for Medicare Advocacy in Congress, Voicing Concerns on Behalf of Beneficiaries
- Affordable Care Act in Action: People with Medicare Continue to See Savings
- Rewarding Mediocrity: GAO Report Concerning Medicare Advantage “Bonus” Payments
- Fact vs. Fiction: Medicare is Not Going “Bankrupt”
- Toby Edelman Statement to Senate Committee Regarding Antipsychotic Drugs in Nursing Facilities
- Medicare Under Threat: Health Reform Versus the Ryan Budget
- Health Care Reform On Trial
- The Second Anniversary of Health Care Reform is Good News Will There be a Third?
- Bad Apples: Combating Medicare Fraud While Ensuring Access for Beneficiaries
- Congressional Subcommittee Examines Issues of Dental Health
- The President’s Proposed 2013 Budget: Impact on Medicare
- Investing in Our Future: Strengthening Medicare for 2012 and Beyond
- Protecting Medicare and the Middle Class: Themes from the President’s State of the Union Speech
- Payroll Tax Extension Includes Important Provisions for Medicare Beneficiaries
- Forcing Dual Eligibles Into Private Health Plans is No Quick Fix
- Supercommittee Update
- Health Care Reform Update: Where Are We, and What’s Up for 2012?
- Breaking Good News for Medicare Beneficiaries
- “Skin in the Game,” Health Equity and Deficit Reduction
- Medigap – Fact & Fiction
- The President’s Plan for Economic Growth and Deficit Reduction: A First Look at the Impact on Medicare
- CMS to Begin Round Two of Its Competitive Bidding Program for the Provision of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)
- Medicare Reimbursement For Skilled Nursing Facilities Remains High For 2012 Despite Reductions In Overpayments
- Raising the Medicare Eligibility Age Will Actually INCREASE Costs
- Medicare Facts & Fiction: 3 More Lessons to Combat Medicare Spin
- Amended Appeal Rules for Employer and Individual Health Plans
- Medicare Facts & Fiction: 3 Quick Lessons to Combat Medicare Spin
- What Does the Debt Ceiling Agreement Mean for Medicare?
- New Initiatives to Improve Services for Dual Eligibles
- House Plans Vote to Slash Medicare and Social Security through Balanced Budget Amendment
- Recommendations for Beneficiary Protections In Models Approved by CMMI
- Lower-Premium Pre-Existing Condition Insurance Plans Take Effect in Many States
- Real Solutions to Save Medicare Dollars in Skilled Nursing Facilities
- First Appellate Court Rules on Health Reform Law, Holds it Constitutional
- Why Medicaid Matters to People with Medicare
- So, What Would You Do? Real Solutions for Medicare Solvency and Reducing the Deficit
- New Rules for Medicare Advantage and Part D Plans
- Many Uninsured Individuals with Pre-Existing Conditions Will Find It Easier to Obtain Coverage
- Combating Fraud, Waste and Abuse in Health Care
- 2011 Medicare Trustees Report
- Send Us Medicare Summary Notices (MSNs)
- Preserve Medicaid – Share Your Story!
- Proposed Notice Requirements About Quality of Care: Endorsement, with Concerns
- New Hospice Face-to-Face Requirement: Help or Hindrance?
- Senators Kerry and Snowe, with Representatives Courtney and Latham, Introduce Legislation to Ensure Skilled Care for Seniors
- Health Care Changes: Challenges to Medicare
- What Happens to Current Nursing Home Residents if the House Budget Resolution Becomes Law?
- 25 Years of Medicare Advocacy, and Hope for 25 More
- Keeping Medicare and Medicaid Strong?
- Why Medicaid Matters to Medicare Beneficiaries and Their Families
- Happy Anniversary, Health Care Reform
- More Nurses in Nursing Homes Would Mean Fewer Patients Headed to Hospitals
- The Burden of Out-of-Pocket Costs on Medicare Beneficiaries
- Center for Medicare Advocacy to Congress: Defunding the Affordable Care Act Will Hurt Medicare Beneficiaries and Their Families
- Center for Medicare Advocacy Submits Testimony to House Ways & Means Committee: The Affordable Care Act Strengthens the Medicare Program and Retains Its Guaranteed Benefits
- New Hospice Regulations are a Mixed Bag for Beneficiaries Seeking High Quality End of Life Care
- New Regulations Are a Mixed Bag for Beneficiaries Seeking High Quality End-of-Life Care
- New Medicare Home Health Regulations: Improvement is Not Required to Obtain Coverage
- Medicare Changes Effective January 1, 2011
- Be Cautious Before Combining Medicare and Medicaid
- Be Cautious Before Combining Medicare and Medicaid
- CMA Alert: Medicare Home Health Regs: Improvement NOT Required; Also Extender Act and More
- Center for Medicare Advocacy Urges Policy-Makers to Rethink Medicare Cuts
- Health Care Reform Does Not Cut Medicare Benefits
- Health reform is Already Working, More Help Starts Tomorrow
- Affordable Care Act Expands Medicare Coverage for Prevention and Wellness
- Extended Observation Stays in Acute Care Hospitals: Criticism, Legislation and Discussion
- Medicare's 45th Anniversary: Promise Kept and Promises to Keep
- The Right to Visit Partners and Others In Medicare Participating Hospitals
- Health Reform in Action: Donut Hole Rebate Checks Start Arriving June 10, 2010
- Don’t “Fix” Medicare Out of Existence
- Myths About Nursing Home Tort Reforms
- Recommendations for a Coordinated Care Benefit in the Medicare Program
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