Obama Loots $716 Billion from Medicare

And again, you are in the bag for obama, and you are doing your very best to spin the facts. So stop lying, it is already been established that obama is raiding medicare. The result of this raiding will result in lower payments to hospitals and doctors, hence they will stop accepting patients on medicare

http://www.washingtonpost.com...
The Romney campaign has gone on the offense on Medicare, charging that the Affordable Care Act “cuts $716 billion” from the entitlement program.

That $716 billion figure is one you’ll probably be hearing a lot about during this election cycle. It’s worth understanding where it comes from and what the spending reductions mean for the Medicare program.

First, where it comes from. On July 24, the Congressional Budget Office sent a letter to House Speaker John Boehner, detailing the budget impact of repealing the Affordable Care Act. If Congress overturned the law, “spending for Medicare would increase by an estimated $716 billion over that 2013–2022 period.”

As to how the Affordable Care Act actually gets to $716 billion in Medicare savings, that’s a bit more complicated. John McDonough did the best job explaining it in his 2011 book, “Inside National Health Reform.” There, he looked at all the various Medicare cuts Democrats made to pay for the Affordable Care Act.

The majority of the cuts, as you can see in this chart below, come from reductions in how much Medicare reimburses hospitals and private health insurance companies.


The blue section represents reductions in how much Medicare reimburses private, Medicare Advantage plans. That program allows seniors to join a private health insurance, with the federal government footing the bill. The whole idea of Medicare Advantage was to drive down the cost of health insurance for the elderly as private insurance companies competing for seniors’ business.

That’s not what happened. By 2010, the average Medicare Advantage per-patient cost was 117 percent of regular fee-for-service. The Affordable Care Act gives those private plans a haircut and tethers reimbursement levels to the quality of care administered, and patient satisfaction.

The Medicare Advantage cut gets the most attention, but it only accounts for about a third of the Affordable Care Act’s spending reduction. Another big chunk comes from the hospitals. The health law changed how Medicare calculates what they get reimbursed for various services, slightly lowering their rates over time. Hospitals agreed to these cuts because they knew, at the same time, they would likely see an influx of paying patients with the Affordable Care Act’s insurance expansion.

The rest of the Affordable Care Act’s Medicare cuts are a lot smaller. Reductions to Medicare’s Disproportionate Share Payments — extra funds doled out the hospitals that see more uninsured patients — account for 5 percent in savings. Lower payments to home health providers make up another 8.8 percent. About a dozen cuts of this magnitude make up the green section above.

It’s worth noting that there’s one area these cuts don’t touch: Medicare benefits. The Affordable Care Act rolls back payment rates for hospitals and insurers. It does not, however, change the basket of benefits that patients have access to. And, as Ezra pointed out earlier today, the Ryan budget would keep these cuts in place.

Again, that is not a reliable source. The pie chart you have there, for example, does not even have a source on it. Opinion pages and blogs are not economic data. Look, I can pull them out of thin air to back up what I have to say, too-

http://www.csmonitor.com/USA/...

http://www.philly.com/philly/...

http://leftcall.com/the-716-b...

http://www.politifact.com/tru...

http://my.firedoglake.com/wig...

There are no cuts outlined in the bill. It is fact. This is a reduction in the growth curve. Medicare will cost $716bn less in ten years because the ACA reduces the cost. Not because it is being cut. The non-partisan CBO has outlined this. Read the document. It tells you in black and white.

http://blog.heritage.org/2012...

Last week, a new Congressional Budget Office (CBO) report updated the amount of money Obamacare robs out of Medicare from $500 billion to a whopping $716 billion between 2013 and 2022.

According to the CBO, the payment cuts in Medicare include:
•A $260 billion payment cut for hospital services.
•A $39 billion payment cut for skilled nursing services.
•A $17 billion payment cut for hospice services.
•A $66 billion payment cut for home health services.
•A $33 billion payment cut for all other services.
•A $156 billion cut in payment rates in Medicare Advantage (MA); $156 billion is before considering interactions with other provisions. The House Ways and Means Committee was able to include interactions with other provisions, estimating the cuts to MA to be even higher, coming in at $308 billion.
•$56 billion in cuts for disproportionate share hospital (DSH) payments.* DSH payments go to hospitals that serve a large number of low-income patients.
•$114 billion in other provisions pertaining to Medicare, Medicaid, and CHIP* (does not include coverage-related provisions).

*Subtract $25 billion total between DSH payments and other provisions for spending that was cut from Medicaid and CHIP.

In total, Obamacare raids Medicare by $716 billion from 2013 to 2022. Despite Medicare facing a 75-year unfunded obligation of $37 trillion, Obamacare uses the savings from the cuts to pay for other provisions in Obamacare, not to help shore up Medicare’s finances.

The impact of these cuts will be detrimental to seniors’ access to care. The Medicare trustees 2012 report concludes that these lower Medicare payment rates will cause an estimated 15 percent of hospitals, skilled nursing facilities, and home health agencies to operate at a loss by 2019, 25 percent to operate at a loss in 2030, and 40 percent by 2050. Operating at a loss means these facilities are likely to cut back their services to Medicare patients or close their doors, making it more difficult for seniors to access these services.

In addition, as MA deteriorates under Obamacare’s cuts, many of those who are enrolled in MA (27 percent of total Medicare beneficiaries) will lose their current health coverage and be forced back into traditional Medicare, where Medicare providers will be subject to further cuts. The Centers for Medicare and Medicaid Services chief actuary predicted in 2010 that enrollment in MA would decrease 50 percent by 2017, when Obamacare’s cuts were estimated at only $145 billion. Now that the cuts have been increased to $156 billion (or possibly $308 billion, as the Ways and Means Committee estimates), MA enrollment will surely decrease even further.

But Obamacare’s raid of Medicare doesn’t stop with cuts; it includes a redirection of tax revenue from the Medicare payroll tax hike in Obamacare. The payroll tax funds Medicare Part A, the trust fund that is projected to become insolvent as soon as 2024. Obamacare increases the tax from 2.9 percent to 3.8 percent, which is projected to cost taxpayers $318 billion from 2013 to 2022. However, for the very first time, Obamacare does not use the tax revenue from the increased Medicare payroll tax to pay for Medicare; the money is used to fund other parts of Obamacare, much like the $716 billion in cuts are.

With a raid on Medicare of this magnitude, President Obama’s assertion that his new law is protecting seniors and Medicare is astonishing. The truth is that Obamacare does the opposite.

The following is from Forbes, not known to be partisan to either side

http://www.forbes.com/sites/a...
Fact-Checking the Obama Campaign's Defense of its $716 Billion Cut to Medicare

Five days ago, Democrats were cheering the selection of Paul Ryan as Mitt Romney’s choice for Vice President. Democrats thought that Ryan’s efforts at Medicare reform would terrify seniors (with Dems’ encouragement, of course), thereby handing the election to President Obama. Contrary to their expectations, however, it has been the Obama campaign that has been forced to defend its $716 billion in cuts to the Medicare program, cuts that Mitt Romney promises to repeal. In the weeks ahead, those defenses won’t hold up. Here’s why.


Defense #1. Paul Ryan’s GOP budget preserved Obamacare’s Medicare cuts

Yuval Levin calls this the “Ryan did it too” defense. It has the merits of being factually accurate, up to a point. As I discussed on Tuesday, it’s true that the House GOP budget preserved Obamacare’s Medicare cuts. But it’s hard to see how “Ryan did it too” allows Democrats to say that Ryan is throwing granny over a cliff, unless they are confessing guilt to the same crime.

There are two other points to bear on this subject. The first is that Ryan’s Medicare cuts were solely used to extend the solvency of the Medicare trust fund, and not to fund new spending elsewhere. By contrast, Obamacare cut $716 billion from Medicare in order to fund $1.9 trillion in new health care spending, through the law’s expansion of Medicaid and its new subsidized exchanges.

The second point is that Mitt Romney is not campaigning on the Ryan budget. He’s campaigning on his own budget, which fully repeals Obamacare, and eliminates that law’s Medicare cuts.

APOTHEFACT CONCLUSION: Romney’s budget doesn’t preserve Obamacare’s Medicare cuts. Simple as that.

Defense #2. Obamacare’s Medicare cuts don’t harm seniors’ health benefits

“Mitt Romney’s Medicare ad is dishonest and hypocritical,” claims Obama campaign spokeswoman Lis Smith. “The savings his ad attacks do not cut a single guaranteed Medicare benefit.”

This is a deeply misleading statement by the campaign. It’s true that the Obamacare Medicare cuts don’t make any changes to the Medicare insurance benefit, which means that the health-care services covered by the Medicare insurance plan are technically unchanged. But Obamacare’s Medicare cuts are bluntly structured, in ways that will harm seniors’ access to care.

Of the $716 billion in cuts, $415 billion come in the form of “updates to fee-for-service payment rates,” a euphemism for reducing Medicare’s payments to doctors and hospitals. But what happens when you reduce payments to doctors? Doctors stop being willing to see Medicare patients. And if you can’t actually get a doctor’s appointment, what does it really matter what your insurance plan covers on paper?

We already see this happening in the Medicaid program, where sick and injured children can’t get appointments to deal with urgent medical conditions, because Medicaid so severely underpays doctors relative to private insurers. By the end of this decade, under Obamacare, Medicare reimbursement rates are set to fall below those of Medicaid.
The Obama administration’s own Medicare actuary, Richard Foster, has explained that the Obamacare Medicare cuts could make unprofitable 15 percent of hospitals serving Medicare patients. “It is doubtful that many [hospitals and other health care providers] will be able to improve their own productivity to the degree” necessary to accommodate the cuts, Foster has written. “Thus, providers for whom Medicare constitutes a substantial portion of their business could find it difficult to remain profitable, and, absent legislative intervention, might end their participation in the program (possibly jeopardizing care for beneficiaries. [Our] simulations…suggest that roughly 15 percent of [hospitalization] providers would become unprofitable within the 10-year projection as a result of the [spending cuts].”

Sarah Kliff cited a study yesterday that showed that every $1,000 that a hospital lost in Medicare reimbursements was associated with a 6-8 percent increase in mortality rates from heart attacks. John Goodman pointed out in the Wall Street Journal that Obamacare’s coverage expansion will not be accompanied by an increase in the supply of doctors, which will lead doctors to focus their time on the privately-insured patients who pay them the best.

APOTHEFACT CONCLUSION: Seniors’ benefits won’t change on paper. But they will change in reality, because fewer and fewer doctors will accept their insurance.

Defense #3. Obamacare cuts wasteful spending from the Medicare Advantage program

Of the $716 billion in Medicare cuts, the next biggest chunk, $156 billion, is taken out of the market-oriented Medicare Advantage program, known to wonks as Medicare Part C. Nationwide, 24 percent of all seniors are enrolled in Medicare Advantage, though that percentage is meaningfully higher in important swing states like Florida (32 percent) and Ohio (34 percent).
The rationale for cutting Medicare Advantage’s rates is that, prior to Obamacare, the government paid $1.14 per retiree in an MA plan, vs. $1.00 per retiree in a traditional plan. President Obama has called these differences “unwarranted subsidies [that] pad [private insurers’] profits but don’t improve the care of seniors.”

But the comparison between MA and government-run plans can’t be made on price alone. Due to the constraints placed on MA plans, those plans are incentivized by Congress to offer more benefits at the expense of lower prices. Imagine if you were searching airfares from New York to London, but couldn’t shop on price, only on what the planes served for food, and what movies were on board.

However, on an apples-to-apples basis, if you take out the extra benefits, Medicare Advantage plans are 9 percent cheaper than government-run plans. That was the finding of three Harvard economists, published in the Journal of the American Medical Association this month.
So, how will Obamacare’s Medicare Advantage cuts affect seniors who are currently enrolled in MA plans? My co-blogger, Robert Book, published a 2010 paper on this subject, along with Jim Capretta. Robert and Jim found that “Medicare beneficiaries who would have enrolled in the Medicare Advantage program under prior law will lose an average of $3,714 in 2017 health care services.” You can see a state-by-state distribution of the effects on the map below.
Personally, I have no problem with eliminating the extra subsidy for Medicare Advantage plans. But that elimination should have been accompanied by regulatory changes, so that Medicare Advantage plans could compete on price with traditional government-run Medicare. That would have saved the government even more money, instead of forcing seniors out of the program.

APOTHEFACT CONCLUSION: Medicare Advantage offers seniors higher-quality care at a lower cost than government-run Medicare. Obamacare should have sought to save money by expanding the program, instead of undermining it.

Defense #4. The Romney plan for Medicare is worse, because it would shift costs to seniors

A talking point that President Obama has repeated on the campaign trail is that the Romney Medicare plan would “shift costs to seniors.” This is plainly dishonest, and the President knows better.

The 2011 version of the Ryan plan required that those younger than 55 enroll, upon retirement, in privately-run Medicare plans. These future retirees would be able to choose among a menu of plans, and would get a fixed amount of “premium support” with which to choose among those plans. Because the amount of premiums support would increase at the rate of inflation, whereas health-care costs have historically grown at a faster rate, critics have worried that these trends, if continued into the future, would expose seniors to higher health-care costs out-of-pocket.

Advocates of the 2011 Ryan plan, myself included, argue that precisely because of the premium support mechanism, seniors would be incentivized to shop for value with their insurance plans, creating a market incentive that would moderate health care cost growth. But the Congressional Budget Office assumes that market competition would have no effect on spending growth, hence the argument that the 2011 Ryan plan would shift costs to seniors.

However, Mitt Romney pointedly refused to endorse this 2011 plan. Instead, he offered his own plan, one which addressed the above critique of the 2011 Ryan reform using a mechanism called competitive bidding, whereby seniors would be guaranteed to be able to purchase a fully-subsidized plan offering Medicare’s traditional set of insurance benefits. Weeks later, Paul Ryan and Democratic Sen. Ron Wyden (Ore.) produced a very similar plan, a plan that was incorporated into the 2012 GOP budget.

APOTHEFACT CONCLUSION: President Obama is not being honest about the Romney Medicare reform plan, which was expressly designed to respond to the cost-shifting critique of the 2011 Ryan plan. The Romney plan preserves Medicare’s benefits without exposing seniors to rising health-care prices.

What Seniors Have to Fear From ObamaCare
http://townhall.com/columnist...

Last August, the Office of the Medicare Actuary predicted that within nine years Medicare will be paying doctors less than what Medicaid pays. Think about that. In most places around the country Medicaid patients have extreme difficulty finding doctors who will see them. As a result, they end up seeking care at community health centers and in the emergency rooms of safety net hospitals. In a few more years seniors will be in that same position -- with this difference. From a financial point of view, the seniors will be perceived as less desirable customers than welfare mothers. Also, by that point one in seven hospitals will have to leave the Medicare system.

As Medicare Chief Actuary Richard Foster (page 282) said in the 2010 Medicare Trustees' report, "Well before that point, Congress would have to intervene to prevent the withdrawal of providers from the Medicare market and the severe problems with beneficiary access to care that would result."

But suppose Congress didn't intervene. Suppose that the law continues on the books exactly as it is written.

Consider people reaching the age of 65 this year. Under ObamaCare, the average amount spent on these enrollees over the remainder of their lives will fall by about $36,000 at today's prices. That sum of money is equivalent to about three years of benefits. For 55-year-olds, the spending decrease is about $62,000 — or the equivalent of six years of benefits. For 45-year-olds, the loss is more than $105,000, or nine years of benefits.

In terms of the sheer dollars involved, the planned reduction in future Medicare payments is the equivalent of raising the eligibility age for Medicare to age 68 for today's 65-year-olds, to age 71 for 55-year-olds and to age 74 for 45-year-olds. But rather than keep the system as is and raise the age of eligibility, the reform law instead tries to achieve equivalent savings by paying less to the providers of care.

What does this mean in terms of access to health care? It almost certainly means that seniors will have extreme difficulty finding doctors who will see them and hospitals who will admit them. Once admitted, they will certainly enjoy fewer amenities (no private room, no gourmet meal choices, and no cable TV perhaps) as well as a lower quality of care. We will have a two-tiered health care system, with the elderly getting second class care.

All these problems will be exacerbated by what ObamaCare does in the rest of the health care system. In just two years, 32 million people will become newly insured. If economic studies are correct, they will try to double the amount of health care they have been consuming. In addition, almost everyone else (including most above-average income families) will be forced to obtain more generous insurance than they have today. With more coverage for more services these people will also try to greatly expand their consumption of care. Yet the health reform act did not create one new doctor or nurse or other paramedical personnel to meet this increased demand.

We are about to experience a system wide rationing problem, which will be reflected in longer waits at doctors' offices, emergency rooms and clinics and delays in getting almost every kind of care.