As the presidential race enters its final two-week stretch, legislators in Congress and Obama administration officials continue to wrangle over what has emerged as a major point of contention between the presidential contenders: the administration’s implementation of Medicare cost-cutting measures under President Obama’s signature 2010 health reform law.
On October 22, the Republican-chaired House of Representatives Oversight and Government Reform Committee sent a subpoena to the Department of Health and Human Services (HHS) for documents relating to a Medicare Advantage (MA) demonstration project that the committee claims the department failed to satisfactorily provide after months of repeated requests.
In late 2010, the Centers for Medicare and Medicaid Services (CMS), an agency within HHS, announced that it would implement the demonstration instead of a quality-based MA initiative provided for under the reform legislation. Under the demonstration, which is expected to cost more than $8 billion over 10 years and defray more than one-third of MA payment reductions projected for 2012 through 2014, MA health insurance plans are eligible for bonus payments if they maintain three stars on a five-star quality scale, with five stars representing the highest quality. By contrast, the measure under the reform law would require plans to maintain between four and five stars to receive bonuses.
Earlier this year, the Government Accountability Office, an independent oversight agency, recommended that CMS cancel the demonstration after concluding that it would not produce meaningful results and that its legal authority was questionable. Citing these findings, the House committee speculated in its correspondence to HHS that the only plausible explanation for the demonstration is “to temporarily cover up Obamacare’s large cuts to the 13 million seniors enrolled in Medicare Advantage until after this year’s election.” HHS and congressional Democrats have countered these assertions with arguments that the demonstration will allow the government to test potential quality and cost reforms in Medicare and that the House committee’s investigation is politically driven.
With future implementation of the reform legislation uncertain in the last days of the presidential race, it remains to be seen how HHS will respond to the House committee’s subpoena.