On September 7, 2011, Democrats on the House Ways and Means Committee put forth a 13-page outline of potential cuts in healthcare spending for consideration by the deficit-cutting congressional “supercommittee,” charged with proposing a $1.2 trillion savings plan. In addition to the two-dozen policy recommendations, the outline emphasizes the need to maintain (or accelerate) reforms included in the Affordable Care Act (ACA). The recommendations include:
- Raising the Medicare eligibility age to 67 by 2027 in two-month annual increments. The outline conditions this reform on retaining the ACA provisions designed to assist low-income Americans in purchasing insurance, warning that many near-elderly Americans without access to employer-based insurance would not otherwise be able to afford coverage.
- Increasing Part B premiums for high-income Medicare beneficiaries.
- The elimination or phase-out of Medicare bad debt reimbursement.
- Cuts to graduate medical education reimbursement.
- Reductions to reimbursement for Part B drugs administered in physician offices.
- A one- or two-year freeze on market basket adjustments for post-acute care providers (home health agencies (HHAs), skilled nursing facilities (SNFs), long-term care hospitals and inpatient rehabilitation facilities.
- A downward “rebasing” of HHA payments by 2015. The ACA implemented a four-year rebasing of HHA payments beginning in 2014. This proposal would implement the full rebasing two years ahead of the ACA.
- An increase in beneficiary cost-sharing obligations for SNF and HHA services, as well as for Medicare-covered clinical laboratory tests.
- Implementation of a non-budget neutral SNF value-based purchasing program.
The supercommittee has until November 23, 2011, to submit its recommendations to Congress as part of the August agreement to increase the Federal debt ceiling. If Congress fails to pass the supercommittee plan by December 23, 2011, Medicare providers will face across-the-board cuts of up to 2 percent beginning in 2013. The House Democrats’ list of recommendations is available by clicking here.