Numerous proposals have been advanced recently to restructure cost-sharing requirements for beneficiaries participating in traditional Medicare. Motivated by both a desire to modernize Medicare’s benefits and reduce the growth of Medicare spending, these proposals typically include a unified deductible for Parts A and B, coinsurance or copayments for all services, a cap on out-of-pocket expenses, and policies to reduce the use of Medigap and other supplemental policies that provide first-dollar coverage. These proposals have raised concerns about low-income beneficiaries, for whom additional cost sharing may be burdensome. Depending on their income and assets, individuals with incomes below 135 percent of the federal poverty level currently receive help with cost sharing and/or premiums under the Medicare Savings Programs (MSPs). Participation in these programs is low, however. This Forum Session provided an overview of the MSPs and their limitations, reviewed Medicare cost-sharing restructuring proposals, and discussed various options and approaches for protecting low-income beneficiaries.
Leslie Fried, JD (bio)
Director, Policy and Programs
National Council on Aging
Stephen Zuckerman, PhD (bio)
Health Policy Center
The Urban Institute
Thomas P. Miller, JD (bio)
Health Policy Studies
American Enterprise Institute
See the Forum's products: "Recent Proposals to Limit Medigap Coverage and Modify Medicare Cost Sharing" (Issue Brief No. 845, February 24, 2012); "Medicare Supplemental Coverage: Weighing the Consequences and Trade-Offs for Medicare Spending and Beneficiaries" (Forum Session, December 9, 2011); and "Rethinking Medicare's Cost Sharing and Supplemental Coverage: Options and Implications" (Forum Session, April 12, 2013).
- Stephen Zuckerman, Baoping Shang, Timothy Waidmann, "Policy Options to Improve the Performance of Low Income Subsidy Programs for Medicare Beneficiaries," Urban Institute, Health Policy Center, January 2012
- Thomas P. Miller, "Daring to Be Cautious?: Bigger Steps Needed for Medicare Cost-Sharing Reform," American Enterprise Institute for Public Policy Research, March 2013
- Robert Berenson, John Holahan, and Stephen Zuckerman, "Can Mediare Be Preserved While Reducing the Deficit?" Urban Institute, March 2013
- Government Accountability Office, "Medicare Savings Programs: Implementaiton of Requirements Aimed at Increasing Enrollment," GAO-12-871, September 14, 2012