Groups Weigh In on How Debt Panel Could Affect Health Care Issues

The National Association of Medicaid Directors is urging the federal debt-reduction committee to relax rules that guide how states can make changes to their Medicaid programs, The Hill's "Healthwatch" reports.

NAMD said relaxing the rules would result in cost savings for both states and the federal government (Baker [1], "Healthwatch," The Hill, 9/22).

The organization urged the debt panel to give states authority to "enroll any Medicaid eligible population in care-management programs" without obtaining a waiver from CMS. The state authority also would apply to using managed care for dual eligibles.

The group is one of several health-related organizations that are weighing in on the debt panel's work.

American College of Radiology Comments on Imaging Industry 

In a statement on Thursday, the American College of Radiology said the debt panel should reject an Obama administration proposal to cut payments to the imaging industry by $1.3 billion over five years.

The group said the industry already has faced $5 billion in reimbursement reductions over the previous five years and the cuts "would likely force many suburban and rural imaging providers to close, drive imaging care back to metropolitan medical centers and cause patients to endure longer commutes and wait longer for appointments to receive care."

Insurance Commissioners Group Addresses Medigap Policy

Meanwhile, the National Association of Insurance Commissioners in a letter to the debt panel said the Obama administration's Medigap policy would "simply shift more costs onto seniors ... and not address the underlying cause of increased medical costs."

NAIC said they have enforced the standardized Medigap policies and worked with Congress over the past two decades to protect beneficiaries. The group said that seniors will forgo needed medical care because the proposed changes will affect cost-sharing coverage for "medically necessary" services, and Medigap policies only pay cost-sharing for services that Medicare has deemed necessary.

American Medical Association Weighs In on SGR Formula

In addition, the American Medical Association in a letter on Thursday asked the debt panel to overhaul the sustainable growth rate formula for Medicare physician payments. They said the current budget baseline "assumes that massive physician payment cuts will be implemented, even though Congress has rejected less severe cuts 12 times over the past decade" (Norman, CQ HealthBeat, 9/22).

Nursing Home Group Combats Cuts

The Alliance for Quality Nursing Home Care on Thursday released an analysis that found nursing homes are the least costly option for care after hospitalization.

The report found that Medicare pays nursing homes almost three times less than long-term care hospitals to treat people who have had a heart attack, and similar discrepancies exist in payments for other conditions.

"Weakening the sector with an overwhelming barrage of regulatory and budgetary cuts -- with more funding cuts contemplated -- is counterproductive and illogical," AQNHC President Allan Rosenbloom said (Baker [2], "Healthwatch," The Hill, 9/22).

'Modest Adjustments' in Obama Plan Fail To Address Long-Term Problems

The deficit-reduction proposal President Obama released on Monday does not include proposals to address "long-term structural problems" within Medicare, which could be the largest contributor to future deficits, National Journal reports.

According to National Journal, the proposal includes "wishful accounting" that might overstate its savings, including avoiding the "doc-fix" problem and calling for the Independent Payment Advisory Board to slow Medicare cost growths to levels the program has never before achieved.

The proposal also implies that Medicare cost reduction will be facilitated through provisions in the federal health reform law, but it is not certain which pilot projects will be successful and whether they will be implanted nationwide, according to National Journal (Sanger-Katz, National Journal, 9/22).

Poll Finds Opposition to Medicare Cuts

A majority of voters from both parties oppose cutting Medicare and Social Security to help reduce the federal deficit, according to a poll released on Tuesday by the National Committee to Preserve Social Security and Medicare.

The survey of 800 likely voters was conducted between Sept. 8 and Sept. 11. It has a margin of error of plus or minus 3.5 percentage points.

The poll found:

• 82% of Democrats, 73% of Independents and 58% of Republicans oppose cuts to Social Security and Medicare; and
• 94% of Democrats, 82% of Independents and 64% of Republicans favor tax increases on the wealthy (CQ HealthBeat, 9/22).