MEDICARE+CHOICE: Program ‘Not Stable,’ MedPAC Chair Says

      The Medicare+Choice program "is not stable" and its long term viability is questionable, according to Medicare Payment Advisory Commission Chair Gail Wilensky. She pointed to recent pullouts by Medicare HMO plans and slowing enrollment in private plans by Medicare beneficiaries as a signal that "what we have now is an unstable alternative." She said that lawmakers should opt for a "premium support" program similar to the plan covering federal workers or a "modernized version" of the old Medicare program. She also countered attacks from House Ways and Means health subcommittee Chair Bill Thomas (R-Calif.) and others that MedPAC's support of higher Medicare hospitals payments was the result of industry lobbying. Wilensky said MedPAC commissioners became "concerned" after seeing 1998 data showing that hospital margins had fallen for both Medicare and private patients. Despite MedPAC's recommendation, Wilensky was skeptical that Congress would "throw tens of billions more dollars back into Medicare" this year because of recent reports showing a 3%-4% increase in program spending. Part of that rise is a response to Medicare "givebacks" from last year. Wilensky also speculated that recent hikes in private insurance premiums may brighten providers' overall financial pictures, making "the hospital case less compelling than last year." The commission's June report is scheduled to be delivered to Congress today (Rovner, CongressDaily, 5/31).