We are celebrating an anniversary. Sixty years ago, as President Lyndon Johnson signed Medicare into law, he proclaimed “No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings that they have so carefully put away over a lifetime so that they might enjoy dignity in their later years. No longer will young families see their own incomes, and their own hopes, eaten away simply because they are carrying out their deep moral obligations to their parents, and to their uncles, and their aunts.”
Sixty years later, another Johnson, Speaker of the House Mike Johnson, is also addressing Medicare. Although he has repeatedly said that Republicans will not cut Medicare benefits for current beneficiaries, his plans differ. He will be looking to change Medicare for younger people who will become eligible in the future. In a Louisiana radio interview, he stated that Social Security, Medicare and Medicaid “have to be adjusted and fixed.” He added: “We have a plan to do next year.” He added again, “Desperate times call for desperate measures.”
Continuing to make America great again, The Trump administration announced that a temporary program that helped stabilize Medicare Part D premiums will end after 2026. The administration says the program will not continue in 2027. This has the potential for increasing the prescription-drug-plan costs of the approximately 25 million people in standalone Part D plans.
Medicare is ending a subsidy program to insurance companies for their standalone Part D drug plans that has helped keep enrollees’ premiums in check. That means starting in 2027 seniors enrolled in standalone Part D drug plans could face a larger premium increase than they have in recent years. Other cost reductions include reducing payments to private insurance companies. Medicare Advantage insurers receive payments from Medicare. An obvious way of reducing federal Medicare spending without formally cutting the benefits promised to seniors is to reduce payments to the private insurers. The Congressional Budget Office estimates that Medicare Advantage enrollees would receive fewer supplemental benefits and have higher average out-of-pocket costs.
Another possibility is reducing what Medicare pays doctors, hospitals or other providers. CBO has identified numerous ways of reducing Medicare spending, but the economic consequence can hurt: if Medicare payments become less attractive to providers (doctors, hospices and hospitals) some providers could become less willing to accept Medicare patients. This means that a “provider payment cut” can become an access-to-care problem rather than a formal benefit cut.
There are also proposals that would change what Medicare beneficiaries themselves pay. CBO has examined establishing a uniform Medicare cost-sharing system with an out-of-pocket limit. That would save federal money, but it would redistribute costs among beneficiaries. These CBO priorities illustrate why the phrase “we won’t cut benefits” doesn’t necessarily mean “Medicare beneficiaries won’t pay more.”
The programs of two Johnsons: one giveth, other taketh away. Be careful of those for whom you vote. Your vote may cost you big time.
Sally Lam is a retired educator who has served as the president of The Naples Branch of the American Association of University Women and on the Collier County Development Services Advisory Committee as its environmental component. She is currently an active volunteer in the Naples area.
This article originally appeared on Naples Daily News: Sixty years of Medicare: A tale of two Johnsons | Opinion
Reporting by Sally Lam / Naples Daily News
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By Sally Lam | USA TODAY Network
