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obody -- and I mean nobody -- should be surprised by this: Amid heavy pressure from insurers, lawmaker and advocates, the Obama administration has backed off proposed cuts to Medicare Advantage for the second year in a row. They’ll rise by 0.4 percent in 2015 instead of undergoing the originally proposed 1.9 percent cut....“The changes CMS included in the final rate notice will help mitigate the impact on seniors, but the Medicare Advantage program is still facing a reduction in payment rates next year on top of the 6 percent cut to payments in 2014,” said [AHIP] president Karen Ignagni....

It is a fool’s errand to attempt a cost-benefit analysis on government programs. War, for example, is probably the oldest government program. It is easy enough to determine the cost in lives and treasure, but it is far more difficult to determine the benefits, and then, if these benefits were worth the cost. Back in the day, victory was the goal, and presumably the overriding benefit. In the past, “victory” was always understood as causing your enemy to surrender. Nowadays, of course, that is no longer the case. In the 1960s, it became popular to declare “war” on all sorts...

The Obama administration on Monday canceled planned cuts to Medicare Advantage amid a drumbeat of election-year opposition from Democrats. The cuts would have reduced the benefits that seniors receive from insurance plans in the program, which offers an alternative to traditional Medicare. The reversal came as a relief to many Democrats, who feared the cuts would create a backlash among seniors in the midterm elections. “In many parts of the country, including New York, Medicare Advantage works very well. They’ve shouldered their share already and this proposed cut would have been disproportionate, hurting seniors who would lose doctors or pay...

Democrats are facing a senior problem that could get even worse this year. The party has traditionally had trouble with older voters, losing the group aged 65 and over by 21 points in 2010 — when Republicans picked up 63 seats — and by 12 points in the 2012 presidential race. Seniors are the GOP’s most reliable voting bloc in midterm years, turning out in higher numbers than Democratic base voters. A recent Gallup poll showed seniors have become even more Republican over the last two decades; in 2013, 48 percent considered themselves Republican. That spells trouble for Democrats, who...

Democrats are battling the White House over proposed cuts to Medicare Advantage, creating a new divide on healthcare just as the party had begun to rally around ObamaCare’s 7.1 million enrollees. The issue threatens the newfound momentum Democrats have on healthcare after a late surge of ObamaCare enrollees surprised and electrified a party that had been beaten down after months of bad news associated with the healthcare law’s rollout. It’s particularly sensitive during an election year, as both parties court senior voters, who make up a disproportionate percentage of the voting population in midterm elections. The issue creates another...

hamden >> Seniors and U.S. Rosa L. DeLauro planned their next move Friday as they looked for ways to keep UnitedHealthcare and federal agencies accountable after the large insurer cut Yale-New Haven Hospital and more than 2,200 doctors around the state from their Connecticut networks. DeLauro, D-3, said she will ask the federal General Accounting Office to investigate the Center for Medicare and Medicaid Services on how it determined the remaining practitioners will be enough to serve patients and whether UHC gave the required notice to Greater New Haven clients. The letter has been signed by all five of Connecticut’s...

WASHINGTON (AP) — House Budget Committee Chairman Paul Ryan unveiled an updated Republican budget plan Tuesday that would slash $5.1 trillion in federal spending over coming decade and promises to balance the government's books with wide-ranging cuts in programs like food stamps and government-paid health care for the poor and working class. Ryan's plan would also cut Pell Grants for low-income students and pensions for federal workers, while steering away from cuts to benefits for senior citizens, at least in the short term. The proposal would reprise a voucher-like Medicare program for future retirees that would be the basis for...

You won’t read about the International Classification of Disease (ICD) on TMZ or hear it discussed on The View, but it has the potential to be an unpleasant October surprise in the health care world. It is a list of codes that physicians and hospitals use when billing insurance companies. These codes cover all manner of medical diagnoses for diseases, conditions, and injuries. The first version of the ICD appeared in 1946, with periodic revisions since. Six months from now, on October 1, the latest version, the ICD-10, will be implemented in the U.S. We are late to the party,...

The problems with the implementation of the Affordable Care Act may be masking another major change in the way health care is delivered to U.S. consumers, experts believe. At a conference in Washington on Thursday, health care and business professionals said that there’s an increasing trend in the industry toward cutting insurance companies out of the process entirely, as large, regional hospital systems move into the insurance business. Dr. Kenneth L. Davis, CEO and president of Mount Sinai Health System, the largest health care provider in the state of New York, said that starting next year, Mt. Sinai will begin...

And that sort of a backlog has Democrats worried. POLITICO brings us up to date: Rep. Jim McDermott (D-Wash.) is sounding the alarm this morning about a massive backlog within the Office of Medicare Hearings and Appeals. The 357,000-appeal clog delays providers from having their cases heard for longer than two years, McDermott noted in a letter to HHS Secretary Kathleen Sebelius. ” “The agencies must review their administrative procedures and act now to protect seniors who are struggling to get Medicare payment appeals addressed,” he wrote. He argued that problems with recovery auditors have been identified as the leading...

The possibility of being called a liar by Harry Reid isn't stopping this group of senior citizens from speaking out.

March 10, 2014, 12:38 pm Obama drops Medicare changes By Elise Viebeck The Obama administration is abandoning a surprise plan to alter Medicare drug coverage rules after it was almost unanimously panned by Congress and K Street. Medicare chief Marilyn Tavenner alerted lawmakers Monday that her agency would not finalize regulations giving insurers more leeway to limit the number of drugs they cover for Medicare beneficiaries. Critics argued that making the change, which the administration said would save money, would have hampered seniors' access to necessary medications Democrats had worried the issue could have hurt them in the midterm elections....

A new report by the Robert Powell Center for Medical Ethics at National Right to Life warns that one of the Obamacare provisions that ex-House Speaker Nancy Pelosi said Americans would discover if Congress passed the bill is that some seniors will not be allowed to spend as much as they wish on their health care. The extreme position was revealed in a special report by the NRLC titled “The Affordable Care Act and Health Care Access in the United States,” which analyzes four fundamental policy areas of Obamacare. It finds several ways that the federal health care law “will...

For better or worse, the incursion of national governments into health care—including our own Medicare system—has permanently altered virtually all aspects of how care is delivered. Even before the Affordable Care Act (Obamacare) explicitly brought federal control to every facet of this industry irrespective of the type of insurance coverage, Medicare’s influence would reach far beyond its statutory purview of health care for seniors. Not surprisingly, the Centers for Medicare & Medicaid Services (CMS) has become the lead agency for Obamacare, and, somewhat ironically, has spared no expense in the pursuit of saving money on health care. For example, CMS...

The health insurance industry fighting proposed cuts to Medicare Advantage payments argued they will raise seniors' out-of-pocket costs next year. America's Health Insurance Plans (AHIP), a trade group, blasted the reductions with a report Thursday finding that beneficiaries could pay as much as $900 more in 2015 if the cuts take effect. The report by consulting firm Oliver Wyman concluded that Medicare Advantage (MA) plans could see a 5.9 percent total cut to their payments next year as a result of changes proposed by federal health officials. The Centers for Medicare and Medicaid Services (CMS) floated a 2015 cut of...

A northern-Michigan hospital is cutting 43 positions in part because of costs related to the Affordable Care Act, its CEO says. David Zechman of McLaren Northern Michigan told a local television station the layoffs were “something that we had no choice in doing.” Zechman cited the changes to Medicaid and Medicare under the health-care law that cut reimbursement rates for the hospital’s services. “We still have the same costs of taking care of patients, but it’s hard to keep doing the same things you’re doing if you’re paid less for the same amount of costs and services you provide —...

An alliance of drug companies and patient advocates, joined by Democrats and Republicans in Congress, is fiercely opposing an Obama administration proposal that would allow insurers to limit Medicare coverage for certain classes of drugs, including those used to treat depression and schizophrenia. The administration’s proposal would remove the protected status from three classes of drugs that has been in place since the program’s inception in 2006: immunosuppressant drugs used in transplant patients, antidepressants and antipsychotic medicines. They include many well-known drugs, such as Wellbutrin, Paxil and Prozac to treat depression, and Abilify and Seroquel to treat schizophrenia. Three other...

Last month, Ed brought up the subject of how insurance companies were reacting to scheduled cuts to Medicare which were part of Obamacare. The news wasn’t good for them, and now Democrats are moving toward full blown panic mode after HHS announced that the cuts are on the way. The Obama administration ignited a new election-year controversy Friday when regulators handed down fresh cuts to Medicare Advantage (MA).Next year, plans in the program will see their payments cut by at least 2 percent on average between ObamaCare and a regular annual update, the announcement stated.The Centers for Medicare and Medicaid...

The critics are right, however, that some people will choose to work less because they qualify for a tax-credit based subsidy. If not for this government program, they would have to work harder and employment numbers would be higher. So might total output or gross domestic product. This aspect of the Affordable Care Act distorts economic efficiency. But don't kid yourself that this is anything new. Social Security has the same effect. About 41 million people currently get Social Security retirement benefits. Many still do work, at least part-time. But most do not. If not for their monthly checks, which...

Cuts are on the table next year for Medicare Advantage plans, the Obama administration says. The politically dicey move affecting a private insurance alternative highly popular with seniors immediately touched off an election-year fight. The announcement gave new ammunition to Republican critics of President Barack Obama’s health care law, while disappointing some Democratic senators who had called on the administration to hold rates steady. Insurers are still hoping to whittle back the cuts or dodge them altogether. …