Dive Brief:
- A bill introduced on Wednesday by Sen. Ron Wyden, D-OR, would establish a spending cap on out-of-pocket costs for traditional Medicare beneficiaries.
- The legislation, dubbed the Medicare Affordability and Enrollment Act, would also streamline enrollment and expand eligibility for low-income beneficiaries to obtain financial assistance to cover their premiums and out-of-pocket costs.
- Wyden's proposal would set the spending limit at $5,500 for 2018, which would provide similar financial protection as under Medicare Advantage and most commercial insurance plans.
Dive Insight:
The finance committee suggests Medicare as it currently stands has become outdated since it was created in 1965 and needs to be updated to protect seniors and make healthcare more affordable.
“Today, the promise of Medicare falls short for too many who find their health costs becoming more and more unaffordable,” Wyden stated, arguing that the program needs improved policies to provide a firm foundation for the next generation of seniors.
Across the industry, out-of-pocket costs are being eyed as a barrier that those with insurance are more frequently facing, potentially leading to patients forgo care and wind up with worse and costlier outcomes in the long run.
Wyden argues with 86.5% of beneficiaries using supplemental insurance, that illustrates that the base Medicare benefit needs to be improved. "Beneficiaries who do not have supplemental coverage are often the most vulnerable - those likely to be poorer, disabled, from a rural area or in poor health," the legislation summary notes.
The legislation also aims to update Medicare's outdated enrollment process and end issues in which enrollment mistakes can permanently cost beneficiaries more, such as when failure to initially enroll in Medicare Part B can result in permanently higher premiums once people do enroll.
Republicans are not expected to support the legislation, however, so the move is unlikely to take hold unless Democrats gain a Senate majority.