John Yarmuth, House Budget Chair (D-Ken.), acknowledged that what we want is more costly than what we will be able to accomplish. This week, he acknowledged it.
The Senate and House committees are currently putting together the package. They are considering options such as a longer phase in of benefits, skimpier coverage with greater cost-sharing, or means-testing to limit new benefits to the poorest beneficiaries.
Rep. Lloyd Doggett (D.Texas), who chairs the House Ways and Means Health Subcommittee on seniors, stated that seniors may end up paying a portion of the cost for their hearing, vision, and dental services. This is despite concerns about the impact it could have on low-income Medicare beneficiaries.
He said that we have discussed the importance of making sure that those who are most in need are able to receive help.
The American Dental Association and other groups are trying to influence the outcome. They want Congress to provide a greater benefit to those who earn less than 300 percent of federal poverty.
We will focus on the people who can't afford to go to the dentist and those most likely to end-up in the emergency department, stated Michael Graham, senior vice president of government and public affairs at the association.
Many lawmakers and advocacy groups believe such means-testing in Medicare could set a dangerous precedent, and change the nature and character of a program that benefits more than 61,000,000 elderly and disabled beneficiaries.
Melissa Burroughs, the associate director for strategic partnership at Families USA, stated that dental is the most expensive medical service. It costs more than prescription drugs and anything else. So to claim you can only help a few people doesnt make sense. This is a benefit we want to offer all Medicare beneficiaries.
AARP is lobbying for as generous a benefit to be available, and warns of a backlash if it takes too long or covers too few services.
We are advising Congress to do a great job with the hearing, vision, and dental benefits. If our members show up to their dentists and find that the new program doesn't cover them, they will be very upset," said Bill Sweeney the senior vice president of government affairs. It must be comprehensive."
The health insurers are retorting, warning that new coverage may reduce other benefits such as free transportation to appointments and free over-the counter drugs.
It is unfair and unnecessary to ask 27 million Americans for their new hearing, vision and dental benefits instead of services they have come to depend on, stated Matt Eyles (president and CEO of America’s Health Insurance Plans), the industry's powerful Washington lobby.
To offset the rising cost of new benefits, insurers want Congress to increase the amount that the government pays private Medicare Advantage plans. Progressives such as Doggett argue that Medicare Advantage payments are too high. They are looking to reduce them to fund the entire bill.
He said that if we are unable to pay for it with [drug price negotiations], then we should consider the excessive Medicare Advantage plan payments. Traditional Medicare does not have comprehensive coverage, so insurance companies don't want it.
A source in the insurance industry said that Congress' deliberations are frightening companies because they worry seniors will abandon their private plans and switch to traditional Medicare once new benefits are implemented. The source claimed that the industry is aware of the negative consequences of public opposition to coverage for eyeglasses and dental care, as well as the potential impact on hearing aids.
Staffers in the Senate and Democratic House say that they don't give much weight to industry arguments. Senior Senate Democratic aide stated that the concerns of insurers were not surprising and are a constant thing when major reforms are being considered.
The aide stated that they were still working hard to add these benefits. It's long overdue.
Top Democrats insist that the new Medicare benefits will be included in the package in some way. They point to President Joe Biden's endorsements and recent endorsements by the House and Senate leadership. However, aides warn that the program might not be as generous than some think.
Doggett stated that the House is currently discussing whether hearing and vision benefits would be available to the House. These benefits are expected to be cheaper than dental care and will kick in within the first few years of passage. There would also be a longer phase-in period for dental. The senior Senate Democratic aide stated that the upper chamber is currently working on an interim policy to provide seniors with some relief. This will include help paying for all three services immediately while the administration sets up the full benefit over the next few years.
For weeks to come, there will be arguments about when benefits will begin and end and what services will be covered at which levels. Unresolved issues include whether the focus should be on preventative care as in other government health programs. The Democrats will also need to decide whether to authorize the benefits for only a few years. They are betting that they'll still be the majority when it comes to renewing it.
Another senior Democratic aide admitted that there will be tradeoffs in any health policy. We are currently trying to balance co-insurance, timing and generosity in various categories of benefits.
Megan R. Wilson contributed reporting.
