When it comes to long-term federal spending obligations and the debt picture, Medicare has always been
the story. And the spectacular savings (cumulative trillions of dollars so far) in Medicare savings that have been achieved since the Affordable Care Act passed in 2010 are also a key part of that story.
Well, I'm pretty sure why, but I guess others are still wondering what odd thing happened in 2010 to make both Medicare and the entire American health care system more sustainable. Anyway, the New York Times clues in today on "the most important thing that has happened to the federal budget in...
debatepolitics.com
Some of the savings in that law came from fixes to the way payments to insurers participating in Medicare Advantage, the privatized part of the program, are determined. Those payments were significantly inflated back when the ACA passed, with private insurers being paid ~18% more than traditional Medicare paid for the same care. Even as the ACA reduced those overpayments, enrollment in Medicare Advantage has grown (contrary to conservatives' predictions a decade ago). When the ACA passed, 26% of Medicare beneficiaries were in Medicare Advantage; this year 52% are.
With a majority of beneficiaries now enrolling in those private plans, it raises the stakes on the fact that, whack-a-mole-style, those insurers have again been finding ways to game the system to inflate their payments. And that's generating some tension between some of the commissioners of MedPAC, the group of experts convened by Congress to serve as its advisory body on Medicare payment policies.
MedPAC Report on Medicare Advantage Growth, High Costs Generates Kerfuffle
Hard to see how we tackle spending and debt--and build on the impressive savings that have been achieved to date--without again addressing the extra payments that Medicare Advantage insurers are getting from the taxpayers.