Medicare projects that the 2018 base premium for its Part D drug benefit will be 61 cents cheaper than this year, despite the rising cost of drugs, particularly specialty drugs. It is the first decrease in five years. The base premium will drop from $35.63 to $35.02 as of Jan. 1, the Centers for Medicare & Medicaid Services announced last week. The agency also calculated the average basic premium in 2018. This methodology, unlike that used for the base premiums, includes all plan types, adding in special needs plans and private fee-for-service plans, that are left out of the base premium calculation. It’s weighted by projected enrollment and accounts for the likelihood that a portion of enrollees will switch to lower cost plans. The result for this calculation was even more impressive. The average basic monthly premium is projected to drop by an estimated $1.20, from $34.70 in 2017 to $33.50 in 2018.
In a sign that the Democratic Party is embracing more progressive health care ideas, eight Democratic senators announced last week that they were co-sponsoring legislation that would allow people 55 and older to buy in to Medicare. Sen. Debbie Stabenow (D-MI) introduced the Medicare at 55 Act with the immediate support of Democratic Sens. Tammy Baldwin (WI), Sheldon Whitehouse (RI), Sherrod Brown (OH), Jeff Merkley (OR), Patrick Leahy (VT), Jack Reed (RI), and Al Franken (MN). The bill, which would allow Americans aged 55 to 64 to purchase Medicare coverage, reflects the growing influence of progressive activists who are pushing for a single-payer health care system they dub “Medicare for all.” Although the bill stops short of making Medicare universal, its embrace of expanded public health insurance, rather than the private model at the heart of the Affordable Care Act, or Obamacare, marks a distinct leftward shift for the party. “People between the ages of 55 and 64 often have more health problems and face higher health care costs but aren’t yet eligible for Medicare,” Stabenow said in a statement. “If you live in Michigan, are 58 years old, and are having a hard time finding coverage that works for you, this bill will let you buy into Medicare before you turn 65.”
Even though advance directives have been promoted for nearly 50 years, only about a third of U.S. adults have them, according to a recent study. People with chronic illnesses were only slightly more likely than healthy individuals to document their wishes. For the analysis, published in the July issue of Health Affairs, researchers reviewed 150 studies published from 2011 to 2016 that reported on the proportion of adults who completed advance directives, focusing on living wills and health care power-of-attorney documents. Of nearly 800,000 people on whom the studies reported, 36.7 percent completed some kind of advance directive. Of those, 29.3 percent completed living wills, 33.4 percent health care proxies and 32.2 percent were “undefined,” meaning the type of advance directive wasn’t specified or combined the two. People older than 65 were significantly more likely to complete any type of advance directive than younger ones, 45.6 percent vs. 31.6 percent. But the difference between people who were healthy and those who were sick was much smaller, 32.7 percent compared with 38.2 percent. The Medicare program began reimbursing physicians in January 2016 for counseling beneficiaries about advance-care planning. This study doesn’t incorporate any data from those changes. Rather, it can serve as a benchmark to gauge improvement, said Dr. Katherine Courtright, an instructor of medicine in pulmonary and critical care at the University of Pennsylvania.
While Republicans in the Senate clamber to find a solution to their health care reform dilemma in the wake of a fresh setback Monday night, House lawmakers on Tuesday released a budget blueprint that includes severe cuts to social programs – including Medicare. Despite the promises President Donald Trump made during his campaign not to touch Medicare, the House budget text says: “Doing nothing would result in programs like Medicare falling off a cliff.” The 2018 plan, authored by Rep. Diane Black (R-TN), includes more than $200 billion in cuts to entitlement programs. Current federal spending rates for Medicare, Medicaid, and Social Security are referred to as “unsustainable” in Black’s budget. Calls for cutting projected Medicare costs, the second largest entitlement program after Social Security, involve turning the program into an “optional premium support” system where future beneficiaries would receive a fixed amount of money to buy health insurance on the open market. The document says traditional plans would remain available, but a new arrangement, similar to the structure of Medicare Advantage, would be put in place aimed at driving down costs by increasing competition among insurers. According to the annual trustee’s report, if nothing is done, Medicare faces insolvency by 2028, while OASDI funds will run dry in the mid-2030s.
Seniors are increasingly in danger of being denied housing because of rising home prices, Housing and Urban Development Secretary Ben Carson said Monday at a conference at the ChampionsGate Resort. Carson was speaking on senior housing issues as the keynote speaker at the LeadingAge Florida annual convention at the Omni Hotel in northwestern Osceola County.
“I’m very concerned about seniors who become destitute, who are forced into low-income housing,” Carson told the audience. “Many look to HUD for affordable housing or assisted housing, but they confront a brutal reality: The market is becoming more expensive. Inner cities have become high-end markets, pricing low- and middle-class Americans out.” The Trump administration’s proposed budget for fiscal year 2018 includes more than $6 billion in budget cuts to HUD, including funding for senior and public housing. But Carson said afterward that HUD has increased public housing programs for the elderly this year. He said he did not have details on those latest numbers. Steve Bahmer, president and CEO of LeadingAge, an association of about 250 senior service providers across Florida, said the senior affordable housing situation in the state was in “crisis … reaching perhaps new levels.” Seniors can expect to wait three to five years for an affordable apartment in Central Florida, Bahmer said, with waits of five to seven years in the Miami area. “There’s a lack of infrastructure, a lack of housing units available,” Bahmer said. “The waiting list doesn’t end when new apartments are available, the waiting list ends when people in old apartments die.”