Medicare Cuts May Alienate Senior Voters

Preface: Rep. Dave Camp, ranking Republican of the House Ways and Means Committee, has compiled this list of when different aspects of the recently passed health care legislation will go into effect. The main effect of the new health reform law is to cut Medicare benefits in order to extend coverage to the uninsured. The main political risk for Democrats is antagonizing seniors who are the most singularly reliable voting bloc and the most skeptical about the health reform bill.

2009

1) Medicare cuts to hospitals begin (long-term care (7/1/09) and inpatient and rehabilitation facilities (fiscal 2010)) 2009

2010

2) Medicare cuts to inpatient psych hospitals (7/1/10)

2011

3) Medicare Advantage cuts begin

4) No longer allowed to use FSA, HSA, HRA, Archer MSA distributions for over-the counter medicines

5) Medicare cuts to home health begin

6)Medicare reimbursement cuts when seniors use diagnostic imaging like MRIs, CT scans, etc.

7) Medicare cuts begin to ambulance services, ASCs, diagnostic labs, and durable medical equipment

8) Prohibition on Medicare payments to new physician-owned hospitals

9) Penalties for non-qualified HSA and Archer MSA distributions double (to 20%)

10) Seniors prohibited from purchasing power wheelchairs unless they first rent for 13 months

11) New Medicare cuts to long-term care hospitals begin (7/1/11)

12) Additional Medicare cuts to hospitals and cuts to nursing homes and inpatient rehab facilities begin (fiscal 2012)

13) New tax on all private health insurance policies to pay for comp. eff. research (plan years beginning fiscal 2012)

2012

14) Medicare cuts to dialysis treatment begins

15) Require information reporting on payments to corporations

16) Medicare to reduce spending by using an HMO-like coordinated care model (Accountable Care Organizations)

17) Medicare Advantage plans with a 4 or 5 star rating receive a quality bonus payment

18) New Medicare cuts to inpatient psych hospitals (7/1/12)

19) Medicare cuts to hospitals with high readmission rates begin (fiscal 2013)
Medicare cuts to hospice begin (fiscal 2013)

2013

20) Increase Medicare wage tax by 0.9% and impose a new 3.8% tax on unearned, non-active business income for those earning over $200,000 or $250,000 for families (not indexed to inflation)

21) Eliminate deduction for Part D retiree drug subsidy employers receive

22) Impose 2.3% excise tax on medical devices

23) Medicare cuts to hospitals which treat low-income seniors begin

2014

24) Individuals without government-approved coverage are subject to a tax of the greater of $695 or 2.5% of income

25) Employers who fail to offer “affordable” coverage would pay a $3,000 penalty for every employee that receives a subsidy through the Exchange

26)Employers who do not offer insurance must pay a tax penalty of $2,000 for every full-time employee

27) More Medicare cuts to home health begin

28) Impose tax on nearly all private health insurance plans
Medicare payment cuts for hospital-acquired infections begin (fiscal 2015)

2015

29)More Medicare cuts to home health begin

2016

30)States can form interstate insurance compacts if the coverage with HHS approval (2016)

2017

31) Physician pay-for-quality program begins for all physicians

32)States may allow large employers and multi-employer health plans to purchase coverage in the Exchange.

33) States may apply to the HHS secretary for a limited waiver from certain federal requirements

2018

34) Impose “Cadillac tax on “high cost” plans, 40% tax on the benefit value above a certain threshold: ($10,200 individual coverage, $27,500 family or self-only union multi-employer coverage)