Very quietly over the last year, President Obama -- primarily through his press secretary but also through other surrogates -- has announced his Medicare reform proposal. This is his reponse to bipartisan Congressional and think-tank proposals and ideas from his own budget commission. This stealth process counters the Republican charge that the Democrats do not want to change anything about Medicare.
Under the Obama plan for Medicare:
- Original Medicare -- Medicare Parts A and B -- will be managed by private insurers (Original Medicare is also often called traditional Medicare or "Medicare as we know it" by the President and the Democrats)
- It will have lifetime limits (no catastrophic coverage)
- It will have no annual out of pocket limits
- If hospitalized and admitted under the Democratic plan for Medicare, seniors will pay up to $6000 a year in deductibles
- The Democratic reform of Medicare "features" unlimited 20% co-pays if inpatient in a hospital but not admitted or if outpatient or visiting a doctor (after a $150 deductible)
- The plan will include no vision/dental/annual-physical/drug coverage
- There are very rigorous geographic restrictions.
- Fees to doctors for Medicare services -- already set well below market prices -- will be cut 30% more beginning January 1, 2013; as a result fewer and fewer doctors will accept "Medicare as we know it"
- There will be fewer and fewer accountable care organizations (ACOs) in Medicare (currently about 20% of Medicare beneficiaries belong to one) despite the fact that ACOs are the lynchpin of the President's Patient Protection and Affordable Care Act, which he designed for those under 65
- Private Medigap plans, used to make up for the gaping holes in the above "features" of the President's reform of Medicare would be restricted in such a way as to pass more costs to seniors (proposed by President Obama in September 2011--not yet passed)
OK, this was a trick headline.
In fact, what I described above is the way President Obama's "Medicare as we know it" works today and will work under PPACA except for the last bullet. The last bullet -- the changes to Medigap -- were proposed by President Obama in September 2011.
Luckily (or not surprisingly), very few people as a percentage of the total number of Medicare beneficiaries depend on "Medicare as we know it" today, and the Centers for Medicare/Medicaid Services have recruited 25,000 volunteers across the country and put them in senior centers to try and talk that small percentage into another, more sane approach than the one the President supports.