Public Part C Medicare managed care was formalized in 1997, signed into law by President Clinton, after 20 years of bipartisan demonstration projects to test managed care methods for seniors. But the program has been in the cross-hairs of Democratic Party repeal for about 10 years now since President George W. Bush signed legislation that siginificantly improved on President Clinton's bill and made public Part C Medicare Advantage wildly popular.
In addition to wanting to kill the plan because Democrats hate George Bush, the Democrats want to kill public Part C Medicare Advantage because -- for the last four years1 -- the Part C plan has cost the beneficiary-funded Medicare trust funds an average of 3% more per individual than it has cost in trust fund money to pay for beneficiaries on fee for service Medicare.
I agree that there should be no difference and that could happen again as soon as next year. However this will be a problem for poor, particularly minority, seniors, who use Part C disproportionately more than middle class and upper income seniors. The government will have to find some other assistance for these seniors so the cost of Medicare will not actually come down if the Democrats are able -- as proposed -- to kill Part C Medicare Advantage.
1For the first seven years of the Part C program, the beneficiaries on the program cost the government an average of 5% less per individual. For a few years in the middle the difference was as high as 14% and probably averaged about 8% more between 2007-2010. Over the 17 years history of formal Part C, the cost has netted out to about even.
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