A bunch of left wing Congressional Budget Office employees (the CBO is run by a Clintonian who appears a little less lefty than his employees) have wasted tax dollars reviewing the most popular Federal health care insurance program ever invented and found it wanting. The document appears to be another propaganda piece in the Democratic Party's 12-year-long effort to repeal Part D. The report about the Part D standalone drug program and -- peripherally -- the Part C Medicare health plan program is probably the worst example of how low-level partisan civil servants completely tied to Democratic Party ideology mislead voters and even Congresspeople.
The report supposedly reviews the Low Income Subsidy portion of the law that set up Part D. It never really identifies any burning issue facing Part D in general or LIS in particular but still comes up with some changes Congress should desparately make.
And somehow incredibly the left-wing CBO's report goes on for 40 or so pages without ever mentioning the Part D donut hole. From the beneficiary’s point of view, the report mentions LIS’ advantages as to premiums, deductibles, co-insurance and co-pays but leaves out the donut hole protection, which in my opinion is the biggest advantage – along with the ability to change plans at any time -- of LIS. The report also seems to leave out how the donut hole coverage is accounted for by the government. Perhaps CBO ignores this because so few people – relatively – reach the donut hole.
This is all significant because the donut hole is the linchpin of Democratic Party propaganda used to promote the repeal of Part D. But the donut hole does not affect people on LIS because of the way the law was passed by the Republicans against almost1 unanimous Democratic Party opposition. Most of Part D's much maligned unfunced" cost goes to the LIS part of the program, money that was previously spent by Medicaid (so it wasn't unfunded; it just moved from my left pocket to my right pocket). So let's hide these facts under the rug is the Democratic group's approach.
Other problems with the CBO report
- There is no such thing as a Part D “LIS plan” that I can find in the literature but that is a term used throughout the report.
- The report is full of various indictments against LIS plan sponsors but all the same insruance companies are involved; they offer plans and people on LIS plans can choose any of the plans in their county; CBO has invented a category of insurance company that “caters to LIS beneficiaries?”
- In some sections the report counts people on both Parts C and D as being on D; people on C generally do not choose a health plan because of the specifics of its built-in drug coverage (although they might choose it because it has built-in drug coverage). Still they get the LIS subsidy if they qualify and can apply it to a Part C health plan if it includes drug coverage.
- The CBO report mentions “step therapy” as sort of a bad practice against LIS beneficiaries. It is both a major part of almost all Part D plans and is considered a best practice from a health care perspective.
- The report's research timeframe predates the increased use of and popularity of the preferred pharmacy concept
- The report tries to claim the fact that most plans below the benchmark (average of all plans) had deductibles and most above the benchmark had no deductibles is tied to LIS; it’s just the way pricing for anything is done
1I think the Democrat's opposition to the most popular Federal health plan ever was unanimous but don't feel like looking it up so I threw in the word "almost"
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