Among the foremost threats to individual freedom in America is the abusive and oftentimes lawless behavior…
CFIF on Twitter CFIF on YouTube
More Legal Shenanigans from the Biden Administration’s Department of Education

Among the foremost threats to individual freedom in America is the abusive and oftentimes lawless behavior of federal administrative agencies, whose vast armies of overpaid bureaucrats remain unaccountable for their excesses.

Among the most familiar examples of that bureaucratic abuse is the Department of Education (DOE).  Recall, for instance, the United States Supreme Court’s humiliating rebuke last year of the Biden DOE’s effort to shift hundreds of billions of dollars of student debt from the people who actually owed them onto the backs of American taxpayers.

Even now, despite that rebuke, the Biden DOE launched an alternative scheme last month in an end-around effort to achieve that same result.

Well, the Biden DOE is now attempting to shift tens of millions of dollars of…[more]

March 19, 2024 • 08:35 AM

Liberty Update

CFIFs latest news, commentary and alerts delivered to your inbox.
Obama’s Medicare Politics Show Ryan Is Right on Policy Print
By Ben Shapiro
Thursday, April 10 2014
[T]he attractiveness of MA plans will diminish substantially if CMS guts the program to help fund ObamaCare.

In a surprise move, the Obama administration has reversed course on an ObamaCare-mandated cut to Medicare Advantage, replacing the long-feared cut with a slight increase in funding. Though motivated by political calculations, the episode confirms that the fundamentals for reforming health care support the policy changes sought by Paul Ryan.

Monday, April 7, was seen as a kind of D-Day for health insurance companies operating Medicare Advantage (MA) plans. Months ago, the Centers for Medicare and Medicaid Services (CMS) announced a 1.9 percent cut in MA’s 2015 reimbursement rates by the federal government. Over the next decade CMS’s goal is to reduce MA’s reimbursements by $156 billion, in order to use the money to help fund part of ObamaCare.

If implemented, the MA cuts would be passed on to consumers in the form of reduced options at higher prices. Much like the health plans offered on ObamaCare exchanges, MA plans in the future would be characterized by narrower doctor networks, fewer hospitals and higher out-of-pockets costs.

And yet since the 1990s, MA plans have been the most popular part of Medicare. Nationwide, enrollment grew 9 percent last year. The reason is choice. Because MA plans are run by private insurance companies, consumers can choose MA policies delivered by Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) plans, Special Needs Plans (SNPs), or Medical Savings Account (MSA) plans.

In short, MA’s flexibility is driving its popularity. But the attractiveness of MA plans will diminish substantially if CMS guts the program to help fund ObamaCare.

In the run-up to April 7, the insurance industry saturated senior-heavy media markets with ads reminding politicians that “seniors are watching” to see whether their representatives in Washington would oppose the Obama administration’s funding swap. Not only did CMS bow to the pressure and cancel next year’s1.9 percent cut; it also announced a 0.4 percent increase in reimbursement rates for 2015.

The logic is purely political. Vulnerable Democrats up for reelection can’t afford to anger seniors who typically turn out in high numbers to protect their health benefits. If the Obama administration could be persuaded to delay parts of ObamaCare that hurt businesses and younger individuals – such as the employer mandate and grandfathering cheap pre-ObamaCare plans for up to three years – then it could certainly put off defunding a program that covers one-in-three American seniors.

And while they’re at it, why not throw in an extra half-percent of new spending so White House-aligned Members of Congress can confuse the folks back home?

But the politics driving the MA delay also reveal the fundamentals of health insurance reform. The variety of coverage options means consumers get to choose the level of care they want, while a standardized reimbursement rate gives insurance companies the security they need to negotiate terms with doctors and hospitals.

Contrast this with traditional Medicare’s fee-for-service system where a one-size-fits-all price schedule annually short-changes doctors and hospitals for the services they provide as a way to reduce costs. Most years Congress intervenes with a so-called “doc fix” that stops CMS from paying only a fraction of Medicare’s health bills. Doctors and hospitals put up with the stingy payment structure because accepting traditional Medicare ensures a greater volume of patients. Whatever they can’t recoup gets passed on to other customers.

The federal government’s health care spending would be more transparent and less subject to abuse if, instead of quibbling over each and every service provided, CMS simply capped the amount it spends per plan and let providers design plans consumers want.

If this sounds familiar, it is essentially what Paul Ryan has been calling for in every budget proposal since 2011. But his idea is even better. Ryan would convert traditional Medicare into a revamped MA program. Seniors would get a set amount in subsidies to purchase a plan, with any savings from spending under the cap going to the individual senior. This change would promote more choices in senior health care, and give government budget writers much more certainty about the amount of money to set aside for Medicare each year.

Of course, Ryan’s idea also invites comparisons to how ObamaCare subsidies work on state-based exchanges. As a matter of economics, they are very similar since individuals in both models get subsidies to help pay for part of their insurance premium. However, as a matter of political economy, they could hardly be more different.

The key difference between Ryan and ObamaCare is the direction of reform. Ryan wants to make Medicare operate more like a market by expanding choices among private providers. ObamaCare exchanges, on the other hand, reduce choices by shrinking the number of insurance plans, doctors and hospitals previously available to consumers.

When it comes to health care reform, Americans want more choices and greater consistency. Since ObamaCare can’t deliver, it’s time to try ideas that will.

Notable Quote   
 
"Americans do not trust several major U.S. institutions, including the national news media.The recently released Center Square Voters' Voice poll found that 43% of Americans say the media is trustworthy, compared with 54% who said it is not trustworthy.Younger people were more likely to trust the media, with 47% of those ages 18-34 saying they trust it and 46% saying the opposite.The numbers steadily…[more]
 
 
— Casey Harper, The Center Square
 
Liberty Poll   

Do you believe the U.S. Supreme Court will ultimately reject the new Biden administration automobile emissions rule as beyond the scope of administrative agency authority?