The National Committee to Preserve Social Security and Medicare has endorsed the Medicare Drug Savings Act (S. 740, H.R. 1588), introduced by Senator Rockefeller and Representative Waxman.  This legislation would require drug manufacturers to pay rebates for the drugs used by individuals who are dually eligible for both Medicare and Medicaid and for people receiving the Medicare Part D Low-Income Subsidy (LIS).  Drug manufacturers provided rebates for the dual eligible population prior to the enactment of the Medicare Modernization Act of 2003, which established the Medicare Part D drug benefit.  The Congressional Budget Office (CBO) estimates that this bill would save $141 billion over 10 years. 

The House of Representatives approved Budget Committee Chairman Paul Ryan's (R-WI) Budget Resolution for Fiscal Year 2014, H. Con. Res. 25 on March 21, 2013 (221-207). The Ryan budget calls for significant reductions to Medicaid funding, potentially jeopardizing access to nursing home care and long-term services and supports (LTSS) in the community, rationing health benefits, and impairing low-income seniors' ability to pay for Medicare benefits. The Senate rejected the Ryan budget on March 21, 2013 (40-59).

Established in 1965, Medicaid is the largest public health insurance program in the United States, covering over 60 million people (1 in 5 Americans). Medicaid provides health insurance coverage to multiple low-income populations, assistance to low-income Medicare beneficiaries, long-term services and supports (LTSS) to seniors and people with disabilities and support to safety net hospitals and health centers.

As Congress moves forward to deal with the debt limit, the sequester, the Fiscal Year 2013 Continuing Resolution and the Budget for Fiscal Year 2014, the National Committee to Preserve Social Security and Medicare, along with the vast majority of Americans of all ages and political affiliations, urges Congress to oppose all efforts which would adversely affect Social Security, Medicare and Medicaid beneficiaries today and in the future. 

Dear Chairman Baucus and Ranking Member Hatch,

The undersigned organizations write to urge you to protect low-income older adults’ health care access by preserving scheduled payment increases for primary care services paid for by Medicaid.

The current Medicaid program is a joint partnership financed by the federal government and the states in which states receive a fixed amount of money. Changing Medicaid to federal block grants means that states would receive less federal money but would have additional flexibility to design and manage their Medicaid programs. Because annual increases likely would not keep pace with rising health care costs, states could run out of money to pay for needed services.

The following comments are from the National Senior Citizens Law Center and the National Committee to Preserve Social Security and Medicare on the Massachusetts Memorandum of Understanding (MOU) related to the state’s dual eligible demonstration project. We tried to be comprehensive in our comments, noting both larger and smaller issues. The first section highlights positive elements, the second identifies broad concerns applicable to all MOUs, and the third notes specific issues/questions by section and page number.

There are several key issues that we believe require attention to prevent negative outcomes for dual eligible individuals an the overall demonstrations. These areas are: 1. Specificity/clarity of state proposals, 2. Size/scope, 3. Enrollment, 4. State readiness, 5. Plan readiness, 6. Plan quality, 7. Continuity of care and transitions, 8. Quality measurement, 9. Oversight and evaluation, 10. Rebalancing and reinvestment of savings.

The National Committee to Preserve Social Security and Medicare believes our nation does not have a Medicare spending problem; it has a health care cost growth crisis. Cutting Medicare alone will shift costs to a segment of the population least able to bear it, and will ultimately reduce access as seniors find health care increasingly unaffordable.