While the ending of the government shutdown has led Congress and President Donald Trump to focus on affordability of health care under the Affordable Care Act tax credits, that is not the only health care cost issue facing leaders.
Seniors will soon be paying the price for a private sector health system that doesn’t want to pay for rising costs and a government that won’t.
The basic Medicare price has gone up to $212 from $185 per month, an increase of 14.5%. Medicare supplements cost another $150 per month while prescription drug coverage adds about $10 a month.
Many supplemental programs (needed for things like routine physicals) will increase by an average of 16%, according to a report in the Star Tribune based on government records.
Medicare advantage plans run by everyone from Blue Cross Blue Shield, Medica and Humana have been under financial pressure and have been lobbying the government to refrain from cutting reimbursements they say do not cover their costs. The government says many of the companies are over billing or incorrectly billing for some services.
This conflict has induced health care insurers to cut back their offerings and reduce the number of plans to choose from while raising prices. That’s not good for seniors or other health care consumers.
The insurers are in turn balancing their bottom lines on the backs of insurance agents by cutting their pay and commissions. Many of these agents have thousands of clients in Mankato alone who they advise on a very complicated system, according to a recent report in The Free Press.
While some advisers will continue to help their clients with no pay, others will not be able to sustain that business model. Already senior help lines on Medicare have long waiting times.
The system for senior health care is not only in chaos, but it appears to be threatened in ways not seen in decades, according to the agents.
Locally, there will be fewer plans offered. Mayo Clinic Rochester told the Star Tribune it will no longer be taking referrals or accepting most Medicare advantage plans that are out of network. Blue Cross and Blue Shield also will no longer be accepting other local providers in some plans.
The insurers are pulling back in major ways that will likely affect some 30% of seniors, according to Bloomington-based HealthPartners.
And make no mistake, these problems are not related to Obamacare. President Bill Clinton and Congress approved the Medicare advantage plans through the Balanced Budget Act of 1997, while the program was greatly expanded to offer prescription drug coverage under George W. Bush and Congress in 2003.
Trump once again recently promised a better health care plan that sends money to consumers and not insurance companies, but few details have been released.
It’s clear the Medicare program and supplements are treading water, risking the health of seniors and the affordability for all. It’s time for Congress and the state Legislature to address this critical problem as a top priority.