Sunday, March 31, 2013

They have NOW read the bill, maybe

A big political story this year is likely to be Democrats turning on their White House minders as the harmful and unpopular parts of the Affordable Care Act ramp up. On the heels of the recent 79-20 Senate uprising against the 2.3% medical device tax, now comes the surge of Democrats pleading on behalf of Medicare Advantage.

Liberals have claimed for years to hate this program, but by now Advantage provides private insurance coverage to more than one of four seniors. And those seniors like it.
However, the ObamaCare true believers who run the Health and Human Services Department don't answer to voters, and they have written draft regulations that cut Medicare Advantage even more deeply than Congress mandated in the Affordable Care Act. Those cuts will bite hardest in states like Oregon (where 42% of Medicare beneficiaries use Advantage), or Florida (37%), New York (33%), California (37%) and Arizona (38%).

The extra cuts stem from HHS's discretion and were dropped from the sky with no warning in February. More than a few Democrats seem to have caught the anvil. Some 139 Members of Congress have formally objected in 16 letters to HHS so far, and the signers include 26 Democrats in the House and 13 in the Senate.

The latter include both Senators from New York (Chuck Schumer and Kirsten Gillibrand), Colorado (Mark Udall and Michael Bennet), Minnesota (Al Franken and Amy Klobuchar) and Oregon (Ron Wyden and Jeff Merkley). Aficianados of irony may recall that Messrs. Franken and Bennet were among the leading supporters of the so-called "public option"—traditional Medicare for every American—during the ObamaCare debate.

Meanwhile, all nine Massachusetts Congressmen—yes, Ed Markey and Joe Kennedy III included—have asked HHS to reverse the extra cuts "to preserve access and affordability for these highly popular plans." Six ultra-liberal House Democrats even referred to Advantage as a "health-care safety net." Such language is especially notable because the letter was signed by Keith Ellison of Minnesota, who co-chairs the left-wing Congressional Progressive Caucus.

These Democrats purport to be especially upset that HHS conjured the extra cuts with that old reliable, the Medicare sustainable growth rate, which has abetted more fiscal dishonesty than almost anything else in health care—which is saying something. This phony formula pretends that Medicare's payments to doctors will plunge by 25% in the future, but for 11 years Congress has always blocked the cuts.

This time HHS pretended Congress wouldn't pass such a "doc fix," a fake assumption that yields an artificially lower reimbursement rate for the insurers in Advantage. So the doctor-pay con gets you coming and going. This gambit is so controversial (and cynical) that the word on Capitol Hill and in industry circles is that the White House will bigfoot HHS and make the final decision on the Advantage cuts. We'll learn at close of business Monday.
It's possible these new Democratic critics are merely preening for the midterm elections in public, while privately hoping that HHS and the White House go ahead and starve Medicare Advantage anyway. Still, we thought it would be a cold day in The Villages of central Florida before Democrats came out for a private version of Medicare. Paul Ryan, call the White House.

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