Why Medicare politics are heating up : Shots

Why Medicare politics are heating up : Shots

Prescription drug coverage is just one part of Medicare, the federal government’s health insurance program for people age 65 and over.

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Prescription drug coverage is just one part of Medicare, the federal government’s health insurance program for people age 65 and over.

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The White House released President Biden’s $6.8 trillion proposed budget last week, listing his priorities for the upcoming fiscal year. Among other things, Biden singled out Medicare — the federal health insurance program for people aged 65 or older. Republican leaders insist they won’t be threatening cuts to Medicare in upcoming budget negotiations, but others in the party have floated the idea of making changes over time to the program — including benefit cuts they say will be necessary to keep Medicare solvent.

NPR’s Michel Martin, as co-host of All Things Considered, sat down this week with veteran health care journalist Julie Rovner, of Kaiser Health News, to get a better sense of where the debate is headed over how to fund Medicare, an expensive, but popular program. The following excerpt of their conversation has been edited for length and clarity.

MARTIN: So, what is the issue here?

ROVNER: Medicare’s trustees say that within six years, the trust fund is going to run out of reserves, and so it won’t be able to pay all of the current benefits. So basically, in order to bring down the cost, you have three options: You can make the people who are on the program pay more, you can make taxpayers who help support the program pay more, or you can pay health care providers — doctors and hospitals and all those folks — less.

Everybody considers any of those things, “cuts,” although paying providers less is usually only considered a cut to the providers. If the cuts get too big, and the health care providers say “We’ll walk away from the program,” that’s a problem too.

But Medicare is very popular, and I think in the State of the Union, when the president said he wasn’t going to do anything to Medicare, people sort of slapped back and said, “But Medicare is going to go broke if we don’t do anything.” So in the budget, Biden said, well, here are a couple of things that we could do, none of which affect how much beneficiaries pay.

MARTIN: What are the top lines of what President Biden’s proposing, in regards to Medicare?

ROVNER: It’s actually fairly small. Last year, for the first time, Medicare was given legal permission to negotiate the price of drugs. There is a short list of drugs. This budget would make the list longer, and it would have those negotiations happen faster. It would also raise a tax on very high-income earners — those earning over $400,000. The Biden budget would raise that Medicare tax from 3.8{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} to 5{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} on those high earners.

MARTIN: Republicans have said that they can balance the budget over the next decade, but won’t touch Medicare. Is that a credible stance?

ROVNER: It is, but only if they go after Medicaid — the actually larger public health insurance program for people with low incomes — and the subsidies on the Affordable Care Act, which the president has now also said he won’t go after. It is possible to balance the budget without touching Medicare or Social Security or raising taxes, but you would have to cut so much from the rest of the budget. That’s why we haven’t seen a Republican plan yet. They’re still trying to figure it out.

MARTIN: Senate Minority Leader Mitch McConnell has already said publicly that Biden’s plan to increase the Medicare tax on high earners, “will not see the light of day.” So what are we likely to see next?

ROVNER: Well, at some point, you know, the two parties are going to have to come together before the Medicare trust fund runs out of money. This is not the first time we’ve been within this close period where the trust fund could run out of money. It’s happened several times in the past. Eventually, the parties do get together and figure out some way to shore it up. And I’m sure that will happen this time, too, but I suspect this year is going to be more of a fight leading up to the 2024 elections.

MARTIN: The talks over the debt ceiling are approaching. The leaders of both parties have said that Medicare is off the table. But is it conceivable that Medicare won’t be implicated at some point in these talks?

ROVNER: No. Of course Medicare is going to be implicated at some point in these talks. First of all, what Republican leaders say is not necessarily what all of the Republican rank and file will do. That’s true of the Democrats, too, so it’s hard to imagine that Medicare won’t be put on the table in some way, shape or form.

MARTIN: So, what will you be paying attention to as these discussions continue over the next couple of weeks and months?

ROVNER: Something needs to be done to Medicare, lest it run out of money. So I think that pretty much the entire federal panoply of health programs is going to be up for discussion — and that’s what I’ll be watching.

MARTIN: I’m just wondering, is this the kind of subject that the public really can focus on, can really get galvanized around?

ROVNER: It can and it can’t. The trick is how this gets negotiated and how it gets presented to the public as to whether it will actually affect their health care.

Julie Rovner is the Washington correspondent for KHN and host of “What The Health?” — KHN’s weekly health policy news podcast. After nearly eight years of hosting Weekend All Things Considered, Michel Martin is taking on a new hosting role on NPR’s Morning Edition.

How the Medicare political wars could hurt seniors : Shots

How the Medicare political wars could hurt seniors : Shots

Previous 7 days in Florida, at the University of Tampa, President Joe Biden promised to guard and reinforce Social Security and Medicare, as effectively as reduce overall health care prices.

Mandel Ngan/AFP through Getty Images


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Past 7 days in Florida, at the College of Tampa, President Joe Biden promised to safeguard and strengthen Social Stability and Medicare, as properly as reduce wellness treatment expenditures.

Mandel Ngan/AFP through Getty Photos

The Medicare wars are again, and practically no a person in Washington is stunned.

This time it truly is Democrats accusing Republicans of seeking to maim the pretty well-liked federal well being plan that covers 64 million seniors and persons with disabilities. In the previous, Republicans have efficiently pinned Democrats as the risk to Medicare.

Why do politicians persistently wield Medicare, as well as Social Security, as weapons? Due to the fact heritage displays that performs at the ballot box. Generally, the celebration accused of menacing the sacrosanct entitlements pays a rate — although it’s the thousands and thousands of beneficiaries relying on feuding lawmakers to keep the systems funded who stand to drop the most.

Republicans have repeatedly warned they would maintain boosting the federal debt ceiling hostage until Democrats negotiated changes to Medicare, Medicaid, and Social Protection. The 3 systems jointly, along with funding for the Inexpensive Care Act and Kid’s Health Insurance policy Method, account for almost 50 {bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of the federal spending plan.

The political bomb that went off all through President Joe Biden’s Point out of the Union speech had been ticking for months. In his speech, Biden threatened to veto any Republican efforts to cut Social Security or Medicare. It was one particular of only 3 veto threats he designed that night time. For the duration of a journey to Florida just after the speech, he stated it more forcefully: “I know a large amount of Republicans, their dream is to lower Social Safety and Medicare. Properly, let me say this: If which is your aspiration, I am your nightmare.”

Senior Republicans have distanced them selves from the proposals Biden was referencing, notably ideas from the Home Republican Research Committee and Sen. Rick Scott, R-Fla., to make cuts or even permit Medicare expire unless Congress votes to preserve it going.

“That’s not the Republican program which is the Rick Scott strategy,” Senate Minority Leader Mitch McConnell stated on a Kentucky radio demonstrate Feb. 9, echoing his opposition to the program last yr.

“Cuts to Social Safety and Medicare are off the table,” Residence Speaker Kevin McCarthy declared the day prior to Biden’s veto danger.

McConnell and McCarthy know a thing that Rick Scott seemingly does not: Politicians threaten large, well-known entitlement packages at their peril. And, typically, it’s been Republicans who put up with the electoral outcomes.

How Medicare fights have shaped elections

This dates at the very least to 1982, when Democrats used threats of Republican cuts to Social Security to select up additional than two dozen Residence seats in President Ronald Reagan’s initial midterm elections. In 1996, President Invoice Clinton won reelection in section by convincing voters that Republicans led by House Speaker Newt Gingrich required to privatize Medicare and Social Protection.

At the commencing of his next term, in 2005, President George W. Bush designed it his best priority to “partly privatize” Social Safety. That proved singularly unpopular. In the following midterm elections, Democrats won again the Dwelling for the to start with time given that getting rid of it in 1994.

In 2010, Republicans turned the tables, employing what they explained as “Medicare cuts” in the Cost-effective Care Act to sweep again to electrical power in the House. (These “cuts” have been typically reductions in payments to companies beneficiaries essentially obtained more advantages by the ACA.)

The use of the Medicare cudgel possible reached its zenith in 2012, when Democrats took intention at Medicare privatization proposals presented by Paul Ryan, the Home Price range Committee chair and Republican vice presidential applicant. That discussion developed a controversial political ad, paid for by the progressive Agenda Project Action Fund and recalled by many in Washington, that showed a suited male in a purple tie – presumably, Ryan – dumping a wheelchair-bound “granny” off a cliff as the terms flashed, “Is The us Stunning without the need of Medicare?”

The actuality is that Medicare’s price as a political weapon also sabotages any hard work to occur alongside one another in a bipartisan way to resolve the program’s financing troubles. The last two instances the Medicare Clinic Insurance policy Have faith in Fund was this close to insolvency — in the early 1980s and late 1990s — Congress passed bipartisan costs to keep the application afloat.

A person person’s ‘cut’ can be another’s ‘benefit’

Even the phrase “slash” can be political. A person stakeholder’s Medicare “lower” is another’s gain. Decreasing payments to health-related companies (or, additional normally, cutting down the size of payment boosts to doctors and hospitals) could decrease premiums for beneficiaries, whose payments are primarily based on full prices of the Medicare software.. Meanwhile, increasing premiums or cost sharing for beneficiaries is a reward to all taxpayers, who enable fund Medicare. Increasing offered rewards allows physicians, hospitals and other health and fitness companies, as perfectly as beneficiaries, but prices a lot more for taxpayers. And on, and on.

There are essential variances involving the events that cannot be papered more than. Lots of Republicans want Medicare to shift from a “described profit” plan — in which beneficiaries are guaranteed a particular set of solutions and the authorities pays whatsoever they value — to a “described contribution” system, in which beneficiaries would get a certain amount of money of income to finance as much as they can — and would be on the hook for the rest of their health care expenses.

This would change the risk of overall health inflation from the government to seniors. And even though it plainly would advantage the taxpayer, it would disadvantage equally companies and the persons on Medicare.

But there are quite a few, quite a few intermediate steps Congress could acquire to at least delay insolvency for both equally Medicare and Social Protection. Some are more controversial than others (elevating the payroll tax that funds Medicare, for instance), but none are further than the measures preceding Congresses have taken each and every time the packages have neared insolvency.

Republicans are right about this: Medicare and Social Security are unable to be “set” until equally sides lay down their weapons and start conversing. But each time a politician unsheathes their speaking details about “Medicare cuts,” that truce looks considerably less and a lot less achievable.

Does Medicare Help Pay for Gym Memberships?


The answer isn’t a simple yes or no. Whether you can count on Medicare to cover these costs depends on what type of coverage you have, but you do have options.

Staying fit is beneficial at any age. Regular physical activity helps all older adults, according to the federal Centers for Disease Control and Prevention (CDC), reinforcing the long-known belief that exercise positively affects our physical health and our emotional well-being.

While the way to do that is through a mix of aerobic activity, strength training and maintaining flexibility, these workouts often require specific equipment that’s available only at gyms or fitness centers. And those memberships are pricey.

Original Medicare (Parts A and B) doesn’t cover gym memberships, but it does cover some fitness-related benefits in special situations. For example, Medicare covers:

  • Group sessions for prevention of diabetes and programs to help you manage your condition, change your diet, exercise more and control your weight.
  • Weight-loss counseling for people with a body mass index (BMI) of 30 or higher, which includes obesity screening, a dietary assessment and behavioral therapy designed to help you lose weight by focusing on diet and exercise.

Does Medicare Advantage pay for gym memberships?

If you opt for a Medicare Advantage plan through a private insurer instead of original Medicare, coverage for gym memberships and fitness centers is available.

Almost all Medicare Advantage members (98 percent) were in plans that covered some fitness benefits in 2022, according to a Kaiser Family Foundation study. These benefits take several forms, including membership in the popular SilverSneakers program for people 65 and older or its competitors Renew Active and Silver&Fit.

SilverSneakers provides access to more than 15,000 fitness locations across the country; online dance, exercise, meditation, stretch and yoga classes; and an on-demand video library of prerecorded workouts. A free SilverSneakers GO fitness app for Apple and Android phones is also available. Other Medicare Advantage plans also offer free gym memberships with access to a nationwide network of health clubs and exercise locations, personalized fitness plans and on-demand workout videos.

In addition to gym access, many plans provide incentives to stay active, such as a free fitness tracker every two years, discounts on a smartwatch or exercise equipment if you meet activity goals, or gift cards if you take certain healthy actions, such as exercising or getting a flu shot.

How do I find Advantage plans with fitness benefits?

To find Medicare Advantage plans with fitness benefits in your area, go to the Medicare Plan Finder, type in your zip code and choose Medicare Advantage Plan for the search. It will prompt you to put in your medications, but you can bypass that.

Next, you’ll see a list of Medicare Advantage plans available in your area. The Plan Benefits summary for each option will have a green check mark if the plan has vision, dental, hearing, transportation to and from a medical appointment, or fitness benefits. Click on the Plan Details button and scroll down to Extra Benefits for a summary of fitness benefits available. To learn more details beyond “Not covered” or “Some coverage,” you can contact the plan at the phone number at the top of the Plan Details web page or read plan documents on the insurer’s website, linked at the top of the page.

Do Medigap plans offer fitness benefits?

Even though Medicare supplemental plans, also known as Medigap, don’t include fitness benefits as part of their standard coverage, you may find they include gym membership as well as discounts for dental, hearing, and vision services at no additional cost. Some plans offer low-cost packages to add these benefits.

Here, too, you can use Medicare’s Plan Finder tool to learn more about Medigap plans in your area.

Keep in mind

You can get free gym memberships and fitness benefits in other ways.

  • Employer and retiree health insurance may include wellness benefits, such as exercise programs, gym memberships, health coaching, health education classes, stress-management counseling and weight-loss programs.
  • Local gyms and fitness centers often offer senior discounts. Some YMCAs, for example, offer discounts for people 65 and older and financial assistance for people with low incomes.
  • Senior centers may have free or low-cost exercise programs and gyms, group biking or walking programs, health and wellness education and even personal trainers. Senior centers are usually affiliated with local Area Agencies on Aging, which you can find through the Eldercare Locator.

Published December 14, 2022