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From UK Telegraph

A decision to rescind endorsement of the drug would reignite the highly charged debate over US health care reform and how much the state should spend on new and expensive treatments.

Avastin, the world’s best selling cancer drug, is primarily used to treat colon cancer and was approved by the US Food and Drug Administration in 2008 for use on women with breast cancer that has spread.

It costs $8,000 (£5,000) a month and is given to about 17,500 women in the US a year. The drug was initially approved after a study found that, by preventing blood flow to tumours, it extended the amount of time until the disease worsened by more than five months. However, two new studies have shown that the drug may not even extend life by an extra month.

The FDA advisory panel has now voted 12-1 to drop the endorsement for breast cancer treatment. The panel unusually cited “effectiveness” grounds for the decision. But it has been claimed that “cost effectiveness” was the real reason ahead of reforms in which the government will extend health insurance to the poorest.

If the approval of the drug is revoked then US insurers would be likely to stop paying for Avastin.

The Avastin recommendation led to revived allegations that President Barack Obama’s overhaul of the US health care system would mean many would be denied treatments currently available.

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From Human Events

obama-liarThe Department of Health & Human Services (HHS) is providing $160 million to the state of Pennsylvania to set up a new high-risk insurance pool program that pays for abortions, as part of a larger $5 billion commitment of taxpayer funds that will include abortion coverage for over 400,000 people nationwide.

“This is the boldest admission yet from the Obama administration that the President’s Executive Order on taxpayer-funded abortion was a sham.  The fact that the high-risk pool insurance program in Pennsylvania will use federal taxpayer dollars to fund abortions is unconscionable,” said House Republican leader John Boehner.

Steven Ertelt reports on LifeNews.com that HHS has approved the program in Pennsylvania that will soon spread to other states paying abortions nationwide.

From the report:

[HHS] has quietly approved a plan submitted by an appointee of pro-abortion Governor Edward Rendell under which the new program will cover any abortion that is legal in Pennsylvania.

“The Obama Administration will give Pennsylvania $160 million in federal tax funds, which we’ve discovered will pay for insurance plans that cover any legal abortion,” said Douglas Johnson, legislative director for the National Right to Life Committee.

Johnson told LifeNews.com: “This is just the first proof of the phoniness of President Obama’s assurances that federal funds would not subsidize abortion — but it will not be the last.”

The pro-life community strongly opposed the executive order and said Rep. Bart Stupak and other House Democrats who voted for the pro-abortion health care bill in exchange for it were selling out their pro-life principles. This first case of forcing taxpayers to pay for abortions under the new law appears to prove them right that the bill language and executive order were ineffective.

Boehner has led the effort to require President Obama to keep his word that no tax dollars would be used to fund abortions.  Holding the president to his word is a tall order.

“Just last month at the White House I asked President Obama to provide the American people with a progress report on the implementation of his Executive Order, which purports to ban taxpayer-funding of abortions.  Unfortunately, the President provided no information, and the American people are still waiting for answers,” Boehner said.

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From the Washington Times

berwick_4_.JPG

Donald Berwick is no household name, but President Obama just handed him immense power to shape what kind of health care will be available to every American man, woman and child.

Berwick is the president’s newly appointed administrator of the Centers for Medicare and Medicaid Services, the federal agency that is ground zero for Obamacare’s politicization of American medicine. Obama installed Berwick with a recess appointment, a rarely exercised authority given to the president by the Constitution to use when the Senate is out of session for long periods. Berwick will have the job until the end of 2011. He assumes his duties without a Senate confirmation hearing or a Senate vote on his nomination.

Here’s another name few Americans are likely to recognize: Linda O’Boyle. According to the London Sunday Times, O’Boyle died in 2008 after British National Health Service officials cut off her “free” treatment by government doctors. Her sin was that she used her life savings to pay for an unapproved cancer drug earlier in the year. Her doctors had told her the drug, cetuximab, was markedly more effective in combating bowel cancer than the NHS-approved chemotherapy. Unfortunately, cetuximab was rejected by NHS officials as “not cost-effective.” O’Boyle, an NHS occupational therapist, was dead within a few months, a victim of rationed health care. She was also one of the tragic human beings behind a statistic Obama and Berwick likely hope you never hear about: Britain’s cancer survival rate ranges between 40.2 percent and 48.1 percent for men and between 48 percent with 54.1 percent for women, compared with 66 percent for U.S. men and 63 percent for U.S. women.

Now consider this quote from Berwick: “Cynics beware, I am romantic about the National Health Service, I love it.” Here’s another Berwick quote: “The decision is not whether or not we will ration care, the decision is whether we will ration with our eyes open.” It is bad enough that Obama would nominate an individual who holds such views to head Medicare and Medicaid. To install him under a recess appointment with no Senate hearing and no Senate confirmation vote is an arbitrary act of an imperial presidency so outrageous as to embarrass even Richard Nixon. Since Berwick can only occupy the position for approximately 17 months, the question inevitably arises: What does Obama want Berwick to do that is so important that it justifies circumventing the Senate’s constitutional duty to advise and consent on presidential appointments?

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From the Washington Examiner

All you need to know about Dr. Donald Berwick, President Obama’s choice to head the Centers for Medicare and Medicaid Services, is summed up in the nominee’s own words. At the 60thanniversary celebration of Britain’s socialized National Health System, Berwick praised NHS, which he clearly views as superior to America’s private medical system: “You could have had the American plan … Britain, you chose well.”

The families of 1,200 patients who died prematurely in recent years while in the care of NHS doctors and nurses might beg to differ.A shocking 2010 report by Queen’s Counsel Robert Francis found that NHS patients were left unattended “for unacceptable amounts of time” in urine- and feces-soaked beds. At one NHS hospital, four members of the same family — including a newborn girl — died within 18 months of each other because of medical blunders. “There can no longer be any excuse for denying the enormity of what occurred,” Francis noted, harshly criticizing “a lack of care and mistreatment which have no place in any civilized and well-run health service.”

Yet Berwick has called NHS a “global treasure,” saying he is “a romantic about NHS. I love it.” It’s no coincidence that this centrally planned, government-run health care system appeals to a Harvard-educated pediatrician who views patients not as individuals, but as members of collective “units of concern” defined by age, disease or socioeconomic status. Berwick has criticized the use of new life-saving technologies and wants non-physician “primary care providers” to ration care by controlling access to specialists and diagnostic tests to reduce each “unit’s” per-capita costs. He has also characterized aggressive interventions in terminally ill patients as “assaults,” not heroic attempts to extend their lives.

This is a radical departure from the focus on individual patients and their private relationship with doctors of their choice that have made American medicine the best in the world. And while Berwick was among the first to introduce industrial-style quality controls in 3,000 American hospitals, which by all accounts has been a huge success in improving patient care, his rigidly ideological view that America’s health system should mimic Britain’s NHS is inimical to the preservation of individual freedom and high-quality care. His nomination should be decisively rejected by the Senate. Americans live longer, healthier lives than Brits precisely because government bureaucrats have not been in charge of their health care for the past 60 years. If confirmed by the Senate, Berwick will define that quality down to British standards. That would not be choosing well.

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From Investors Business Daily

pinocchioBroken Pledge: An early draft of regulations written for the health care overhaul estimates that more than half of U.S. workers will see their medical insurance change. Funny, that’s not the promise we remember.

Late last week, reports surfaced that an 83-page White House document had been leaked from the White House. If the rules included in this draft are promulgated, the health plans of 51% of workers will be subject to change within three years.

In the new system, companies that modify employee coverage after Jan. 1, 2014, will lose their “grandfather” status and be forced to comply with ObamaCare rules. This means they will have no choice but to buy plans that will cost more because the law says they must include expanded coverage.

Changes in plans that would cause a company to lose its grandfather status can be as modest as a small shift in the co-payment amount or in the employees’ contribution to the coverage. By merely asking workers to share a bit more of the burden, companies will have to buy new plans.

Many Americans are likely to find the added coverage of the new plans unnecessary for their needs and the extra costs taxing to household budgets. How many who liked their plans will have new ones forced on them by a bureaucracy that’s not equipped to make decisions for people it doesn’t know?

According to the midrange estimate cited in the White House document, small businesses will be hit hardest. Two-thirds of them “will relinquish their grandfathered status by the end of 2013″ while 45% of large employer plans will be affected.

“In the worst-case scenario,” reported IBD’s Sean Higgins and David Hogberg on Monday, “69% of employers — 80% of smaller firms — would lose that status, exposing them to far more provisions under the new health law.”

Are the bureaucrats writing these regulations unfamiliar with the promise President Obama made repeatedly last year: “If you like your health care plan, you can keep your health care plan”?

Did they know that Linda Douglass, the White House fixer who said it was her job to “keep track of all the disinformation out there about health insurance reform,” assured the public that Obama was sincere when he said that? The answer to both is an emphatic yes.

So why write regulations that break a presidential promise? Because that promise was never meant to be kept. Like all the misrepresentations about cost, it was meant to mislead the public and generate support for, or at least blunt opposition to, a government takeover of the health care sector.

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From Investors Business Daily

WEB2c0614_fullInternal administration documents reveal that up to 51% of employers may have to relinquish their current health care coverage because of ObamaCare.

Small firms will be even likelier to lose existing plans.

The “midrange estimate is that 66% of small employer plans and 45% of large employer plans will relinquish their grandfathered status by the end of 2013,” according to the document.

In the worst-case scenario, 69% of employers — 80% of smaller firms — would lose that status, exposing them to far more provisions under the new health law.

The 83-page document, a joint project of the departments of Health and Human Services, Labor and the IRS, examines the effects that ObamaCare’s regulations would have on existing, or “grandfathered,” employer-based health care plans.

Draft copies of the document were reportedly leaked to House Republicans during the week and began circulating Friday morning. Rep. Bill Posey, R-Fla., posted it on his Web site Friday afternoon.

“It’s been passed around the staffs here on Capitol Hill. Congressman Posey thought it was important enough to share,” said spokesman George Cecala.

In a statement, Posey said the document showed that the arguments in favor of ObamaCare were a “bait and switch.”

“The president promised repeatedly that people who like their current plans can keep them, but now the details of their plan actually confirm what many suspected all along, most Americans will lose their current health care plan,” Posey said.

A White House official told IBD: “This is a draft document, and we will be releasing the final regulation when it is complete. The president made a promise to the American people that if they liked their health care plan, they can keep it. The regulation, when finalized, will uphold that promise.”

However, the source conceded: “It is difficult to predict how plans and employers will behave in the coming years, but if plans make changes that negatively impact consumers, then they will lose their grandfather status.”

It’s unclear how the document leaked out. An HHS spokeswoman confirmed that the department was working on a draft paper about grandfathered plans but said it hasn’t been made public yet.

A House Republican staffer said the rumor was that the document had been erroneously posted on the Office of Management and Budget Web site earlier in the week and somebody spotted it before it was taken down. IBD has not been able to confirm this report.

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From the Washington Examiner

Tom_CoburnBy Senator Tom Coburn — President Obama and his allies kicked off an unusual, and perhaps unprecedented, taxpayer-subsidized political campaign this week to sell to the public a legislative program that has already been signed into law.

The obvious coordination between the White House and its allies outside government who are running a $125 million campaign raises troubling questions. But, first, I’ll address the substance of what the president talked about, and ignored.

On Tuesday, the president trumpeted a provision in his plan that will give seniors a $250 rebate check if they reach the Medicare prescription drug benefit “doughnut hole” coverage gap in 2010. The president also spent a great deal of time repeating his talking points from last year’s health care debate. He claimed his plan would reduce the deficit and claimed the arguments of his critics were not “anchored in reality.”

As a practicing physician with more than 25 years of experience, and as a former business owner in the health care sector, I’d suggest this new PR campaign is grounded in politics rather than reality. The so-called experts behind this effort appear to be political hacks and career politicians who have zero real-world experience in the health care sector.

First, the president’s claims about the supposed benefits of a $250 rebate check for seniors are wildly out of proportion to both the reality of Medicare and his own program. Less than 10 percent of seniors enrolled in Medicare will receive a rebate check.

On the other hand, a greater percentage of seniors enrolled in Medicare – the 25 percent participating in Medicare Advantage – will see their benefits cut because the White House ultimately wants to kill the program for ideological reasons. Seniors are about to learn that if they like their plan, they can’t keep it. Medicare Advantage providers are already planning on cutting benefits and raising fees because of the law.

The president’s interest in the doughnut hole also suggests the PR campaign is willfully overlooking and exacerbating a much greater threat – Medicare’s $38 trillion unfunded liabilities. Our real national challenge is not the doughnut hole but our financial black hole of debt that is threatening to swallow not only Medicare but our entire economy.

During the most recent meeting of the president’s debt commission two esteemed economists, Kenneth Rogoff of Harvard and Carmen Reinhart of the University of Maryland, declared that our debt is already at 90 percent of our GDP, which they view as a tipping point at which economic growth slows considerably.

Borrowing from future generations and foreign governments to pay for rebate checks represents the kind of perverse short-term decision making that has brought our nation to the edge of a fiscal black hole. At best, throwing rebate checks at Medicare is an exercise in futility that will postpone real reform.

The president made a number of other claims that weren’t anchored in reality, such as his claim that his plan will reduce the deficit. When real-world accounting is applied to health care spending and necessary expenses like the doctor fix are included, all of the so-called savings evaporate.

Even the Congressional Budget Office, which the White House sites as its authoritative source, has contradicted the White House. CBO Director Douglas Elmendorf recently said, “The rising costs of health care will put tremendous pressure on the federal budget during the next few decades and beyond … In CBO’s judgment, the health legislation enacted earlier this year does not substantially diminish that pressure.”

Yet, perhaps the most important reality check in this debate is to acknowledge the obvious. This new PR campaign has nothing to do with improving the health of Americans and everything to do with improving the job security of politicians who voted for this bill against the wishes of their constituents. Turning federal agencies into de facto direct mail and political advertising branches of the Democratic political establishment will refill the swamp and remind voters why they loath Washington.

The American people have not only made up their minds about this bill, they are fatigued with this debate and the condescension of the Washington establishment who considers their objections to be based on fear, scare tactics and hysteria.

The American people have studied this law more intently the politicians and unelected staff who wrote it. They have made decisions based on information, not misinformation. The campaign’s rhetoric of victimization is not a comeback at Republicans but an insult to the millions of Americans who did their homework and made good faith, informed judgments about a bill that fixed the wrong problem.

The reality is Congress and the White House had a chance to do something bold and bipartisan to fix the real problem, and they blew it. This law represents a failure of content, not communication. Sooner or later, a nation that aspires to a future beyond a rendezvous with debt will insist that this misguided law be repealed and replaced.

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From Health Care News

NFIBThe National Federation of Independent Business (NFIB)—the nation’s largest small-business advocacy organization—has joined the ranks of twenty state attorneys general in a lawsuit attacking the constitutionality of President Obama’s new healthcare law.

The May 14 announcement came on the heels of repeated calls from NFIB members nationwide to challenge Obamacare in court, according to Elizabeth Milito, senior executive counsel for the NFIB Small Business Legal Center in Washington, DC. Milito said the lawsuit charges the new healthcare law directly undermines the organization’s mission, which is to promote and protect the rights of small business owners to “own, operate, and grow their business.”

“NFIB worked diligently throughout the legislative process to try to shape and improve the healthcare bill as it was being debated,” Milito said. “When we felt the legislation had reached a point that was unacceptable to our members and us, we were vehemently opposed to the bill and worked to defeat it.”

 

‘This Unconstitutional Law’

There are many provisions in what she called “this unconstitutional law” that will devastate small business, Milito said, noting the lawsuit’s two main legal claims relate to the “unconstitutionality” of the individual mandate.

“We do not believe the commerce clause of the U.S. Constitution gives Congress the authority to regulate inactivity,” Milito said. “Requiring every individual to purchase health insurance or face a fine is an unprecedented and unconstitutional act of Congress. Requiring NFIB members to obtain and maintain health coverage deprives our members of their liberty and property interests without the due process of law.”

John Graham, director of health care studies at the California-based Pacific Research Institute, agrees.

“By allowing the federal government to define ‘coverage’, Obamacare reduces individuals’ and businesses’ freedom to decide what they want in a health-insurance policy and how much of their health dollars they’d prefer to spend on medical care, which is under their own control,” Graham said.

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From Washington Examiner

the_pillAs further evidence of how politicized health care would become under Obamacare, Politico reports that Planned Parenthood is pushing for a national mandate that insurers must provide free birth control.  Over the objections of those who think that Americans should be free to seek out health plans consistent with their own moral or religious beliefs, or the dictates of their own conscience, Planned Parenthood (a backer of Obamacare) is launching lobbying efforts aimed at “getting no-cost birth control in the bill,” as it seeks to persuade Obama administration officials to rule that Obamacare requires private insurers to provide birth control — and to do so free of any co-pays or out-of-pocket costs.  (Costs would instead be passed along through slightly higher premiums.)

Meanwhile, a coalition including the Center for Reproductive Rights is seeking to find justification to extend this mandate to include free emergency “contraception” as well.

Somewhat amusingly, Politico writes, “Planned Parenthood has other plans in the works, too. It might soon tap young adults, particularly those who have had their dependent coverage extended up to age 26 [by Obamacare], who are curious about what benefits they will receive. ’Certainly, we have a very large, grass-roots organization interested in making an impact,’ [Laurie] Rubiner [Planned Parenthood’s vice president of public policy] said.”  Politico adds, “College campuses, too, could be fruitful territory…”

If nothing else, you’ve got to give them credit for seeking out new and creative reasons for people to back Obamacare:  Sure, it would raise health costs and deficits, expand the powers of the federal government to heretofore unthinkable levels, and reduce the quality of American medicine.  But, on the other hand, insurers would be required to give those up to the age of 26 free birth control as part of their parents’ insurance policy.

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From The Hill

iStock_000001968723XSmallThe new healthcare law will pack 32 million newly insured people into emergency rooms already crammed beyond capacity, according to experts on healthcare facilities.

A chief aim of the new healthcare law was to take the pressure off emergency rooms by mandating that people have insurance coverage. The idea was that if people have insurance, they will go to a doctor rather than putting off care until they faced an emergency.

People who build hospitals, however, say newly insured people will still go to emergency rooms for primary care because they don’t have a doctor.

 

“Everybody expected that one of the initial impacts of reform would be less pressure on emergency departments; it’s going to be exactly the opposite over the next four to eight years,” said Rich Dallam, a healthcare partner at the architectural firm NBBJ, which designs healthcare facilities.  

“We don’t have the primary care infrastructure in place in America to cover the need. Our clients are looking at and preparing for more emergency department volume, not less,” he said.

Some Democrats agree with this assessment.

Rep. Jim McDermott (D-Wash.) suspects the fallout that occurred in Massachusetts’ emergency rooms could happen nationwide after health reform kicks in.

Massachusetts in 2006 created near-universal coverage for residents, which was supposed to ease the traffic in hospital emergency rooms.

But a recent poll by the American College of Emergency Physicians found that nearly two-thirds of the state’s residents say emergency department wait times have either increased or remained the same.

A February 2010 report by The Council of State Governments found that wait times had not abated since the law took effect.

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From Human Events

iStock_000008363749XSmallThe non-partisan Congressional Budget Office (CBO) released a new estimate yesterday of the cost of Democrats’ government takeover of health care.  The new estimate shows Obamacare will cost at least $115 billion more than first claimed.

The CBO continues to sort through the consequences of the Democrats’ smoke and mirror accounting just as the White House launches its campaign to try to convince the public that Obamacare is not as bad as it really is.

“Before trying to ‘sell’ the new health care law, the Obama administration may want to be honest about how much it’s going to cost American taxpayers,” said House Republican Leader John Boehner (Ohio).  “This new CBO analysis showing that the new health care law will cost at least $115 billion more than advertised provides ample cause for alarm.  This comes just weeks after the Obama administration itself released an analysis confirming that the new law actually increases Americans’ health care costs.”

Late last month, in yet another blow to the Democrats’ credibility on health care (if there was any left), Obama’s own Centers for Medicare & Medicaid Services (CMS) released a report showing that the new law actually increases national health care costs after President Obama pledged it would not.

“The American people wanted one thing above all from health care reform: lower costs, which Washington Democrats promised, but they did not deliver,” Boehner added.  “The American people don’t want soothing soundbites, they want the truth.”

The new estimate pushes the pricetag for Obamacare over the $1 trillion mark.  And counting.  This latest estimate still includes the half-trillion dollars in cuts to Medicare Democrats figured into the mix.  It also represents only six years of spending supported by 10 years of new taxation.

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From the Washinton Examiner

hospitalPhysicians at McBride Orthopedic Hospital had ambitious plans for their Oklahoma City hospital before Obamacare. Two new operating rooms and a four-bed intensive-care unit were part of a multimillion-dollar expansion project that promised to bring competition and more health care choices to the community.

But once President Obama’s signature was dry on the 2,409-page Patient Protection and Affordable Care Act, so, too, was the McBride project. The recently enacted law imposed a series of new federal regulations on physician-owned hospitals, including an immediate ban on expansion.

“We pulled the plug when the law was signed,” McBride Chief Executive Mark Galliart said. “We were ready to break ground. We had everything approved by the state. We had the construction agreement in place. We were going to meet our timeline until the legislation passed.”

Within days of enactment of the new law, developers across the country nixed plans for 24 new physician-owned hospitals under construction. It will be a struggle for an additional 47 new such hospitals under construction to meet an Obamacare-imposed deadline of Dec. 31 to be finished and have their Medicare certification.

Galliart is now preparing McBride for other onerous requirements imposed by Obamacare on the nation’s 260 physician-owned hospitals. In addition to limits on expansion and new construction, the law restricts new investments, requires new annual reports to the government and sets fines for hospitals that fail to abide by transparency rules.

Imagine if the government owned General Motors and the Congress passed a bill that barred Ford from producing “any new cars and couldn’t expand on its existing cars,” Galliart said. “What other industry would put up with this? If we were spending money recklessly and harming people, that’s one thing. But physician-owned hospitals are doing it better and more efficiently.”

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From John Goodman’s blog

richardfosterRick Foster is the Chief Actuary of Medicare, and his office has just released a devastating critique of the Administration’s health reform law.

Before getting to details, let me say there is nothing in the report that is surprising to independent health economists. The conclusions are consistent with everything The Lewin Group and other private estimates have been saying for months. What is surprising is that one of the most respected agencies of the U.S. government is completely undermining the Alice-in-Wonderland fables being spun by the White House, on Capitol Hill and in the mainstream media. To wit:

  • You cannot take close to one trillion dollars away from one group of people and spend it on another group of people and somehow leave those footing the bill better off.
  • You cannot give millions of people large increases in medical care without creating any new doctors, new nurses or other paramedical personnel.
  • You cannot arbitrarily reduce what you are paying providers by billions of dollars and still expect to get the same quantity and quality of care.
  • You cannot give millions of patients and thousands of doctors new incentives to waste medical resources and then expect health care spending to go down.

In other words, the Chief Actuary is simply saying reality is reality. Economics is economics. A is A.

 

Convenient summaries of the Actuary’s report have been produced by the Republican staff of the House Ways and Means Committee and by the Senate Republican Policy Committee. Although these are partisan groups, the summaries appear to be quite faithful to the source. Here are the salient findings (with page numbers in the Actuary’s report):

  • Health care costs will go up, not down. National health expenditures will increase from 17 percent of GDP now to 21 percent under the new law and will be higher than without the legislation. [Page 4] Net federal spending on health care will also increase.
  • Health care shortages are “plausible and even probable.” Because of the increased demand for health care, “supply constraints might initially interfere with providing the services desired by the additional 34 million insured persons.” [Page 20]
  • 14 million employees will lose their employer coverage. Employees of small firms are especially at risk (despite small employer tax credit subsidies). [Page 7]
  • 2 million employees who lose coverage will have to enroll in Medicaid. [Page 3]
  • A Medicaid insurance card is not a guarantee of care. An estimated 18 million people will be added to Medicaid. [Page 3] However, because there is no corresponding increase in the supply of caregivers, “it is reasonable to expect that a significant portion of the increased demand for Medicaid would be difficult to meet, particularly over the first few years.” [Page 20]
  • One in ten insured workers will see their health benefits taxed. By 2019, more than 10% of insured workers will “be in employer plans with benefit values in excess of the thresholds (before changes to reduce benefits) and this percentage would increase rapidly thereafter.” [Page 13]
  • Higher taxes will lead to higher premiums. The new taxes on medical devices, prescription drugs, and insurance plans “would generally be passed on through to health consumers in the form of higher drug and device prices and higher insurance premiums.” [Page 17]
  • There are more than one-half trillion in Medicare cuts. The new health law cuts “$575 billion” from Medicare. [Page 4]
  • Medicare cuts would threaten almost one in every seven hospitals. About “15 percent of Part A providers would become unprofitable within the 10-year projection period.” [Page 10]
  • Overall access to care for seniors would go down. Because of the law’s payment reductions, “providers for whom Medicare constitutes a substantive portion of their business could find it difficult to remain profitable and, absent legislative intervention, might end their participation in the program. [Page 10]
  • 7.4 million people will lose access to Medicare Advantage plans. Enrollment in MA plans will be cut in half (from its projected level of 14.8 million under the current law to 7.4 million under the new law). [Page 11]
  • False advertising: The new “Medicare Tax” doesn’t go to Medicare. “Despite the title of this tax, this provision is unrelated to Medicare; in particular, the revenues generated by the tax on unearned income are not allocated to the Medicare trust funds.” [Page 9]
  • False advertising: Budgetary double-counting does not improve Medicare’s solvency. Medicare cuts “cannot be simultaneously used to finance other federal outlays (such as the coverage expansions) and to extend the [life of the Medicare] trust fund, despite the appearance of this result from the respective accounting conventions.” [Page 9]
  • The new long-term care insurance plan (CLASS Act) is unsound. The program faces “a significant risk of failure” because the high costs will attract sicker people and lead to low participation. [Page 15]
  • The promise to those with pre-existing conditions is unfunded. “By 2011 and 2012 the initial $5 billion in Federal funding for [high risk pools] would be exhausted, resulting in substantial premium increases to sustain the program.” [Page 16]
  • The law does almost nothing to limit actual fraud and abuse. The fraud provisions in the law will save only about two percent of $47 billion in suspect claims.

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