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There has been a lot of excitement around here about a proposed medicare buy in for those over 55.  This would be a step forward, certainly, and it would benefit many of our families and parents.  However, I think we also need to recognize that it is EXTREMELY unlikely to pass for several reasons:

There has been a lot of excitement around here about a proposed medicare buy in for those over 55.  This would be a step forward, certainly, and it would benefit many of our families and parents.  However, I think we also need to recognize that it is EXTREMELY unlikely to pass for several reasons:

  1. Kent Conrad will not vote for it.  Medicare rates to hospitals in his state have been an obsession of his for almost this entire process.  He has indicated that he could only support a medicare buy in that was a separate pool with negotiated rates rather than medicare rates.  This would of course negate any cost savings for those 'buying in' to medicare as they would not be getting medicare at all.

And although he described himself as being “intrigued” by the newest public option compromise being put forward, Conrad also reiterated that would oppose a Medicare buy-in that did not address his concerns about low payment rates to rural hospitals. Moreover, he added, “from a national perspective, you’d have to be concerned about the effect on the national pool,” referring to the concern that the 55 to 64 year old population added to the Medicare pool tends to be a sicker population. When asked how he’d resolve these issues, Conrad said that he’d propose having the Medicare buy-in be treated as “a separate pool” that could have negotiated rates, rather than those set by the existing Medicare program.

But, as the House negotiations over the public plan made clear, having negotiated rates for the Medicare buy-in would severely diminish any cost-saving potential for the proposal, significantly increasing the cost of the plan in the bill.

http://www.tnr.com/...

  1. Snowe is absolutely opposed to the medicare buy in, and given Lieberman's intransigence and Nelson's obsession with Stupak language, she is likely necessary for achieving 60 votes.

She's expressed her doubts to Senate Majority Leader Harry Reid. "I told him I have concerns," she said. "The Medicare buy in is problematic."

A reporter asked if that meant she's not inclined to support the idea. "Correct," she said.

http://tpmdc.talkingpointsmemo.com/...

  1. The FAH (Federation of American Hospitals) is about to go into full swing opposing this idea, and it is hard to imagine a more powerful lobby in this whole process.  They get what they want, and here is the memo that they sent out to their activists and lobbyists about the medicare buy in idea:

*****URGENT GRASSROOTS ALERT*****

CONTACT YOUR DEMOCRATIC SENATORS TODAY
OPPOSE MEDICARE BUY-IN PROPOSAL

Senate negotiators are seriously considering adding a Medicare Buy-In provision to the health reform bill. In general, a Medicare Buy-In would allow non-Medicare eligibles to purchase Medicare coverage. One of the proposals under discussion would be to allow those between 55-64, who could not afford or access employer coverage, to purchase Medicare coverage.

The FAH is strongly opposed to this proposal.

Hospitals have already agreed to the largest voluntary provider contribution to pay for health reform -- $155B in Medicare and Medicaid cuts. Any Medicare Buy-In would invariably lead to crowd out of the private health insurance market, placing more people into Medicare. The Medicare Payment Advisory Commission (MedPAC) has documented negative and declining Medicare hospital margins for seven years. A Medicare Buy-In would involve Medicare rates; would be controlled by CMS; and would crowd out older workers with private coverage who may choose early retirement as a result. Such a policy will further negatively impact hospitals -- after we have already agreed to contribute the maximum level of sustainable reductions that community hospitals can reasonably endure.

It is critical that you click here to contact your Democratic Senators today!

Urge them to oppose any Medicare Buy-In proposal!

Talking Points:

· On behalf of [Name of Hospital] and its [# of employees] located in [name of city], I urge you to oppose any Medicare Buy-In proposal under discussion as part of health reform.

· Hospitals have already agreed to the largest voluntary provider contribution to pay for health reform -- $155B in Medicare and Medicaid cuts.

· Any Medicare Buy-In would invariably lead to crowd-out of the private health insurance market, placing more people into Medicare.

· The Medicare Payment Advisory Commission (MedPAC) has documented negative and declining Medicare hospital margins for seven years.

· A Medicare Buy-In would pay Medicare rates; would be controlled by CMS; and would crowd out older workers with private coverage who may choose early retirement as a result.

· Such a policy will further negatively impact hospitals -- after we have already agreed to contribute the maximum level of sustainable reductions that community hospitals can reasonably endure.

Don't wait! Click here to take action against a Medicare Buy-In proposal.

Federation of American Hospitals, 801 Pennsylvania Ave., N.W. Suite 245 Washington, DC 20004-2604

http://www.politico.com/...

I realize I will get flamed for telling it like it is, but we need to understand reality.  There is no deal possible with nihilists who only care about industry stakeholders, and as much as I wish that wasn't true, I am more and more convinced that we are just setting ourselves up for another betrayal.

Originally posted to evangeline135 on Wed Dec 09, 2009 at 10:12 AM PST.

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