The lobbyists defending the current Medicare supplement (Medigap) insurance plan design rules have warded off one blow from federal health policymakers after another, but, today, one serious hit is likely to get through.
Melissa Taylor, a lobbyist at Mutual of Omaha, delivered that message today, in Orlando, Fla., during a Medigap conference organized by the American Association for Medicare Supplement Insurance (AAMSI).
The Senate is gearing up to consider H.R. 2, a 262-page bill that could replace Medicare’s current, much-hated, repeatedly postponed “sustainable growth rate” (SGR) physician reimbursement curbs.
The package includes provisions that are supposed to let the traditional Medicare program shift to paying doctors through “value-based” systems that emphasize that quality and efficiency of care, rather than simply paying doctors a fee for each service rendered.
Drafters have tried to pay for spending increases included in the bill by including “offsets,” or measures intended to reduce other types of federal spending.
Federal law requires issuers of Medigap plans to try to help consumers shop for coverage on an apples-to-apples basis by using standardized plans designated by letters. Two of the most popular of the standardized plans are Plan C and Plan F, which pay the deductible for the Medicare Part B physician and outpatient services plan.
One H.R. 2 spending offset would prohibit Medigap C and F plans from paying the deductible for the Medicare Part B physician and outpatient services plan. This year, the Part B deductible is $147.
The provision would take effect starting in 2020, and it would apply only to consumers newly eligible for Medicare.
Defenders of the C and F Medigap plans argue that they help seniors with tight budgets and poor health do a better job of budgeting for health care costs.
Many health policymakers have long argued that Medigap plans that off “first-dollar coverage,” or near first-dollar coverage, drive up overall spending, by encouraging enrollees to get unnecessary care that leads to use of more unnecessary care. They have been attacking first-dollar Medigap coverage for years.
The new change may not necessarily have a big effect on insurers’ sales, or Medigap product profitability.
But Taylor said the fact that H.R. 2 includes a Medigap design provision to pay for the rest of the bill represents a big change for issuers.