WASHINGTON BUREAU – Dr. Donald Berwick says the changes that the Affordable Care Act made in the Medicare Advantage program are working better than critics had expected, and he is predicting that the act will continue to make Medicare stronger.
Berwick, director of the Centers for Medicare and Medicaid Services (CMS), appeared today at a House Ways and Means Committee hearing on the effects of the Affordable Care Act (PPACA) – the legislative package that includes the Patient Protection and Affordable Care Act — on Medicare.
"Despite earlier projections of enrollment declines and premium increases, the actual data we now have in 2011 shows that enrollment in Medicare Advantage increased 6%, to more than
12 million beneficiaries," Berwick said. "On average, beneficiaries have seen a 6% reduction in their premiums, and there is a 5% increase in the number of beneficiaries who are now in 4- and 5-star Medicare Advantage contracts this year versus last year."
The improvements came despite widespread predictions – including predictions by the Medicare Advantage program's own auditor — that PPACA cuts would cause the program to wither away, Berwick said.
Berwick himself said repeatedly that the PPACA will accomplish its goal of controlling rising medical costs, reducing waste and abuse, and providing security to seniors.
Provisions already in PPACA will prevent many expensive medical problems and reduce costs, Berwick said.
Ways and Means Committee Chairman Dave Camp, R-Mich., told Berwick that many on the committee fear that PPACA will cause some seniors to lose access to health care services, or pay more for the services they still get.
"Sadly, that is already happening–from those who depend on local hospitals to folks who depend on Medicare Advantage plans to retirees receiving retiree drug coverage to seniors who will pay higher prices," Camp said.
Other Republicans on the committee who spoke against PPACA included
Rep. Wally Herger, R-Calif., chairman of the panel's health subcommittee; Rep. Kevin Brady, R-Texas; Rep. Patrick Tiberi, R-Ohio; and Rep. Geoff Davis, R-Ky.
Berwick countered that the PPACA changes have led to higher enrollment, higher enrollment in high-quality plans, and lower costs for the enrollees.
Davis said many Medicare enrollees are disappointed with their health care services under PPACA.
Berwick said he disagrees.
"Under PPACA, Medicare Advantage is stronger and looks like a robust program," Berwick said.
Republicans charged that Berwick was using misleading statistics, because PPACA phases in the Medicare Advantage program cuts. This year, they said, there are no cost-of-living increases but also no actual cuts.
Berwick, a pediatrician, has praised the single-payer health care system in the United Kingdom, and Republicans at the hearing drew attention to his past writings.
Citing a 1996 paper by Berwick extolling the U.K. system, Camp asked Berwick, "Is the British health care system a good model?"
"The American health care system needs an American solution," Berwick answered.
"Do you still think a government-run single payer system is the best option?" Camp asked.
"I believe the Affordable Care Act is the right solution for America," Berwick said.
Berwick declined to comply with Camp's request for a "simple yes or no answer."
Rep. Charles Rangel, D-N.Y., thanked Camp for holding the hearing.
"I thank the Republicans for giving us the opportunity to defend this program," Rangel said.
Democrats are expecting Republicans to come out soon with a proposal to take away the funding needed to implement PPACA . The measure could be part of a "continuing funding" resolution that must be passed by March 4 to keep the government running.
In related news, America's Health Insurance Plans (AHIP), Washington, released a commentary at the hearing that says PPACA will cut $136 billion directly from the Medicare Advantage program and $70 billion indirectly.
The cuts "will result in seniors having less access to [Medicare Advantage] plans; the reduction of additional benefits for seniors who keep their [Medicare Advantage] plan; and higher out-of-pocket costs as well," AHIP says in the commentary. "These deep funding cuts – combined with the new premium tax that begins in 2014 – pose a serious threat to the health benefits and choices of the nation's 11 million Medicare Advantage enrollees."
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