Kaiser: Medicare Reform Ideas
- Raise the age of Medicare eligibility from 65 to 67 ($113 billion over 10 years)
- 10% coinsurance payment on all home health episodes ($40 billion over 10 years)
- Restrict first-dollar Medigap coverage ($53 billion over 10 years)
- Increasing premiums for Part B and Part D: for example, raise Part B premiums by 2% per year until they cover 35% of total Part B expenses ($231 billion over 10 years)
- Increase Medicare payroll tax by 1 percentage point for all workers ($651 billion over 10 years)
- Require manufacturers to pay a minimum rebate on drugs covered under Medicare Part D for beneficiaries receiving low-income subsidies ($137 billion over 10 years).
- Repeal provisions in the Affordable Care Act that would close the Part D coverage gap by 2020 ($51 billion over 10 years)
- Reduce and restructure graduate medical education payments to hospitals ($69 billion over 10 years)
- Rebase SNF and home health payment rates: for example, reducing payment updates for post-acute care by 1.1 percentage points ($45 billion over 10 years)
- Adopt traditional tort reforms at the Federal level ($40 billion to $57 billion over 10 years)
- Establish a combined deductible, uniform coinsurance rate, and a limit on out-of-pocket spending, along with Medigap reforms ($93 billion over 10 years)
- Set Federal contributions per beneficiary at the average plan bid in a given area, including traditional Medicare as a plan, weighted by enrollment ($161 billion over 10 years)
John C. Goodman is president of the National Center for Policy Analysis, a free-market think tank established in 1983. The Wall Street Journal and the National Journal have called Goodman the “Father of Health Savings Accounts.” Goodman’s health policy blog is the premier right-of-center health care blog on the Internet. It is the only place where pro-free enterprise, private sector ...