{"id":179,"date":"2012-10-18T00:28:00","date_gmt":"2012-10-18T04:28:00","guid":{"rendered":"http:\/\/blog.cmhughesmd.com\/?p=179"},"modified":"2012-10-18T00:28:00","modified_gmt":"2012-10-18T04:28:00","slug":"health-care-policy-under-president-romney-nejm","status":"publish","type":"post","link":"http:\/\/blog.cmhughesmd.com\/?p=179","title":{"rendered":"Health Care Policy under President Romney \u2014 NEJM"},"content":{"rendered":"<p><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1210265\">Health Care Policy under President Romney \u2014 NEJM<\/a><\/p>\n<blockquote><p>Also uncertain is whether a Romney administration would seek repeal  of the $716 billion in Medicare savings that would be used to finance  about half the ACA&#8217;s cost. Though Romney has committed to repealing  these savings, his running mate, Congressman Paul Ryan (R-WI),  incorporated them into his House budget resolutions in 2011 and 2012,  with overwhelming support from the House Republican Caucus.<span><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1210265#ref4\" rel=\"#refLayer\">4<\/a><\/span>  Rescinding these savings would advance the insolvency of the Medicare  Part A Hospital Insurance Trust Fund from 2024 to 2016 and trigger an  average increase of $323 in the premiums paid by most Medicare  beneficiaries between 2013 and 2022. Romney has pledged not to change  Medicare for current enrollees.<span><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1210265#ref2\" rel=\"#refLayer\">2<\/a><\/span>  However, premium increases for future enrollees, plus the elimination  of ACA-created Medicare benefits such as no-cost preventive services,  will test that pledge.<\/p><\/blockquote>\n<blockquote><p>Romney and the Republican National  Platform also endorse Ryan&#8217;s proposal to convert Medicare from a  defined-benefit to a defined-contribution program.<span><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1210265#ref2\" rel=\"#refLayer\">2,4<\/a><\/span>  Under this plan, new senior and disabled Medicare enrollees (beginning  in 2023) would receive a capped subsidy (\u201cpremium support\u201d) to purchase  individual coverage from competing private and public (traditional  Medicare) health plans.<span><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1210265#ref2\" rel=\"#refLayer\">2,4<\/a><\/span>  Romney also proposes to increase Medicare&#8217;s eligibility age from 65 to  67 and to provide less premium support to wealthier seniors.<span><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1210265#ref2\" rel=\"#refLayer\">2<\/a><\/span> These changes would reduce future federal Medicare spending beginning in 2023 and would shift growing costs to beneficiaries.<\/p><\/blockquote>\n<blockquote><p>Romney  also endorses Ryan&#8217;s proposal to modify the federal\u2013state Medicaid  partnership by turning the program into block grants and capping the  federal contribution.<span><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1210265#ref2\" rel=\"#refLayer\">2,4<\/a><\/span>  The corresponding budget resolution calls for cuts (beyond those  effected by ACA repeal) of $810 billion over 10 years (2013 through  2022).<span><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1210265#ref4\" rel=\"#refLayer\">4<\/a><\/span>  These cuts would mean curtailing benefits, reducing provider payments,  tightening eligibility, shrinking enrollee rolls, and swelling the ranks  of the uninsured by 14 million to 27 million people, according to the  Kaiser Commission on Medicaid and the Uninsured.<span><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1210265#ref5\" rel=\"#refLayer\">5<\/a><\/span>  Though Romney outlines countermeasures such as state-sponsored  high-risk pools and insurance subsidies, both options are costly and  contingent on flush state coffers.<\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":"<p>Health Care Policy under President Romney \u2014 NEJM Also uncertain is whether a Romney administration would seek repeal of the $716 billion in Medicare savings that would be used to &hellip; <a href=\"http:\/\/blog.cmhughesmd.com\/?p=179\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Health Care Policy under President Romney \u2014 NEJM&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"sfsi_plus_gutenberg_text_before_share":"","sfsi_plus_gutenberg_show_text_before_share":"","sfsi_plus_gutenberg_icon_type":"","sfsi_plus_gutenberg_icon_alignemt":"","sfsi_plus_gutenburg_max_per_row":"","footnotes":""},"categories":[88],"tags":[],"class_list":["post-179","post","type-post","status-publish","format-standard","hentry","category-romney-ryan"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/179","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=179"}],"version-history":[{"count":0,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/179\/revisions"}],"wp:attachment":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=179"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=179"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=179"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}