Beneficiaries' cost-sharing requirements under Medicare Parts A and B have remained largely unchanged since the program's inception in 1965 and are unlike the design of many contemporary health insurance products. Several proposals would alter Medicare's cost-sharing requirements and may combine changes with limits or penalties on supplemental coverage that covers Medicare's cost-sharing requirements. Some of these proposals, such as that from the National Commission on Fiscal Responsibility and Reform (also known as Simpson-Bowles), have the explicit goal of reducing the rate of growth in Medicare spending, while others, such as the Medicare Payment Advisory Commission's (MedPAC's) June 2012 recommendation, seek to protect beneficiaries against high out-of-pocket spending and mitigate the need for supplemental insurance. These and other proposals vary in the amount, if any, they are expected to save the Medicare program, the aggregate amount of Medicare spending that is shifted to beneficiaries, and the redistribution of beneficiary spending across Medicare enrollees depending on their service use. This session explored recent recommendations for restructuring Medicare's cost sharing and policies to limit supplemental coverage and the implications of those policies for the Medicare program and beneficiaries.
"Recent Proposals to Limit Medigap Coverage and Modify Medicare Cost Sharing" (Issue Brief No. 845, February 24, 2012)
Mark Merlis, "Medigap Reforms: Potential Effects of Benefit Restrictions on Medicare Spending and Beneficiary Costs," for the Henry J. Kaiser Family Foundation, Program on Medicare Policy, July 2011
Juliette Cubanski et al., "Restructuring Medicare’s Benefit Design: Implications for Beneficiaries and Spending," for the Henry J. Kaiser Family Foundation on Medicare Policy, November 2011
Medicare Payment Advisory Commission, "Reforming Medicare's Benefit Design," ch. 1 of Report to the Congress: Medicare and the Health Care Delivery System, June 2012