Backgrounder on SCHIP/Medicare Advantage and other programs
This ill-named bill expands the popular State Children’s Health Insurance Program (SCHIP) while, one can only assume from the name, “protect” Medicare. This It does nothing of the sort. In fact, according to the Congressional Budget Office, House Democrats are proposing $193 billion in cuts to Medicare programs that provide flexible, affordable and modern healthcare solutions to more than 8 million American seniors. They include:
$157 billion in cuts to Medicare Advantage for seniors.
$15.3 billion in cuts to Medicare Part A for seniors, including skilled nursing facilities, rehabilitation facilities, and long term care hospitals.
$9.6 billion in cuts to Medicare Part B for seniors, including payments for oxygen and brachytherapy.
$3.6 billion in cuts to the end stage renal disease program for seniors.
$7.5 billion in cuts to home health and more cuts to end-stage renal care for seniors.
The proposed SCHIP expansion currently costs $76 billion more than it will raise, again, according to the Congressional Budget Office. To pay for this expansion, the Democrats’ bill raises money in three ways:
It raises tobacco taxes (NOTE: Ironically, the Heritage Foundation finds that 20 million new smokers will be needed by 2017 to pay for the expansion of this health program);
It effectively eliminates Medicare Advantage in 22 states, freeing up whatever money would be put into the program; Makes other cuts to Medicare service providers.
SCHIP Background
SCHIP was established in 1997 to help insure children from low-income families who earn too much to qualify for Medicaid. Since its inception, SCHIP has reduced the rate of uninsured children nationwide by about 25 percent. However, the program has expanded to include middle-class children and adults – groups that SCHIP was not created to assist. SCHIP funding is delivered to states as a block grant, and states have the option of running SCHIP through a separate state agency, through the Medicaid program or a combination of both. Ohio administers the program through the Medicaid-based Healthy Start program.
Ohio’s recent budget provides for an increase in SCHIP for children up to 300 percent of the federal poverty level – that would take the income level up to $51,510 for a family of three and $61,950 for a family of four. In much of Ohio , families earning those income levels are considered middle class, which is not the demographic SCHIP was created to assist.
The Democrats’ proposal would render the current income eligibility requirement meaningless and create and open-ended government entitlement for families, many of whom already have private insurance coverage.
There are anywhere from 236,000 to 245,000 children in Ohio who currently have no health coverage. But nearly 165,000 of those childrens’ parents have not signed them up for SCHIP, despite already qualifying for the program.
Medicare Advantage Background
The Medicare Advantage (MA) program provides seniors the option of receiving their Medicare benefits through a private health plan, including PPOs, HMOs, private fee-for-service plans, and special needs plans. Many beneficiaries choose MA over traditional Medicare because it often is less expensive and because these plans offer benefits that traditional Medicare does not, like disease management programs and preventive care. In recent years, payments to plans were increased to stabilize the program and expand participation. In 2006, Medicare began to pay plans under a bidding process.
The chart below provides numbers of Medicare beneficiaries and Medicare Advantage program participants by Congressional District in Ohio (Source: Centers for Medicare and Medicaid Services)
CONGRESSIONAL DISTRICT MEDICARE BENEFICIARIES MEDICARE ADVANTAGE
OH01 - Chabot 92,520 21,160
OH02 - Schmidt 96,871 16,075
OH03 - Turner 104,930 19,329
OH04 - Jordan 99,104 5,148
OH05 - Gillmor 92,531 6,152
OH06 - Wilson 113,495 16,100
OH07 - Hobson 96,651 17,734
OH08 - Boehner 95,046 14,627
OH09 - Kaptur 100,106 15,345
OH10 - Kucinich 105,767 23,675
OH11 - Jones 98,978 20,374
OH12 - Tiberi 82,703 13,985
OH13 - Sutton 104,020 19,843
OH14 - LaTourette 104,361 15,782
OH15 - Pryce 74,606 13,519
OH16 - Regula 106,165 25,122
OH17 - Ryan 107,506 25,938
OH18 - Space 106,745 11,508
OH - Ohio 1,782,109 301,416
The Democrats’ Plan to Cut Medicare Advantage Would Hurt Minorities Most
At a March 21 Committee on Ways and Means, Rep. Stephanie Tubbs Jones expressed strong reservations about the effect of Medicare Advantage cuts in minority communities:
“If you take out Medicare Advantage programs, or you address or deal with the funding problem, you are targeting a group of folks who have nowhere else to go. … Experience says to you that if you close down the Medicare Advantage programs, there is a population of people who are without healthcare coverage and they are a population of people who have chronic health problems and they are not covered by other health plans. …Before we go down the road of changing what we have right now, let us make sure we aren’t changing it on the backs of low-income and minority people who already receive disparate health service and access to health care.”
From the NAACP letter:
“MA plans – private health plan options that provide coverage to 8.3 million Medicare beneficiaries – disproportionately provide coverage to low-income and racial and ethnic minority beneficiaries. Specifically, 40 percent of African Americans without Medicaid or employer coverage rely on comprehensive health insurance coverage provided by MA plans. By providing more comprehensive benefits and lower cost-sharing than traditional Medicare, MA plans help racial and ethnic minority populations gain access to health care services that are critical to their long-term health and well-being.”
“Reduced funding for the MA program would have a negative impact on the health and health care of millions of Medicare beneficiaries – particularly for low-income and minority beneficiaries.”
“We urge you not to backtrack on these priorities by cutting funding for the MA program. This program is vitally important to the health and well-being of racial and ethnic minorities who rely on MA to provide them with the comprehensive, affordable, and coordinated care they need.”
From the League of United Latin American Citizens letter:
“Ensuring access to high quality, affordable health care is one of our top priorities, and one that is especially critical in the Hispanic community. We firmly believe Medicare Advantage is helping meet this challenge for Hispanic seniors.”
Making It Easier for Illegal Immigrants to Get SCHIP or Medicaid
In 1996, Congress passed legislation blocking illegal immigrants from receiving federal benefits and the 1997 creating of SCHIP required states to verify a claimant’s citizenship.
The Democrats’ proposal eliminates the requirement that persons applying for Medicaid or SCHIP services show proof of citizenship or nationality.
