Uncertainty in the market adds to the funk the United States experiences as it trudges through a slowly recovering economy. The situation is difficult enough for people who’ve lost jobs or seen paychecks stagnate in recent years. But for seniors depending on pensions, Social Security, Medicare and Medicaid, uncertainty can be downright scary.
“It’s the uncertainty of the state legislature and the federal government,” said Tillie Bishop, a former state senator from Grand Junction who helps address senior issues in Mesa County.
The Associated Press reported in March that seniors could receive their first monthly increase in Social Security checks in three years in 2012. However, an increase in Medicare payments deducted from their checks could more than offset the increase. So while the cost of food and energy continues to rise, seniors could actually experience a pay cut next year.
And things could get much worse if Congress finally imposes a 25 percent reduction in Medicare reimbursements to doctors. The reduction was delayed five times last year and is now due to expire at the end of this year.
The delays occurred during the formation of a congressional committee charged with addressing methods to reduce the federal budget deficit of more than
$13 trillion. While lawmakers might be reticent to reduce benefits for seniors, they also face pressures to reduce spending.
Jennifer Talhelm, a spokeswoman for U.S. Sen. Mark Udall, D-Colo., said his office has faced a big shift in priorities in recent years. “When he was first elected, deficit reduction wasn’t a top priority. It’s turned into a top priority for him.” Talhelm said Udall endorses the recommendations of the deficit reduction committee.
U.S. Sen. Michael Bennett, D-Colo., also has endorsed efforts to investigate potential spending cuts, entitlement changes and tax reform to reduce the deficit.
Should a reduction in Medicare reimbursements take effect in 2012, doctors who’re already reluctant to treat patients who have only Medicare health insurance could be tempted to discontinue treatment of such patients. Doctors say Medicare compensates them for about 60 percent of the amount they charge Medicare-only patients.
Salaries for primary care doctors have hit a plateau in recent years in Mesa County. Many doctors have tried to maintain reasonable fees for patients while also addressing costs for their equipment and employees.
Discussion of Medicare reductions are politically charged among voting-conscious seniors.
“Most folks would not want that to happen,” said Karen Swiat, director of Medicare sales for Rocky Mountain Health Plans in Colorado and Wyoming. “They’re trying to come up with a permanent solution.”
At the same time, Congress is considering compromise plans that could reduce increases to health care costs and promote quality health care outcomes. Also, new legislation calls for gradual reductions to payments in Medicare Advantage plans, which are believed to cost the government more than the original Medicare program, Swiat said. Such reductions can increase the attractive the attractiveness of Medicare Cost Plan insurance offered by companies like RMHP. Some Grand Valley doctors who won’t add Medicare-only patients will consider patients who carry his type of insurance coverage.
Another wild card in the scenario is the effects of the national health care legislation that became law last year. New provisions took effect in January and another round of rules is set to take effect each January through 2014.
The Barack Obama administration touts the legislation as a way to link health care payments to outcomes instead of a fee-for-service system. The system also requires everyone to buy health insurance, although those who can’t afford it might be allowed to enroll in Medicare or Medicaid. So it’s difficult to tell if the government-run health plans will see an increase or a decrease in customers.
Medicaid, the program designed for low-income and disabled people, reportedly compensates doctors for only 30 percent of the average bill. Funding for Medicaid is shared by federal and state governments. Because medical and financial experts project a continued rise in health care costs, Colorado lawmakers anticipate Medicaid funding will take a larger percentage of the budget over the next decade at the expense of such other programs as human services, highways and higher education.
Apart from concerns that next year’s Social Security increase could be wiped out by Medicare charges, seniors worry about continued reports the program’s days are numbered. The fund is not as flush as it once was, seniors are living longer on average than they were when the system was established and Congress borrows from the fund to pay for other programs.
Such developments not only make seniors nervous, they can lead to confusion.