The American Hospital Association board of trustees lent qualified support last week to a "premium support" system for Medicare but cautioned that the revamped system must ensure access for all beneficiaries and not increase bureaucracy.
Under such a system, HCFA would help beneficiaries buy private health coverage rather than pay the bills for healthcare services. The AHA board said its support is contingent on assurance that poor Medicare beneficiaries could afford to pay their share of health insurance premiums.
The AHA also said a premium support system must cover most of the cost of the current Medicare benefit package and must provide timely and adequate payments to providers. And the association warned that a proposed Medicare board must not increase hospitals' administrative burden.
The premium-support system is the leading proposal before the National Bipartisan Commission on the Future of Medicare, the 17-member panel charged with planning for the program's long-term solvency.
The commission is nearing a vote on the premium-support model, which is being advanced by its chairman, Sen. John Breaux (D-La.). The panel must report to Congress by March 1, although it is not expected to vote on a final report until the end of February.
Carmela Coyle, the AHA's senior vice president for advocacy and representation, said the board of trustees stopped short of endorsing Breaux's proposal. "Premium support is just a concept, and there are huge unanswered questions," she said.
A top concern is whether the commission will support extending some of the 1997 laws that reduced payment updates for providers. If those are extended, Coyle said, the AHA will not support the commission's recommendations.
The Federation of American Health Systems also backed premium support when it submitted its recommendations to the commission in November (Dec. 14, 1998, p. 8).