Medicare coverage for voluntary end-of-life planning was part of the original House version of the overhaul legislation in 2009, but it was dropped after Sarah Palin and other Republicans raised the specter of “death panels” deciding the fate of vulnerable seniors. Those charges were later debunked by several non-partisan fact-checking groups.
End-of-life counseling unexpectedly surfaced again late last year in a Medicare regulation that spelled out what would be covered in a new annual checkup, or wellness visit, authorized by the healthcare law. The regulation said such voluntary doctor-patient discussions could be part of the annual visit.
The White House official said the administration is now pulling back the language because there wasn't enough chance for all sides to comment on the change. The official spoke on condition of anonymity to discuss what has turned into an embarrassing episode for the administration.
End-of-life planning is already an accepted part of care for people facing terminal illness, and the administration's reversal is unlikely to have much impact on that. Longstanding federal rules already require hospital patients to be informed of their right to spell out in a living will or similar document their wishes about being kept alive by machinery if there's no hope for a cure.
However, many doctors and public health advocates believe the government should take a more direct role in encouraging people to plan ahead. They say it would save families the ordeal of having to make agonizing decisions when a loved one is incapacitated.
Opponents counter that such decisions are highly personal, and government should stay out. They worry that explicitly including end-of-life counseling in Medicare rules could send an indirect message that people facing serious illness should be nudged toward hospice care, giving up on seeking a cure.