If a primary Medicare trust fund drops below full solvency—as actuaries have warned is possible in coming years—then providers and Congress would have no recourse but to wait for future Medicare tax revenue to cover all of its obligations, according to a new analysis (PDF).
A bicameral group of congressional Republican physicians issued the analysis Tuesday, based on previous research by the Congressional Research Service, of options for covering healthcare provider reimbursements if the Medicare Hospital Insurance Trust Fund becomes insolvent. Recent estimates by federal accountants of when the fund will run out of money to cover all of the payments owed range from 2016 to 2024.
The Republicans, including Sen. Tom Coburn (R-Okla.), concluded that federal law establishing the trust fund bars the administration from issuing payments in excess of the trust find's resources. Also, federal law would prohibit Congress from appropriating any additional money to cover any provider payments shortfall from the fund in a given year. Finally, legal precedents also would deny providers of the ability to successfully sue for full reimbursement in the event the fund fell short and partial payments were issued.