Reform Update: House leaders look to put Medicare on 'sound financial footing'

A little more than a week before Congress returns from its summer recess, leaders of the two House committees that have worked throughout the year on draft legislation to repeal Medicare's physician payment formula are now posing ideas (PDF) to modernize the rest of the Medicare program.

On Thursday, House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) and House Ways and Means Committee Chairman Dave Camp (R-Mich.), along with Reps. Joe Pitts (R-Pa.) and Kevin Brady (R-Texas), the respective chairmen of those two panels' health subcommittees, released the first in a series of papers they say are meant to “initiate a discussion on how to protect seniors and place the Medicare program on sound financial footing.”

Others see another purpose: a launching pad for trial balloons on changes that might pay for the SGR's costly repeal, which the CBO estimates will cost about $139 billion over 10 years.

“I think that the committees are floating these ideas exactly for that purpose, to signal potential offsets and gauge pushback,” Eric Zimmerman, a partner with McDermott, Will and Emery, said in an e-mail.

For instance, the 10-page paper notes that modernizing the Medicare program could begin by establishing a single combined annual deductible for Medicare parts A and B and simplifying a coinsurance rate for spending above that deductible. The paper—which also examined the growth in supplemental coverage and its impact on Medicare costs—noted that Medicare cost-sharing and supplemental coverage reforms have received bipartisan support from groups including the American Enterprise Institute, the Brookings Institution and the Bipartisan Policy Center..

As lawmakers weigh a permanent fix to the SGR or another short-term patch, they do so as they ready themselves for budget battles in the weeks ahead. Those include finding a way to continue funding government operations after the fiscal year ends on Sept. 30 and dealing with the debt ceiling—the Treasury department estimated this week that the nation will reach its debt limit by mid-October.

“I think that's going to have a profound influence again on Medicare spending,” Zimmerman said in an interview, referring to the negotiations over the debt ceiling and funding the government. “All of that could—and probably will—result in finding some Medicare offsets. SGR could be tied up in that.”

The not-for-profit group Enroll America released a toolkit this week that is intended to help hospitals use a simplified application process to enroll eligible patients into Medicaid. “With a few basic pieces of information such as income and household size, hospitals can temporarily enroll patients in Medicaid coverage at the point of service,” Richard Umbdenstock, president and CEO of the American Hospitals Association, said in a statement.

Some Democratic members of Congress are working to raise awareness and understanding of the Patient Protection and Affordable Care Act during the summer recess, even as many Republicans use the break to plot new ways to defund the law. Rep. Ron Kind (D-Wis.) will spend part of next week fielding questions about new coverage options. The Wisconsin Democrat will join representatives from HHS, the Internal Revenue Service and the U.S. Small Business Administration at events on Sept. 4 and 5 in the cities of Eau Claire, Stevens Point, Platteville and La Crosse.

Also next week, Maryland Health Connection—the marketplace of the state-operated Maryland Health Benefit Exchange—will unveil an ad campaign on Sept. 3 to prepare for the exchange's launch. The announcement is expected to include the state's plan for advertising, partnerships and outreach.

Follow Jessica Zigmond on Twitter: @MHjzigmond