Tag Archives for Ed Zesk

Kennedy Must Lead Fight Against Medicare HMO Rate Hikes

Published in The Pawtucket Times on November 19, 2001

Across the nation, seniors who have enrolled in Medicare HMOs are getting hit hard in the pocketbook.  Premiums and copays for hospital care, nursing services and prescription drugs are skyrocketing. Complaining about inadequate federal funding offered to provide health care services to seniors, a growing number of Medicare HMOs are opting out of the program, leaving their senior enrollees high and dry.

In Rhode Island, seniors are also seeing this alarming trend. Last year, United Healthcare discontinued its Medicare Plus Choice program, first in Newport County, then in Bristol County.  Now Blue Cross Blue Shield of Rhode Island (BCBS) informs its seniors that higher premiums and copays come next year for two of their three BlueCHiP for Medicare plans. The increases include prescription drugs, inpatient care, skilled nursing services, and more. The added out-of-pocket costs impacts about 41,000 seniors across the state.

However, Rep. Patrick Kennedy (D-RI) is not buying BlueCHiP’s request for a rate increases.

In a strongly worded letter Tom Scully, the administrator of the Centers for Medicare and Medicaid Services, the agency charged with overseeing the Medicare program, the Rhode Island congressman strongly protested the rate hikes.

He called on the federal official to investigate whether the current market for Medicare HMOs in Rhode Island has created a situation where the types of increases charged by BCBS are more likely to occur and be approved.

Furthermore, he requested a review to determine if the increases are actuarially sound.

Scott Fraser, BCBS spokesperson, acknowledges that the premium increases of the two BlueCHiP plans were the result of higher medical costs passed onto the BlueCHiP plans by hospital and other medical providers. “It’s medical inflation,” he quips, adding that even higher medication costs charged by drug companies has resulted in an increase in drug copays.

Even with next year’s increases, the BlueCHiP plans will not increase the premiums for the most commonly used services, specifically physician visits, laboratory tests and X-ray services, Fraser adds. “These co-pays have been the same for the last three years.”

CMS has reviewed BCBS’s application for the changes in rates and benefits over the summer, says Fraser, adding that the rate increase was given a thumbs up by the Feds.

Are BCBS’s rate increase actually sound thus justifiable?

CMS spokesperson Peter Ashkenaz told All About Seniors “the fact that the request has been approved by CMS speaks for itself. If the costs seem to be higher than what would be paid for in fee-service Medicare, we would have questioned them.”

Ed Zesk, president of Aging 2000, a non-profit consumer advocacy group. Believes that Rep. Kennedy has asked the right questions in his letter to CMS, specifically, “Are these premium and deductible increases justifiable?”

“Consumers just don’t have access to that type of information, Zesk said.

With Medicare reform now on the back burner as the nation gears up to fight terrorism, Rep. Kennedy must use his position on the House Appropriations Committee and Subcommittee on Labor, Health and Human Services and Education, to address the rising out-of-pocket healthcare costs for Medicare HMO enrollees. As the Congressional elections approach, seniors will want to see concrete congressional action leading to meaningful Medicare reforms.

Kennedy Must Lead Fight Against Medicare HMO rate Hikes

Published in the Pawtucket Times on November 19, 2001

Across the nation, seniors who enrolled in Medicare HMOs are getting hit hard in the pocket book. Premiums and co-pays for hospital care, nursing services and prescription drugs are skyrocketing. Complaining about the inadequate federal funding offered to provide health care services to seniors, a growing number of Medicare HMOs are opting out of the program, leaving their senior enrollees high and dry.

In Rhode Island, seniors are also seeing this alarming trend. Last year, United Healthcare discontinued its Medicare Plus Choice program, first in Newport County, then in Bristol County. Now Blue Cross and Blue Shield of Rhode Island BCBSRI) informs its seniors that higher premiums and copays come net year for two of their three BlueCHiP for Medicare plans. The increases include prescription drugs, inpatient care, skilled nursing services and more.  The added out-of-project costs impact about 41,000 seniors across the state.

However, Rep. Patrick Kennedy (D-RI) is not buying  BlueCHiPs request for rate increases.

In a strongly worded letter to Tom Scully, the administrator of the Centers for Medicare and Medicaid Services (CMS), the agency charged with overseeing the Medicare program, the Rhode Island congressman strongly protested the rate hikes.

He called on the federal official to investigate whether the current market for Medicare HMOs in Rhode Island has created a situation where the types of increases charged by BCBSRI are more likely to occur and be approved.

Furthermore, he requested a review to determine if the increases are actuarially sound.

Scott Fraser, BCBSRI spokesperson, acknowledges that the premium increases of the two BlueCHiP plans were the result of higher medical costs passed onto the BlueCHiP plans by hospitals and other medical providers. “It’s medical inflation,” he quips, adding that even higher medication costs charged by drug companies has resulted in an increase in drug copays.

Even with next year’s increases, the BlueCHiP plans will not increase the premiums for the most commonly used services, specifically physician visits, laboratory tests and X-ray services, Fraser adds.  “These co-pays have been the same for the last three years,” he says.

CMS has reviewed BCBS’s application for the changes in rates and benefits over the summer, says Fraser, adding that the rate increases were given a thumbs up by the feds.

Are BCBSRI’s rate increases actually sound, thus justifiable?

CMS spokesperson Peter Ashkenaz told All About Seniors “the fact that the request has been approved by CMS speaks for itself. If the costs seem to be higher than what would be  paid for in fee-for-service Medicare, we would have questioned them.”

Ed Zesk, president of Aging 2000, a non-profit consumer advocacy group, believes that Rep. Kennedy has asked the right questions in his letter to CMS, specifically, “Are these premium and deductible increases justifiable.”

“Consumers just don’t have access to that type of information,” Zesk said.

With Medicare reforms now on the back burner as the nation gears up to fight terrorism, Rep. Kennedy must use his position on the House Appropriations Committee and the Subcommittee on Labor, Health and Human Services and Education to address the rising out-of-pocket health care costs for Medicare HMO enrollees.  As the Congressional elections approach, seniors will want to see concrete congressional action, leading to meaningful Medicare reform.

Social Security funds could be up for grabs

Published in Pawtucket Times on September 10, 2001

Don’t expect quick government action to provide prescription drug benefits to seniors or immediate meaningful Social Security or Medicare reforms soon.  With the backdrop of a $1.35 trillion Bush White House tax cut, a shrinking budget surplus combined with an ailing economy and dwindling consumer confidence, Congress may be forced to take from “Peter to pay Paul.”

But let me give you the political translation…According to a recent released Congression Budget Office (CBO) August 2001 report, the federal government will need to use $9 billion of the tax receipts used to buy bonds invested in the Social Security trust fund in the fiscal year that ends September 30 to made ends meet, increasing the likelihood that heated bipartisan bickering and congressional gridlock will occur when lawmakers being their efforts to pass next year’s 13 spending bills.

Don’t look for things to get better soon, says the nonpartisan CBO, because by 2003 it’s estimated that $18 billion in Social Security reserves will be needed to keep the government in operation.  By 2005, CBO notes that if current tax and spending policies are followed, and the economy performs as the agency estimates, on budget surpluses will emerge.

Senior groups have expressed concern about the federal government having the dip into the cash generated from Social Security payroll taxes, calling it a tragedy that will block passage of any meaningful prescription drug benefit proposals or Medicare and Social Security reforms.  “The loss of tax revenue due to the present’s tax cuts and the slowing economy will lead to new federal debt and $600 billion in additional interest payments over the next ten years,”  predicted Max Richtman, executive director of the Washington D.C. based National Committee to preserve Social Security and Medicare.

“It’s enough to pat for a generous prescription drug benefit under Medicare,” Richtman says.

“Now it looks like the federal government will have to pay bondholders instead of providing seniors with the help they need on prescription drugs, Richtman added, noting that it’s a case of misplaced priorities.

“The $600 billion (in additional interest payments) could fund a prescription drug program with co-payments and deductible at a level that is more affordable for all seniors,”  Richtman says.  Meanwhile, any funds not used could help pay for repair of glasses, refitting dentures and new batteries for hearing aids, all costs not covered by Medicare. 

Adds Ed Zesk, president of Aging 2000, a nonprofit consumer organization focused on improving health care for seniors, “Its is unfortunate that the Bush administration got caught up in tax cut rhetoric to the point where they are focused into a corner and gave a tax cut without accessing its impact on the future of Medicare and Social Security.  While Americans certainly appreciate a few bucks back from Uncle Sam it is a shame that a nation we are potentially mortgaging our future health care and Social Security for a short term tax rebate.

“Clearly the tax cut has made it virtually impossible to develop any kind of meaningful prescription drug proposal for Medicare,”  Zesk told All About Seniors.  “This is just one example of the long-term benefit being sacrificed for the short-term gains,” he says.

Kathleen S. Connell, executive director of AARP Rhode Island, states that  AARP also opposes a federal government raid on the Social Security funds to finance other government programs.  However, the nation’s largest senior advocacy group was pleased that earlier this year both Congress and President Bush had agreed to protect Social Security by using surplus funds in the program for only debt reduction.  “To use the surplus funds other than for debt reduction would undermine that consensus and signal a trend that we believe would not be good economic policy,” Connell said.

According to AARP research, the overall balances for the program funds would not be affected and full benefits could be paid up until 2038, Connell said.  “The key thing that needs to be understood as long as the surplus is used for debt reduction, it would reduce the obligation of future generations and free up money to help the economy.”

With Congress going back into session, lawmakers must now begin the task of passing 13 appropriation bills for the fiscal year beginning October 1.  With the CBO report raising the issue of spending the Social Security receipts, it is now time for Congress to quit finger-pointing and charging each other of raiding the  Social Security and Medicare program.

With the graying of America, Congress must be aside its political differences and work toward long-range bipartisan solutions to ensure the solvency of the Social Security and Medicare programs.  No longer should seniors accept quick political fixes from either political party.