![]() ![]() A September poll conducted by Pew Research and National Journal found that 69 percent of people older than 65 opposed vouchers for Medicare. That opposition came from both Democrats and Republicans. It’s not surprising that Republicans favor the term premium support, as the word voucher elicits a strong negative reaction from the public. “It just means that the government limits the amount of money that it puts up, and people have to add to it if market prices are higher.” “I use the words interchangeably,” said John Goodman, president of the National Center for Policy Analysis, a conservative think tank in Dallas. Others counter that premium support and vouchers are the same thing. “That gives you assurances that there will be a low-cost plan that can be purchased,” she said. Like vouchers, it limits government contributions, but also bases the amount on the premium costs of popular, participating health plans. Bush and is now a senior fellow at Project Hope. Resources & Proposals For Curbing Medicare Cost GrowthĪ premium support model could resemble the existing system for federal employees, said Gail Wilensky, who oversaw Medicare for President George H.W.Health On The Hill: What It Means, What’s Next.CBO Outlines ‘Key Features’ Of Ryan Budget Proposal.Medicare, Medicaid In GOP ‘Path to Prosperity’ Budget.Ryan acknowledged on Fox News Sunday that his Medicare proposals over the past several years included vouchers, but he recommended premium support in his budget Tuesday. In a voucher plan the government would cut a check and then allow seniors to buy the insurance policies they want in the private marketplace. Ryan argues there are important distinctions, and some conservative policy experts agree. Is premium support anything like vouchers? “It wouldn’t be bad to put some number up there, but every year or every five years Congress could take a look at it and say, ‘This is what we want.'” Taylor Scholar in Health Care and Retirement Policy at the conservative American Enterprise Institute. “We don’t want spending per person to grow disproportionately fast or slow because of things like variations in birth rates 65 years ago,” said Joe Antos, the Wilson H. ![]() One variable is how much federal spending would increase each year. “These variations can have huge implications for both beneficiaries’ spending and for federal savings.” (KHN is a program of the foundation.) But the concept is not locked in stone, and sponsors can clearly modify it with various bells and whistles,” said Tricia Neuman, vice president of the Kaiser Family Foundation. “In past iterations, the idea of premium support involved having government pay a share of the premium for a defined set of benefits. Today, there are many ways to shape the model. Bill Frist, R-Tenn., tried unsuccessfully to advance the plan as separate legislation. Breaux, D-La., developed a “ premium support” idea, but it never became a formal recommendation. And in 1998, President Bill Clinton’s National Bipartisan Commission on the Future of Medicare, chaired by then-Rep. Henry Aaron, senior fellow at the Brookings Institution, and Robert Reischauer, president of the Urban Institute and former head of the Congressional Budget Office, in 1995 were among the first to explore alternatives to Medicare’s system of paying for individual services. And enrollees could kick in more money to get better coverage. Under a premium support system, the government would pay a percentage toward the insurance premium for each individual there would likely be more help for low-income and sicker people. Currently, Medicare is an entitlement program, which means that the government must help finance every doctor visit and medical service that an individual needs. Here is a guide to some of the issues and questions raised by Ryan’s plan, which faces enormous political hurdles given expected Democratic opposition.Ī premium support model would fundamentally change the way that Medicare works by limiting the amount of money the federal government spends on medical services for seniors and the disabled. Insurers are eager for the additional business but wonder if payments will be adequate to cover the cost of care. Backers of premium support say it is similar to the health insurance program for federal workers but others say it may not meet seniors’ needs. He says his overall objective is to convert Medicare into a premium support program for which the government will spend a specific amount for beneficiaries’ care, a fundamental shift from the current fee-for-service program. House Budget Committee Chairman Paul Ryan, R-Wis., left many details to Congress when he unveiled Tuesday his plan to make major changes to Medicare as part of a fiscal 2012 budget resolution. ![]()
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