Affordable Care Act Savings Do Not ‘Cut’ Medicare Benefits

CFIF Shows That Owens Opposed “Medicare Benefit Cuts.” The ad’s statement that Rep. Bill Owens “said he’d oppose Medicare cuts” is accompanied by the following screenshot:

[CFIF via YouTube.com, 9/19/12]

Affordable Care Act Reduces Future Medicare Spending, But “Does Not Cut That Money From The Program.” According to PolitiFact: “The legislation aims to slow projected spending on Medicare by more than $500 billion over a 10-year period, but it does not cut that money from the program. Medicare spending will increase over that time frame.”  [PolitiFact.com, 6/28/12]

• CBO’s July Estimate Updates Medicare Cost Savings To $716 Billion. According to the Congressional Budget Office’s analysis of a bill to repeal the Affordable Care Act, repeal would have the following effects on Medicare spending: “Spending for Medicare would increase by an estimated $716 billion over that 2013–2022 period. Federal spending for Medicaid and CHIP would  increase by about $25 billion from repealing the noncoverage provisions of the ACA, and direct spending for other programs would decrease by about $30 billion, CBO estimates. Within Medicare, net increases in spending for the services covered by Part A (Hospital Insurance) and Part B (Medical Insurance) would total $517 billion and $247 billion, respectively. Those increases would be partially offset by a $48 billion reduction in net spending for Part D.” [CBO.gov, 8/13/12]

GOP Plan Kept Most Of The Savings In The Affordable Care Act. According to the Washington Post’s Glenn Kessler: “First of all, under the health care bill, Medicare spending continues to go up year after year. The health care bill tries to identify ways to save money, and so the $500 billion figure comes from the difference over 10 years between anticipated Medicare spending (what is known as ‘the baseline’) and the changes the law makes to reduce spending. […] The savings actually are wrung from health-care providers, not Medicare beneficiaries. These spending reductions presumably would be a good thing, since virtually everyone agrees that Medicare spending is out of control. In the House Republican budget, lawmakers repealed the Obama health care law but retained all but $10 billion of the nearly  $500 billion in Medicare savings, suggesting the actual policies enacted to achieve these spending reductions were not that objectionable to GOP lawmakers.” [WashingtonPost.com, 6/15/11, emphasis added]

Health Care Reform Is Not A “Government Takeover”

PolitiFact: “Takeover” Charge “Does Not Hold Up Under Examination.” According to PolitiFact: “[T]he law increases regulation. But it greatly relies on the private sector to provide health care. Hospitals will not be taken over by the government, doctors will not become federal employees. The act relies on private insurers to compete and provide health care coverage to an expanded customer base. Employer-based coverage through private companies continues. The ‘government takeover of health care’ is a potent political charge that does not hold up under examination.” [PolitiFact.com, 6/16/12]

Federal Government’s Share Of U.S. Health Spending Is Projected To Grow Very Slowly Under ACA. According to Kaiser Family Foundation president Drew Altman: “Measured by the government’s share of health care spending, there is no sign of a government takeover of the health care system.” The following chart, based on analysis by the Center on Medicare and Medicaid Services, shows the projected share of U.S. health spending by the states, the federal government, and the private sector in 2010 and 2020:

[KFF.org, 8/1/11]

IPAB Is Tasked With Finding Additional Savings, But Is Forbidden From Cutting Benefits

The ad’s claim that the Affordable Care Act “could give bureaucrats the power to cut Medicare spending even more” cites a Cato Institute analysis of the Independent Payment Advisory Board from June 14, 2012.

ACA Establishes An Independent, Senate-Confirmed Board (IPAB) To Find Additional Savings. As explained by the Kaiser Family Foundation: “The 2010 health reform law (the Patient Protection and Affordable Care Act, also referred to as the ACA) establishes a new Independent Payment Advisory Board (IPAB) with authority to issue recommendations to reduce the growth in Medicare spending, and provides for the Board’s recommendations to be considered by Congress and implemented by the Administration on a fast-track basis. […]As authorized by the health reform law, IPAB is an independent board housed in the executive branch and composed of 15 full-time members appointed by the President and confirmed by the Senate. [Kaiser Family Foundation, April 2011]

IPAB Proposals Will Be Implemented Unless Congress Finds Alternative Savings Or Supermajority Overturns Them. According to the Washington Post: “Beginning with fiscal 2015, if Medicare is projected to grow too quickly, the IPAB will make binding recommendations to reduce spending. Those recommendations will be sent to Capitol Hill at the beginning of each year, and if Congress doesn’t like them, it must pass alternative cuts — of the same size — by August. A supermajority of the Senate can also vote to amend the IPAB [spending] recommendations. If Congress fails to act, the secretary of Health and Human Services is required to implement the cuts by default.” [Washington Post, 5/8/11]

IPAB Cannot “Ration” Care. According to the Kaiser Family Foundation: “The Board is prohibited from recommending changes that would reduce payments to certain providers before 2020, and is also prohibited from recommending changes in premiums, benefits, eligibility and taxes, or other changes that would result in rationing.” [Kaiser Family Foundation, April 2011]