Medicare Part B Premiums To Rise Slightly in 2012

Despite rumors to the contrary, the basic monthly premium for Medicare will be less than anticipated in 2012.  The new Part B premium, which covers outpatient care, will be $99.90 a month for 2012, approximately $7 less than projected as recently as May.  In other words, the majority of senior citizens will pay $3.50 more a month next year, instead of $10.20, as forecast earlier.  Some younger retirees who enrolled recently will actually see their rates go down.  They have been paying as much as $115.40 a month.  Instead, they’ll also pay $99.90 next year.  The primary reason for the lower-than-expected premiums is a result of the interaction between Social Security cost-of-living adjustments (COLA) and Medicare.

“Thanks to the Affordable Care Act (ACA), Medicare is providing better benefits at lower cost,” said Health and Human Services Secretary Kathleen Sebelius.  She reassured seniors that they have nothing to fear from the healthcare law, and described keeping premiums in check as “pretty remarkable.”

Some Republicans do not see the connection between Medicare premiums and the ACA.  “Lower Medicare premiums are being driven by lower-than-average Medicare spending due to the slow economy” – not the healthcare law, said Antonia Ferrier, spokeswoman Senator Orrin Hatch (R-UT), the ranking Republican on the panel that oversees Medicare.

Part B premiums have been frozen at the 2008 level of $96.40 a month for about 75 percent of Medicare beneficiaries because of a lack of a Social Security COLA during the recession.  Social Security recently announced a raise of an average of $39 a month for 2012.  The Part B premium is of great interest to the 48 million people covered by Medicare.  Average premiums for prescription coverage and for popular Medicare Advantage plans will stay flat or dip slightly for 2012, but fewer beneficiaries opt for those benefits.  In May, government experts forecast that Medicare premiums would rise to $106.60 for 2012.  At that time, they were also estimated a Social Security COLA of just 0.7 percent – but it turned out to be a larger 3.6 percent increase.  As a result, rising Medicare costs could be spread among many more people, resulting in smaller individual increases.

Thanks in part to the Affordable Care Act, people with Medicare are going to have more money in their pockets next year,” added Donald Berwick, MD, administrator of the Centers for Medicare & Medicaid Services (CMS).  “With new tools provided by the Affordable Care Act, we are improving how we pay providers, helping patients get the care they need and spending our healthcare dollars more wisely.”

Advocates for senior citizens also were pleased with the smaller rise in Medicare Part B premiums.  “The payment reforms enacted over the past few years, including those in the Affordable Care Act, in addition to crackdowns on fraud, waste and abuse, are partially responsible for the increased optimism about Medicare’s financial health, the lower-than-predicted Part B premium and an almost unheard-of drop in the Part B deductible,” said Joe Baker, president of New York-based Center for Medicare Rights.  “These developments help show the promise of the ACA’s delivery system reforms, and why we must let them do their job in the coming years.”

AARP echoes that sentiment.  “Millions of America’s seniors are struggling with higher expenses – particularly higher healthcare costs, lower incomes, depleted savings and reduced home equity or homes lost to foreclosure, and this small increase is welcome news,” noted David Certner, AARP’s legislative policy director.

Writing in Family Practice News, Alicia Ault takes issue with the way HHS is tying the low increase to healthcare reform.  According to Ault, “Part B premiums are calculated to cover one-fourth the cost of physician services, plus a contingency margin that is essentially equivalent to an insurer’s reserve.  This has nothing to do with health reform; it’s been a statutory requirement since, well, for a long time. And the contingency margin is always dependent on what happens with the Sustainable Growth Rate (SGR) formula.  CMS assumes every year that the SGR will be overturned, so that calculation also has nothing to do with health reform.  For an administration that prides itself on transparency, it seems to have done little today to pull back the curtain on Medicare spending — even as Dr. Berwick said that transparency itself had led to lower costs.”

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