U.S. Rep. Diane Black (R-TN), a former nurse for more than 40 years, is on a mission to make sure senior citizens pay a fair, reasonable cost for their healthcare plans.
As co-author of the Securing Care for Seniors Act of 2015 (H.R. 2579), Black wants the Centers for Medicare and Medicaid Services (CMS) to reevaluate and, if necessary, make changes to its Medicare Advantage (MA) program, which she said has suffered cuts and changes imposed by Obamacare.
Specifically, the proposed bill aims to guarantee that the MA risk adjustment model metrics – which are used to calculate the risk score that insurance companies use to set payment levels — are accurate, evidence-based, and transparent. This will ensure seniors pay fairer costs for healthcare and that the MA program remains sustainable in the long term, said Black.
Seniors should be “in charge of their healthcare decisions, not ‘Doctor Obama,’” she said.
On June 2, the bipartisan proposal unanimously passed the House Ways and Means Committee and now is up for consideration by the full House, possibly during the week of June 22. Black told the Ripon Advance that she and lead cosponsor Rep. Earl Blumenauer (D-OR) are working to secure strong bipartisan support for H.R. 2579 when it does reach the House floor.
What’s significant about the bill, she said, is that it “calls a time-out on CMS’s changes.”
“The president’s healthcare law drastically slashed MA payments,” Black said. “More recently, the [CMS] enacted secretive changes to the program’s risk adjustment model – its system for paying out benefits based on an enrollee’s predicted health costs – that could leave America’s most vulnerable citizens at risk by discouraging plans to detect and care for chronic conditions in their early stages.”
She also said that such changes were made with “little to no input from Congress and, most importantly, Medicare Advantage beneficiaries.” The Obama administration, she added, seems intent on upending a program that so many seniors depend on to stay well.
In fact, in Black’s home state of Tennessee, one-third of Medicare beneficiaries are enrolled in a Medicare Advantage plan.
“My constituents consistently tell me … that they enjoy the flexibility and choice of MA and they don’t want to see a board of faceless bureaucrats at CMS reconfigure the program’s risk adjustment model in a way that could price them out of a healthcare plan that works for them,” she said.
Black is also working in other ways to offer relief from Obamacare.
For example, also on June 2 the House Ways and Means Committee passed the Preservation of Access for Seniors in Medicare Advantage Act of 2015 (H.R. 2581), which includes language from Black’s VBID for Better Care Act of 2015 (H.R. 2570). She said H.R. 2581 will help MA plans improve delivery of care by allowing them to decrease costs for certain high-value services and treatments, especially for low-income patients.
“I understand the need for healthcare reform, but Obamacare was never the way to do it,” she said. “We were reminded of this just last week when the administration released insurers’ requested rates for 2016 and we learned that health plans across the country are asking approval for double-digit premium increases.
“This is a big warning sign for the future of Obamacare,” she said.
The best solution to “this Obamacare rate shock,” Black said, is for Congress to start over on health reform.
“But until that can be achieved, we’ll keep working to provide relief from some of the most onerous provisions of Obamacare,” she said.