Before the passage of the Affordable Care Act (ACA), in 2010, the U.S. Congress had to approve any proposals that would affect Medicare payment rates and program rules. But that will change in 2017, as the Affordale Care Act created the Independent Payment Advisory Board (IPAB), a 15-member panel that would be empowered to propose changes if Medicare exceeds spending growth thresholds. The IPAB’s proposals are intended to extend the solvency of Medicare, slow Medicare cost growth, and improve the quality of care delivered to Medicare beneficiaries. Any recommendations would automatically go into effect, unless Congress took steps to override them. According to the, Medicare Trustees, a group that oversees the financial operations of the Hospital Insurance and Supplementary Medical Insurance trust funds, the Medicare per capita growth rate is projected to exceed the per capita target growth rate in 2017, triggering the IPAB for the first time. This means three in ten people will be hit with a 25% increase for Medicare Part B, and that 70% of people with Medicare will be exempt from paying. And, according to a recent report from the Medicare Trustees, because the law requires Medicare Part B premiums to cover 25% of program costs, the 30% of those with Medicare premiums will see an increase to at least $159.30 each month, and couples who earn $428,000 annually will pay a monthly premium of $509.80.
Medicare Advantage 2014 Spotlight: Plan Availability and Premiums
While many organizations offer Medicare Advantage plans, a few – particularly Humana, United Healthcare, and the Blue Cross and Blue Shield (BCBS) affiliates – have particularly large geographic spread and these organizations historically account for a disproportionate share of enrollment. In 2014, 44 percent of available plans are being offered by one of these three firms or affiliates (Table A4). Plans offered by these firms are available to most beneficiaries. Nationwide, 83 percent of Medicare beneficiaries will have access to one or more Humana plans, 73 percent will have access to a BCBS affiliated plan (including BCBS plans offered by Wellpoint), and 68 percent will have access to a United Healthcare plan (Exhibit 5; Table A5). The general availability of these firms’ products has not noticeably changed from 2013 to 2014. However, the similarities in BCBS offerings from 2013 to 2014 obscure a decline in availability of BCBS branded Wellpoint plans (declining from 88 plans to 55 plans between 2013 and 2014), which is mostly offset by the growth in plans offered by other BCBS affiliates (growing from 205 plans to 233 plans between 2013 and 2014).
Effect of a Zero Social Security COLA on Part B Premiums in Medicare
Projected Part B Premiums in 2010 and Subsequent Years. CBO estimates that the Part B trust fund account will require about $220 billion in income from premium collections and matching contributions in 2010 to cover expenditures and maintain a contingency reserve, with larger premium collections required in subsequent years. CBO estimates that the hold-harmless provision, in conjunction with the zero COLAs projected for Social Security benefits, will result in the monthly Part B premium for beneficiaries not subject to the hold-harmless provision increasing to $119 in 2010, $123 in 2011, and $128 in 2012 (see note below). Without the hold-harmless provision, CBO estimates that the monthly premium would be $103 in 2010 and would grow to about $109 in 2012, so the interaction of the hold-harmless provision and projected zero COLAs for Social Security will add significantly to the increases called for under current law.There is no effect on Part D premiums because there is no hold-harmless provision in Part D.