Obama Publicly Backs Means-Testing Medicare

[Freddie Stubbs]

Source: Huffington Post

WASHINGTON -- President Barack Obama formally acknowledged on Friday that he would support a plan to means-test Medicare as a part of a deal to raise the nation’s debt ceiling.

“I have said that means-testing on Medicare, meaning people like myself -- I’m going to be turning 50 in a week, so I’m starting to think a little bit more about Medicare eligibility -- but you can envision a situation for somebody in my position, me having to pay a little bit more on premiums or co-pays would be appropriate. And again, that would make a difference,” the president said at a press conference. “What we are not willing to do is restructure the program in the ways we have seen coming out of the House in recent months.”

The comment was the first public acknowledgement from the White House that the president would support changing the payment structure of the entitlement program. Prior to Obama’s remarks, multiple sources in both parties told The Huffington Post that the administration was making it clear to debt ceiling negotiators that such a structural change to Medicare was on the table.

The proposal is not entirely controversial among health care economists. But it will rankle a good chunk of the president's own party, which has sought to keep Medicare's structure as a basic insurance program as opposed to a welfare-like model. Making top earners pay more into the system than their moderate to lower-income counterparts may seem like sound, balanced policy -- but it also makes Medicare's finances vulnerable to future budget slashing or tax-reducing campaigns.

Read more: http://www.huffingtonpost.com/2011/07/15/obama-medicare-means-testing_n_899839.html

[elleng]

1. As he made it perfectly clear, he was referring to high-earners like himself;

SHOULD be a no-brainer, but will likely garner 'OMG OMG OMG' from MANY places, imo.

[FreakinDJ]

2. 'OMG OMG OMG' from Wealthy Elite catering RATpubliCONs

[lark]

35. Actually NO, they would support this

and later call it a first step while they were cutting it. Anything that causes the wealthy to pay more will get cut soon as a Repug president is in office. Our present president is setting Medicare up to be ended within a dozen years. This is not good news, folks. It's the death knell for the program.

[No Elephants]

39. Ordinarly, I might post "IOKIODI."

(It's okay if Obama does it.) However, I am realizing what an understatement that is.

I'll have to come up with something else.

[rampart]

3. means testing is costly and degrading

do we want to spend the dollars on medical care or on making sure that working families spend down their savings and sell their homes before receiving treatment?

[colorado_ufo]

17. Bingo!

The additonal administrative costs alone of checking income, etc. would outweigh any benefit to this. Sucks.

[EFerrari]

21. It's a terrible idea. As soon as the program is only for poor people

it's at risk.

[suffragette]

53. Exactly

[No Elephants]

24. "People like myself" is perfectly clear as to high earners "like him?" I disagree.

Last time I looked (not recently) the President was entitled to salary of $400K a year, I believe.

Medicare is received by recipients of OASDI.

They include the disabled, who by the OASDI definition itself cannot and do not work and therefore earn little to nothing ($500 a month in earnings, I believe and you are an ex-recipient).

Then there are the elderly, not the most employable group. Sure, Warren Buffet is still working at 80, but that's exceptional.

Then there are widows and minor children of a deceased worker who had paid in enough to earn that benefit.

So, high earners like Obama who qualify for Medicare are relatively a very small group. Is that really what he means? I doubt it, don't you?

So, what does he mean? Exactly how much earnings are we talking? Are we also talking unearned income, like stock dividends? Are we talking assets, like your bank account, jewelry, your primary residence, that little shack in the woods you bought?

Perfectly clear? Not really.

Besides, there is always that slippery slope.

[Igel]

44. Medicaid is means tested.

So is welfare and a few other programs.

It can be means tested by income, but that won't get you very much. Do you include SS income? US Bond income? Bank interest? Dividends?

What do you do about IRAs? Is the income "visible" to means testing?

If you're a 65 year old woman in a $2.3 million house whose maintenance is handled by funds in a family trust with $23 million (but crucially moved out from under your SSN) while you've drawn down your survivor's trust to the point where your income is $30k, are you poor enough?

Questions, questions, questions. Meaning that before you can qualify for Medicare *everybody* has to provide documentation as to income, with the temptation to hide under the counter income. And possibly as to assets, with asset hiding fairly easy to do.

[No Elephants]

47. Yes, I know, but Medicaid was always "sold" to the public as a

safety net for the poor, never as insurance for all who had paid into the program .

"Questions, questions.." Yep, I agree.

If you want to hide your income, you'd have to hide it from the IRS, too, because that's where the SSA gets its info about income.

Edited to add the bolded words.

[fasttense]

37. Because when you start "means testing" the goal is to see how low you can go.

Sure maybe they start with millionaires but then they move on to people with $50,000. The test will get meaner and meaner. Soon, all but the most destitute can not pass the test.

Then it becomes nothing but a welfare program (though you pay for it every time you earn a dime). And everyone knows poor people don't vote often enough to make a good voting block. That's why Clinton was able to destroy our welfare system so easily.

What a really stupid idea. Are they going to stop taking Medicare out of our paychecks like they stop taxing the uber rich with pesky things like Social Security? It merely drills a hole in the program in the hopes of destroying it.

[leahcim]

4. Death Panels!!!!

Obviously this will include death panels to weed out people with "too much means" to save money.

Or at least it will in the summary Palin gives to her flock.

[No Elephants]

29. If you do not understand the link between poverty and death,

try living as a disabled person on $800 a month for one year and see how healthy you are at the end of the year. See how funny you think associating cuts with death panels is then.

At that, you'd be spared the stress from knowing that's it for the rest of your life, but maybe a year will be enough for you to get the gist anyway.

[OHdem10]

5. And he said: "Does not require "RADICAL CHANGES" to Social

Safety Net."

Just what is meant by Means Testing. Dick Armery
,the Ultimate Libertarian, and Tea Party Express
has been calling for Means Testing for years. He
has also wanted to sue the Government in order to
opt out of Medicare.

This is confusing.

[GrantDem]

6. NCPSSM

http://www.ncpssm.org/news/archive/vp_meanstesting/

[No Elephants]

26. My father got away with murder! Or, at least without being means tested.

[Hoyt]

28. Good link. If I make $160-230,000 a year in retirement, I'll gladly pay an extra $2400 for Medicare.

Doesn't sound like a big issue to me. Of course, I won't be in that group. Nor will I be in the $423,000 per year group for married couples.

I don't think there is much to criticize there.

[No Elephants]

31. Once the door is open, further cuts will be made. Bet on it.

Besides, we don't know what Obama is proposing as to Medicare.

[Hoyt]

40. They better make some changes because annual increases of 7 - 9% are not sustainable.

Hopefully it will be smart changes, but you can't just sit back and say there is not a problem. There is. The whole health care system needs restructuring for quality and cost purposes.

I'll trust Obama to make smart choices, choices we won't get from GOP. If he makes bad choices, I'll curse him. But so far it's just a bunch of conjecture.

[eridani]

67. The only solutiion to that is single payer, or the establishment of government dictatorship

--over what private insurance is allowed to do, as is the case in France, Germany and Japan.

[former9thward]

49. Means testing is done on assets not just income.

[Hoyt]

54. If I have $1,000,000 in assets -- will be glad to pay $2400 more a year for Medicare.

[former9thward]

57. That is not what they are talking about.

Assets of 200-300k including the value of your home, life insurance, etc. It adds up quickly.

[Hoyt]

59. Exactly, they are not talking about that -- so why the concern?

[former9thward]

60. Plenty of people have 200-300k in assets when they retire.

Especially when you take in the value of a home.

[Hoyt]

61. They are not talking about anything like that.

[former9thward]

62. Well I don't have anything in writing and I suspect you don't either.

If you have a link to a concrete proposal with actual numbers I would like to see it. Not what "people are talking about". In these things they always move the numbers down when they find they can't get the income they need.

[Hoyt]

63. Have a nice weekend and don't worry.

I like one of the comments I read on Huffington Post -- "Does this mean the Koch bros. don't get their free annual DRE ?

[Downwinder]

64. I can guarantee that the same rehab is not available

under Medicare that Giffords received.

[Downwinder]

7. The difference between a top earner and a lower-income counterpart

can be just one illness.

[No Elephants]

32. Yep. Also the difference between a lovely home and a refrigerator carton.

[ooglymoogly]

8. Thereby making it an entitlement program and destroying

it as the insurance program that it is. The cap should be lifted that is all. But then that is just too obvious.

As much as the government tries to make this an entitlement program in order to shut it down, it is not.

[roxiejules]

10. +1

"In this supposed age of bickering, extreme political partisans... where are the people calling for increasing Social Security payments and lowering the eligibility age?

Naturally, that's what the Democrats are doing. Oh, wait...."


- via Corrente

http://www.correntewire.com/just_curious

[Hoyt]

23. Medicare "cap" was lifted years ago.

[Hoyt]

25. So a guy with $1,000,000 income would be disadvantaged paying 30%, rather than 20%, in coinsurance?

I don't think so, because most folks buy insurance to cover the coinsurance, or Medicaid steps in for the poor.

I think Obama is exactly right on this. And it sure beats any GOP proposals.

Yea, I know -- I replied to myself. Fucked up -- sorry.

[No Elephants]

34. No apologies necessary. I bet most of us have posted in the wrong place more than once.

Besides, if people can talk to themselves, replying to yourself has to be okay.

[No Elephants]

33. Do you mean OASDI payments or Medicare premiums?

[ooglymoogly]

68. sorry I misread the OP.

I was only a day out of two surgeries and heavily medicated. I think a means test for medicare is in fact a good thing.

[hayrow]

9. Medicare is a forced savings program

Because the medicare payroll deduction is not a tax, wouldn't the people that paid into the program be allowed to get there money out of the program if they are means tested out? In a way this does not seem to make sense.

[No Elephants]

11. Thing is, many seniors own homes, often outright, having spent 30 or more

years paying off the mortgage with their hard-earned money. And some of those homes were in poor neighborhoods that yuppified while the seniors were in them.

That is true of a number of neighborhoods in Boston, which were reviled until the 1980's, then somehow became THE place everyone wished to be.

Will the present day market value of a home be exempt, no matter what the home is worth? Or will these people have to pay through the nose for Medicare premiums with cash they don't have, unless they sell their homes and trade down or rent?

P.S. Obama's "folks like me" shtick is getting a little tired, too. He has only a few million bucks now, but Bill Clinton made well over $100 million when he left office.

Obama, being America's first African American* President, is likely to make even more. And that's without his government pension. He'll be able to build a hospital just for his family, if he wants, let alone pay a little extra for Medicare premiums.

Until then, he has great doctors attending to him, his family and his dog (if on Air Force One, anyway) wherever they go, at no charge, except to the U.S. taxpayer. Plus he has government health insurance benefits.

So, please, Mr. President, give it a rest. I don't begrudge you a cent of your money or assets, past, present or future, but I do begrudge the pretense.

[swilton]

12. 'Folks like me'

as if Obama were one of the little people is truly laughable and shows how out of touch he is or how stupid he thinks we are or both!

[No Elephants]

16. "Folks like me..." He didn't use those exact words this time, but he has used them

a number of times in the past.

I don't know if Clinton has used those exact words, but he has used the same technique, as in "Someone like me should pay a 'little' more."

No, sirs, someone like you should either voluntarily refuse Medicare or pay one hell of a lot more.

Still, that does not begin to touch asking someone living on $1000 a month to sell their home so they can pay a little more. So, I'm hoping any means testing at least exempts the primary residence of the person or couple.

Better yet, any means testing should be on income. not assets you acquired over a lifetime. If your only income is Social Security, you should be left alone.

Even better yet, the government should keep its promises to the elderly and disabled.

[Lasher]

13. Medicare is already means tested.

Junior and his Bush league lapdog GOP Congress did that when they passed Part D. Since this is so, Obama is clearly talking about lowering the thresholds of the means test so that more of us will be affected.

Many of us here are just fine with means testing as long as they are not personally disadvantaged. But the bad thing about it is, sooner or later you're next. Medicare means testing sucks. I said it back then when it was first established, and I'm saying it now. It should have been abolished, as part of Obamacare legislation.

[No Elephants]

18. I don't understand what you are saying. Don't all OASDI recipients get

Medicare, including whatever benefit Part D is to them without being asked about income or assets? I'm very sure my father was never asked 'cause I would have been the one to fill out the papers if he had been asked.

(Anything from the government makes him more nervous than you would believe and, as far as I know, there is absolutely no rational reason for that.)

[Downwinder]

22. Extra Help with Medicare Prescription Drug Plan Costs

http://www.ssa.gov/prescriptionhelp/

[No Elephants]

27. Thank you for the link, but I am still asea.

At the link, I saw something about qualifying for an Extra Help program, not about qualifying for Part D. Did I miss the bit about Part D? Is "Extra Help" the same as Part D? Or is it to help out with things Part D does not cover?

Sorry to be slow in following your drift.

[Downwinder]

36. The Extra Help comes in .I think, four levels.

It changes the monthly premium, changes the co-pay and closes the donut hole.

I have never figured out how to navigate the program. To start off, agents were not allowed to compare plans. Then you have restrictions on outside help for high dollar medications.

[No Elephants]

41. Thank you.

Per links and explanations people posted, there does seem to be means testing as to premiums charged for Part B of Medicare. You link shows means testing for Extra Help (for those who are limited in income, but high in prescription drug needs), but I have not seen means testing for Part D yet.

"Agents were not allowed to compare plans." Well, that's disgusting, but good to know.

Thank you for your patience. I think I'm finally catching on.

[Downwinder]

46. The Extra Help is a form of means testing.

Just as the donut hole is a deductible that comes into effect down the road.

Name changes.

[Lasher]

30. Means testing determines Part B premium levels, not eligibility for any part of Medicare.

Here is a summary: http://www.ncpssm.org/news/archive/vp_meanstesting/ There you will see the thresholds that I suspect Obama plans to tinker with.

This means testing was passed in 2003 and took effect in 2007.

[No Elephants]

38. OK, thanks I see as well that no one has to report income, except to the IRS.

As long as only income is involved, not other assets, I feel better as no one will have to sell a home (or a 50 year old engagement ring) to make premiums.

However, I would be very surprised if this were the end of it. The door will be open--and a Democrat will have opened it.

The only place I see this leading ultimately is making Medicare pretty much like Medicaid, though that will take a while.

I wish I had an "After me, the deluge" attitude, but I never had it and probably never will.

[Lasher]

50. I share your anxiety, Medicare means testing is a slippery slope.

Don't wish for a different attitude. It is best that we care about the welfare of others, including those of earlier generations. There's too many selfish people who care only about themselves and I'm glad you're not one of them.

Edit: Thanks for asking. I learned something myself, about the Part D Extra Help means testing.

[NC_Nurse]

14. Great. So you work all your life to get enough assets to live decently in retirement and

then you end up having to pay all of it for your "copay" when they means-test you out of Medicare. Fuck that.

[earcandle]

15. Are we waking up yet? Governments job is to levy taxes to pay for services.

Are we waking up yet? Show your understand and solidarity by proudly wearing a TAX ME T-Shirt that clearly states the issue. http://www.cafepress.com/+noodle_brain_productions_womens_cap_sleeve_t,249156846

At least consider the statement posted on the T- shirt:

Governments are not profit seeking,

but exist to meet citizens demands for services,

consistent with the availability of resources

to provide those services.

Our main resources come from our taxes.

Reduced taxes equals reduced services.

Reduced services = third world economics.

so, TAX ME!

[No Elephants]

42. LOL. Problem is, government sold these programs as insurance and we bought them as

insurance by paying taxes all our lives.

People who died before 2009 got the deal offered and accepted. All the rest of us got defrauded and it will probably get worse and worse until all anyone can "look forward to" is maybe a teeny bit of SSI and Medicaid.

Selling someone something under false pretenses is criminal.

[trud]

19. does anyone seriously believe

he means only people with millions in the bank? No. He's letting the Repigs chip away at everything Democrats have gained over decades. But, hey, no touching war spending, right?

[No Elephants]

43. While the Rethugs are talking Constitutional amendments, I suggest we

repeal the one that says Congressional compensation cannot be reduced or denied.

Not exactly shared sacrifice if one group is protected by a Constitutional amendment, is it?

[StarsInHerHair]

65. yeah &China is publicly saying the US should ratchet back its war spending

what a slap in the face; But personally I want the Pentagon's budget means tested & attached to how well the economy is doing-UNLESS war is officially declared.

[Downwinder]

20. I guess it is too much to ask that he just listen to

Physicians for a National Health Program.

[No Elephants]

45. The Secret Service held at least one member for questioning

once or twice. Apparently, she asked someone on the WH grounds, near the fence where she was standing (on the appropriate side of the fence) and someone at a rally if they could please pass the President a note.

He had kept saying that anyone who had a better plan than the one he was proposing should tell him about it. Her note reminded him of that request and her reply was "Single payer." I can't remember if she was questioned on both occasions or only once.

This made her seem like a threat to the President, I guess. Hey, at least she didn't end up in GITMO, so thank heaven for small favors.


She told her story on Bill Moyers Journal not too long before that show ended (whereupon, I saw no further reason to donate to PBS).

[JAnthony]

48. Long overdue, I wish he had these balls on his first day in office

Millionaires should pay for their own Medicare..so should people earning $200,000 after turning 65.

We can help out with those whose care will cost them their life's earnings, we can stop loss from medical bills at say $500,000 per person who has such high incomes, but we should NO LONGER be paying hundreds of thousands of dollars for people's medical care who can very well pay for themselves.

We need some breaks on this train...

[former9thward]

51. I think this is a bad idea.

It will lead to medicare recipients hiding assets, transferring money to children, etc. in an attempt to avoid any medicare penalties. To try and enforce it would be a nightmare of records and investigations. Once the program is set up for x income/assets and below then those with x+1 income/assets lose interest in preserving it.

[Nossida]

52. Goddamned Right

I watch so many 'wealthy' people
in Medical offices using Medicare.
Just another example of Rich republican
leeches sucking off the system ,and
then moaning to high hell for tax
cuts. Screw Em. There should be a
Goddamned Law. Its pure thievery.

[Xithras]

55. Sure. But let the rich opt out of paying for it too.

Perhaps you've forgotten, but Medicare is a savings program and not an entitelement program. It's insurance, not welfare. When you pay for insurance, your right to draw on it shouldn't be limited.

Obama and the Republicans want to turn it into a welfare program. Why? Because once it's an entitlement program "for the poor", they can gut it without most Americans complaining.

Right now Medicare is for EVERYONE when they get old. Cutting it impacts EVERYONE, and is a politically dicey proposal. Make it a welfare program that only exists for a subset of the population, and it suddenly get a lot easier to get the REST of the population onboard with cutting it. "Oh, they're cutting Medicare? That doesn't affect me anyway."

[Bill McBlueState]

56. I suppose people will start demanding drug tests for Medicare recipients, too

It's popular to demand that "welfare" recipients be drug-tested, but I can't actually figure out what metric people use in deciding which government benefit programs should require a drug test for participation.

[former9thward]

58. Of course. Gotta give the War on Drugs people their cut also.

[eridani]

66. It the POTUS doesn't even fucking goddam KNOW that Medicare is already means tested--

--that just goes to show how utterly disconnected he is from people who depend on Medicare to stay alive. If he does know, is this just another trial balloon for dropping the income at which you pay more for Medicare from $170K to a lot less?