Obtaining quality health care isn’t something Americans should have to worry about as they age. Medicare has been instrumental in helping provide access to quality healthcare at a reasonable price for the millions of seniors who depend on it, but alterations to the program could reverse the progress we’ve made.
Recently, the Centers for Medicare and Medicaid Services announced a new payment model for medications covered by Medicare Part B. Medicare Part B covers prescription medications administered in a doctor’s office or outpatient facility and are most often used to treat complicated and serious conditions like cancer or immune deficiency. Essentially, the new model would make certain medications more expensive to administer, which would limit access to patients who rely on these treatments to stay healthy. These restrictions to care would be especially problematic for seniors who already use these medications and would be forced to switch to treatments that could be less effective.
Unfortunately, the overarching model is slated to be implemented nationwide on a mandatory basis, so seniors and their doctors will have no way to opt out of this potentially harmful experiment with their healthcare. Needless to say, this is a matter of great concern for many vulnerable patients at the mercy of the government’s decisions. In fact, in an informal poll of RetireSafe’s members, 76 percent of respondents that receive or have a family member that receives infusions said their health would be in jeopardy if they had to change treatment sites or medicines and 95 percent oppose any change.
Worse, a staggering 13 percent of those respondents reported that they would simply stop getting infusions if they were no longer able to get them from their doctor. Respondents also noted that this is the latest in several cuts to doctor reimbursement rates, which have had the effect of limiting doctors’ ability to profitably administer health care through the Medicare program. As a result, seniors are left with less access to care when they need it most.
However, it’s not just seniors who have expressed their disapproval to this new payment model. Over 300 patient and physician groups have written to Congress outlining their concerns, including the model’s potential to adversely impact patients, as well as the lack of stakeholder input into the development of model that will have almost universal implementation.
Additionally, the model faces opposition from legislators. In May, 242 members of Congress sent a bipartisan letter to CMS demanding the Part B model be withdrawn. The letter, led by Reps. Tom Price, John Shimkus, and Charles Boustany Jr., outlines that the model endangers the most at-risk seniors including those with chronic conditions by restricting access to certain medications and treatments through Medicare.
Recently, Rep. Larry Bucshon and Rep. Robert Dold also introduced legislation to block the implementation of the Medicare Part B Payment Model saying, “We cannot allow unelected DC bureaucrats to run an experiment with Medicare beneficiaries that could disrupt care for the people who need medications most, including those with cancer, arthritis, and other diseases. Their unilateral decision to cut Medicare benefits will compromise the health of our nation’s most vulnerable.”
Overall, the message is clear: America’s seniors, doctors, and lawmakers oppose the harmful change. On behalf of the seniors I represent, I urge CMS to withdraw the proposed model and in the future, consult closely with seniors and those that represent them prior to proposing significant changes to Medicare that could limit access to healthcare.
Thair Phillips is president of RetireSafe, a grass-roots, non-profit organization formed in 1991 to educate and advocate on behalf of mature Americans on issues including Social Security, Medicare, health, safe retirement and financial well-being. Thinking of submitting an op-ed to the Washington Examiner? Be sure to read our guidelines on submissions.
