Rivlin-Domenici

Date November 2010

Proposals for Medicare Reform

Simpson-Bowles
December 2010

2012 Path to Prosperity

April 2011

Budget Control Act

August 2011

Plan Summary Status Premium support/ Privatization Maintain traditional Medicare as default

In 2018, transition Medicare to a premium support system that gives beneficiaries vouchers to purchase private insurance on a regulated Medicare exchange; maintains traditional Medicare as an option.

Continues with traditional Medicare fee-for-service while using Federal Employee Health Benefits program as a pilot program for premium support.

Signed into law August 2011, the act will reduce net federal Eliminates traditional Medicare in spending by $2.1 trillion over ten 2022; replaces it with a premium years and raise the debt ceiling by up to $2.4 trillion. support system. Passed House; failed in Senate. Signed into public law.

Voted down in the House by a Never left Bipartisan Policy Center. large margin. Transforms the Federal Employees Health Benefits program into a premium-support pilot program.

Not mentioned. Not mentioned.

Beneficiary Payments

Establishes single combined annual deductible of $550 for Medicare Part A and Part B; recommends that the CMS Premium support amount would provides catastrophic protection grow by the annual rate of GDP by reducing the coinsurance rate growth per capita +1% both for individuals entering the exchange to 5% after costs exceed $5,500 and caps total cost-sharing at and for those who remain in $7,500. traditional Medicare.

Premium support payments for 65-year-olds in 2022 would be specified to be $8,000; payments would increase each year by an amount that reflects both the increase in the consumer price index (CPI-U) and the effects of aging. Starting in 2022, age of eligibility for Medicare would increase by two months per year until it reaches 67 in 2033. Budget deficits would be around 2% of GDP in the 2020s and would decline during the 2030s. The budget would be in surplus by 2040. Reduces federal health care spending to around 6% of GDP in 2030-2040 and 5% of GDP in 2050.

Not mentioned.

Age of Medicare eligibility

Not mentioned. Reduces federal budget deficits over the 2011-2020 period by about $280 billion.The total effect in 2020 would be a reduction of approximately $90 billion.

Not mentioned. According to the proposal, would cut the deficit by nearly $4 trillion through 2020, and reduce the deficit to 2.3% of GDP by 2015. No CBO analysis available. Establishes a global budget for total federal health care spending and limits the growth to GDP plus 1%. Freezes payments through 2013, with a 1% cut in 2014, after which the SGR formula is reactivated.

Not mentioned. The super committees failure to reduce the deficit by at least $1.2 trillion triggers a 2% across the board cut to Medicare in 2013, which translates into about $123 billion over the next decade. Implements a sequester to Medicare payments to providers and plans, if by 2014 the debt-to-GDP ratio is projected to exceed 2.8% for 2015-2019.

Budget Deficit*

Reduces federal health care spending to around 6% of GDP in 2020, 8% in 2030 and 10% of Health Care Spending* GDP in 2050. Physician payments/ Assumes that there would be a permanent fix to the SGR formula sustainable growth for physician payments. rate (SGR)

Not mentioned. Change applies to people turning 65 beginning in 2022; beneficiaries who turn 65 before then would remain in traditional Medicare with option of converting to the new system.

Not mentioned.

Other

Extends Medicaid drug rebate to dual-eligibles in Medicare Part D; stops reimbursing hospitals and Gradually raises premiums for other providers for unpaid Medicare Part B from 25% to 35% deductibles and copays owed by of program costs over 5 years. beneficiaries.
www.fiscalcommission.gov/sites/fis calcommission.gov/files/documents /TheMomentofTruth12_1_2010.pdf

Not mentioned.

http://www.bipartisanpolicy.org/pr ojects/debt- initiative/about Link to Proposal * Denotes estimates from the Congressional Budget Office (CBO) unless otherwise noted.

http://www.gpo.gov/fdsys/pkg/PL budget.house.gov/UploadedFiles AW-112publ25/pdf/PLAW-/PathToProsperityFY2012.pdf 112publ25.pdf