Medicare and Rx Drug Resource Page
Updated 7/22/2004
The page contains links to references, legislative material, and other items related to the Medicare drug benefit debate.
Outline:
Congressional and Administration Resources
Centrists.Org and Centrist Policy Network Analysis
Other Think Tanks
Congressional and Administration Resources:
Congressional Budget Office A Detailed Description of CBO's Cost Estimate for the Medicare Prescription Drug Benefit (July 2004)
Congressional Budget Office Testimony on Estimating the Cost of the Medicare Modernization Act (includes final estimates of the Medicare drug bill, and comparisons with the Administration's estimates, March 24, 2004)
Congressional Budget Office preliminary estimate of the cost of eliminating the assets test in the Medicare drug benefit (dated March 19, 2004)
CMS Office of the Actuary cost table for Medicare drug bill (released March 23, 2004 as part of the 2004 Medicare trustees report)
CMS Office of the Actuary detailed budget tables: Medicare Part D Drug Benefit
(dated December 23, 2004, released to Congressional staff on March 19, 2004)
CMS Office of the Actuary detailed budget tables: Medicare Part A Hospital etc.
(dated January 8, 2004, released to Congressional staff on March 19, 2004)
CMS Office of the Actuary detailed budget tables: Medicare Part B Physician, Outpatient etc. (dated January 5, 2004, released to Congressional staff on March 19, 2004)
CMS Office of the Actuary memo on differences between CBO and Adminstration estimates (dated February 5, 2004, released to Congressional staff on March 19, 2004)
Congressional Budget Office Medicare Fact Sheet corresponding to March 2004 baseline (March 3, 2004)
Congressional Budget Office Letter to Rep. Jim Nussle regarding a comparison of CBO and Administration estimates of the effect of H.R. 1 on direct spending (February 2, 2004)
CMS Office of the Actuary cost table from June 11, 2003, which shows an estimate of $551 billion over 10 years for a drug benefit plan with roughly the same dimensions as the drug bill that was eventually enacted.
Congressional Budget Office Medicare Baseline Fact Sheet (January 2004)
Congressional Budget Office Letter to Sen. Frist on market-based drug price discounts vs. price controls (January 23, 2004)
Congressional Research Service Overview of the Medicare Prescription Drug and Reform Conference Agreement (updated December 4, 2003)
Congressional Budget Office Letter to Sen. Don Nickles (November 20, 2003)
Table 1, Table 2, Table 3, Table 4
Congressional Budget Office Letter to Conferees and Primary Cost Table on Conference Agreement to H.R. 1 (November 20, 2003)
Legislative Text of Medicare Conference Agreement (as posted on the Ways and Means Committee website on November 20, 2003)
CentristPolicyNetwork.Org Posting
Ways and Means Committee Posting
Summary of Medicare Conference Agreement (as outlined on November 16, 2003)
CMS Graphical analysis of variation in health premiums under a local premium support system in 2013 (dated August 9, 2003). Note: A national premium support system, like the federal employees' health benefits program, would not allow local variation in premiums for national plans.
Kennedy/Daschle/Snowe/Bingaman letter on Medicare conference situation (October 23, 2003)
CBO Cost Estimate of H.R. 2427 (Widespread Drug Importation Without FDA Approval).
Draft Tax Credit for Employers with Medicare-Eligible Employees and Retirees (To help employers retain retiree drug benefits in the presence of a drug benefit with catastrophic coverage based on out-of-pocket drug spending.)
Medicare conference schedule for 9/23-10/17
Congressional Research Service Side-by-Side detailed description of health plan-related features of the House- and Senate-passed Medicare bills (August 8, 2003)
Congressional Research Service Summary of the main features of the Medicare bills (Updated June 19, 2003
Congressional Budget Office Cost Estimate of House- and Senate-passed Medicare bills (July 22, 2003)
Legislative text of H.R. 1568, the Medicare Rx Now Act of 2003, as introduced by Rep. Cal Dooley
Legislative text of Rep. Burr's Medicare for the 21st Century Act
Legislative text of Dooley Rx Now Act, as prepared in the Senate as an amendment (contains capped entitlement with unspecified catastrophic level).
CMS Office of the Actuary (Rick Foster) Letter to Rep. Charles Rangel (June 26, 2003).
Senate-passed bill Table of Contents alone is a graphic illustration of continued Congressional micromangement of Medicare, not reform.
Centrists.Org and Centrist Policy Network analysis:
Centrists.Org Issue Summaries:
Health Basics (revised August 16, 2003)
Cost, Competition, and Chronic Care (revised July 21, 2003)
Medicare and Prescription Drugs (revised January 4, 2004)
Medicare Modernization Act (May 15, 2004)
Centrists.Org Improving the Medicare Drug Discount Cards (June 22, 2004) With a few technical fixes and one big attitude adjustment, the Medicare discount cards will be a successful new model of a public-private partnership.
Centrist Policy Network Democratic Leaders Should Embrace the Drug Discount Cards (June 2, 2004) The Medicare drug cards do no harm, might actually help quite a few people, and offer a significant benefit to low-income seniors.
Centrists.Org Detailed Issue Summary: Medicare Modernization Act of 2003 (May 15, 2004) This new Issue Summary contains a detailed description and preliminary evaluation of the Medicare drug bill.
Centrists.Org Private Health Plans in Medicare -- Cost Trends and Ideological Battles (April 21, 2004) This report attempts to put the debate over Medicare's private health plans into perspective, using new calculations of spending trends and a characterization of the political forces battling over the prospect of direct public-private competition in Medicare.
Centrists.Org CBO vs. The Bush Administration on Medicare -- A Difference of Opinion, Not a "Raised" Estimate (March 23, 2004)
Centrist Policy Network Commentary: Medicare Follow-Up? (January 4, 2004)
Congress should start smoothing over the Medicare Rx bill's rougher edges, even if it means spending more.
Centrists.Org Explaining Premium Support: How Medicare Reform Could Work
revised November 6, 2003) This report outlines the structure of a national (federal employees-style) premium support system in Medicare. It includes the basic rationale for premium support and a step-by-step example of how premiums would be calculated.
Centrists.Org Testimony: Improving Chronic Care in Medicare (November 4, 2003) Statement before the Senate Special Committee on Aging's hearing on disease management initiatives in the Medicare bills.
Centrists.Org Suggestions for Income Testing in Social Insurance Programs
(October 27, 2003) On reflection, the debate over income testing in Medicare is larger than the Prescription Drug bill in Congress -- it raises fundamental questions about how Americans want social insurance programs to work.
Centrist Policy Network Commentary: Drug Benefits and the Emperor's Clothes (October 25, 2003)
Chart: Conference Drug Benefit, gross and net benefits by drug expenditure (October 23, 2003)
Centrist Policy Network Rx Plan "A" is Alive and Twitching (October 15, 2003)
Something had to give. The Medicare drug benefit being prepared for final passage in Congress is over-promised. So what is the solution? Tax cuts. No joke.
Centrists.Org A Better Drug Benefit From The Hill, October 1, 2003 (www.thehill.com)
"The Medicare drug benefit pending in Congress is flawed. The design was a rare political compromise; however, the result is a tortured policy that may be unworkable in practice."
Centrists.Org Passing the Feasibility Test: A Low-Income and Catastrophic Medicare Drug Benefit (September 24, 2003) Testimony: With the Medicare conferees running low on time, a simpler drug benefit based on discount cards might be an acceptable solution.
CentristPolicyNetwork.Org An Exit Strategy for the Medicare Conferees (September 11, 2003) A zero-premium "catastrophic" benefit for seniors with the highest drug expenses (and additional benefits for seniors with low incomes) could help avoid an impasse on the Medicare bills pending in Congress.
Centrists.Org A Preliminary Assessment of CBO's New Budget Projections
(Revised August 29, 2003) Under realistic assumptions, the deficit will be $500 billion in 2004 and will total $6.1 trillion between 2004 and 2013. The public debt will rise from $4 trillion this year to $10 trillion a decade from now. (And after that, things really get bad.)
Centrists.Org Rural Health Care: Rights and Responsibilities (revised August 25, 2003) To qualify for special payment rates or subsidies, rural health providers should be required to sign up with PPO plans in Medicare.
Centrists.Org New Charts: What Seniors Would Pay for the Standard Drug Benefit in the Medicare Bills (August 20, 2003) Seniors would face a tough choice under the rules of the House and Senate drug proposals.
Centrists.Org "Dynamic Scoring" in Health Care (August 7, 2003) CBO should try to point out the long-term or other analytic considerations of the Medicare bills recently passed in the House and Senate.
Centrists.Org Lessons from the New CBO Medicare Estimates (July 28, 2003) 10 new insights and questions stemming from CBO's recently completed estimates of the House- and Senate-passed Medicare and prescription drug bills.
Centrists.Org Medicare's Fee-For-Service "Savings" Are Really Costs (revised July 28, 2003). Out-year cuts in payments to health care providers of $5-10 billion are illusory, make the House and Senate Medicare bills seem less expensive than they really are.
Roll Call On Medicare and Budget Numbers, CBO is Failing by Jeff Lemieux (July 7, 2003)
Centrists.Org Medicare Drug Benefit Costs 1 Percent of GDP by 2030 (If CBO is Right) (June 25, 2003)
CBO's Blurry Medicare Estimates of the Senate drug bill, with links to CBO's estimates (June 20, 2003)
Congressional Budget Office (one paragraph) estimate of the House drug bill (June 25, 2003)
Centrists.Org Will the Senate's Medicare PPO Program Work? (June 11,2003)
Centrists.Org Medicare vs. FEHB Spending: A Rare, Reasonable Analysis (June 23, 2003)
Centrist Policy Network's H.R. 1568 (Dooley) Medicare Rx Now Act of 2003 Resource Page
Other Think Tanks:
Heritage Foundation analysis:
Let's face it, Heritage Foundation scholars don't pretend to be centrists. But on Medicare, like other think tanks, Heritage has consistently supported real reform based on the Federal Employees Health Benefits (FEHB) program. FEHB is an excellent model for Medicare reform, with decent benefits, enrollee choice and cost awareness, a modicum of cost control, internal flexibility and adaptability, and freedom from overmuch Congressional micromanagement.
Medicare's Deepening Financial Crisis: The High Price of Fiscal Irresponsibility
Robert Moffit and Brian Reidl
(March 25, 2004)
Douglas Holtz-Eakin and Jeff Lemieux The Cost of Medicare: What the Future Holds Heritage Foundation Lecture #815 (December 15, 2003) Bush Holds the Nation's Health in His Hands by Stuart Butler, Ph.D.
September 23, 2003
The FEHBP as a Model for Medicare Reform: Separating Fact from Fiction by Walton Francis
August 7, 2003 (Backgrounder #1674)
The Crucial Elements of An Acceptable Medicare Bill by Stuart M. Butler, Ph.D.
July 10, 2003 (WebMemo #311)
How Much Will the Senate Drug Bill Cost a Family of Four? by Derek Hunter and William Beach
June 27, 2003 (WebMemo #306)
An Analysis of the White House Position on Medicare Legislation by Edmund F. Haislmaier, Robert E. Moffit, and Nina Owcharenko, Center for Health Policy Studies
June 26, 2003 (WebMemo #305)
An Analysis of House Medicare Legislation by Lanhee J. Chen, Edmund F. Haislmaier, Robert E. Moffit, and Nina Owcharenko, Center for Health Policy Studies
June 25, 2003 (WebMemo #302) |
Progressive Policy Institute (PPI) analysis:
To help seniors get better chronic care and for reasons of efficiency, the center-left PPI has generally favored reform based on the FEHB model. For practicality's sake PPI has also suggested a catastrophic, low-income, and drug discount card approach, which led to introduction of H.R. 1568, the Medicare RX Now Act of 2003, introduced by Rep. Cal Dooley (D-CA) and about 45 cosponsors. The Dooley bill was denied a vote in the House during a late night (actually early morning), silly session of the House Rules Committee. Senate amendments to subsitute the Dooley bill were thwarted by lack of CBO estimates and misleading comments to Senate offices by CBO staff.
Backgrounder | June 19, 2003
Fix the Medicare Compromise
By David B. Kendall and Jeff Lemieux
Testimony | May 6, 2003
McDonald's v. Burger King: A "Nothing Burger" Debate on Medicare Reform
By Jeff Lemieux
Policy Report | February 14, 2003
An "ABC" Proposal to Modernize Medicare
By Jeff Lemieux, David B. Kendall, Kerry Tremain, and S. Robert Levine, M.D.
Policy Report | February 14, 2003
Healthy Aging v. Chronic Illness: Preparing Medicare for the New Health Care Challenge
By David B. Kendall, Kerry Tremain, Jeff Lemieux, and S. Robert Levine, M.D.
Testimony | February 25, 2003
Making Chronic Care the Focus of Medicare Reform
By Jeff Lemieux
Galen Institute analysis:
Fixing the New Medicare Law: How to Build on the Drug Discount Card
Grace Marie Turner and Joe Antos
March 25, 2004
American Enterprise Institute (AEI) analysis:
AEI scholar Jagadeesh Gokhale has focused on computing the net present value of future unfunded Medicare liabilities, before and after the drug benefit. Although his calculations over-estimate the share of the government's total unfunded liability attibutable to Medicare for technical reasons, his overall estimates of the government's unfunded liabilities are sound, and the Medicare share of that future shortfall is still enormous.
A Benefit That Is Bad For America's Health
by Joseph Antos and Jagadeesh Gokhale
Financial Times, June 20, 2003
Fiscal and Generational Imbalances: New Budget Measures for New Budget Priorities
by Jagadeesh Gokhale and Kent Smetters
AEI Pamphet (12th draft, revised April 26, 2003)
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