Medicare Must Be Reformed and Saved Not Expanded

The 2023 Medicare Trustees Report estimated that Medicare Part A will be depleted by 2026. Medicare beneficiaries are at risk of losing or paying more for their benefits, and taxpayers are at risk of payroll tax increases or a massive bailout due to this inevitable financial shortfall.

Despite the risks, Congress has yet to consider reforms (and has undermined an effective cost-saving tool), and even worse, on October 8, 2024, Vice President Kamala Harris proposed to expand Medicare to cover hearing and vision coverage and establish a new Medicare benefit covering independent in-home care. The cost of this benefit is estimatedto be $500 billion per year (almost $4,000 per American household), but it will likely be even higher.

The election-year proposal, like the Vice President's other promises pandering to voters like grocery and rent price controls, and tax breaks for a single group of business owners, is unlikely to go anywhere if she is elected, so she is doing this in an attempt to buy more votes. A proposal by the Biden-Harris administration to expand Medicare long-term care funding, which would have cost $15 billion, was rejected by a Democratic-controlled Congress in 2021, so an even more ambitious idea is even more likely to go nowhere.

Nonetheless, the Medicare home health care idea may be the most dangerous of the Vice President's promises. Adding more debt to an already struggling government program does not strengthen anything except her deception of the American peoples. The new proposal is said to "support the sandwich generation," but in truth, it will add to their financial burden and push the country further into debt.

Instead of expanding a financially challenged program that tens of millions of Americans rely on for healthcare, focusing on reform and cost reduction to protect it is crucial. One effective way to achieve this goal is by tackling waste, fraud, and abuse in the program.

While this is not the sole solution to Medicare's sustainability, it could free up more funds to provide necessary services for beneficiaries. CMS estimated that the Medicare Fee-for-Service (FFS) improper payment rate for fiscal year 2023 was 7.38%, or $31.2 billion.

In a bipartisan effort to reduce improper payments and help stave off the impending bankruptcy of Medicare, Congress implemented a recovery audit contractor (RAC) demonstration project for Medicare Parts A and B that ran from 2005 to 2008 and recovered more than $900 million in overpayments to providers. Congress enacted legislation to expand the program nationwide and make it permanent, a process that began in early 2009 and was fully implemented by September 2010. Since the beginning of the RAC program, more than $11 billion has been returned to the Medicare Trust Fund. Unfortunately, the program has been opposed by hospitals and state and national trade associations that have pressured Congress and CMS to quietly shrink the scope of RAC oversight. Legislators should not give in to pressure to weaken the RAC program and should aim to reinstate and safeguard the RACs to help slow the depletion of trust funds.

American households are required to operate on a budget to make ends meet each month. These families understand the consequences of not doing so. Medicare is already running in a deficit and is anticipated to be depleted by 2026, meaning cuts to benefits or higher taxes. Yet, Vice President Harris seems to believe that expanding spending in this category is the solution.

No American family discussing their budget at the kitchen table would follow this flawed logic when it comes to personal finances. The federal government should be equally financially frugal by fixing rather than expanding Medicare.

• Healthcare
• Medicare
• Medicaid