Health Care Experts Discuss Medicare 'Trigger' Legislation At Forum
The trigger legislation is required by a provision in the 2003 Medicare law. The provision took effect after Medicare trustees estimated for two consecutive years that general fund revenue would finance more than 45% of total program costs within seven years. Current Congressional Budget Office projections find that general fund revenue will finance 45.1% in 2013 and 51% in 2018, according to CBO Director Peter Orszag. General fund revenue will finance 41% of Medicare costs in 2007 and 2008.
John Rother, director of policy and strategy at AARP, said that the trigger should precipitate a broad examination of Medicare. "If we were going to really look at Medicare's performance, we'd look at cost growth relative to private sector cost growth, we'd look at measures of quality and patient satisfaction, we'd look at burden on providers and participation in the program ... not the balance between dedicated and nondedicated financing sources," he said.
Marilyn Moon, vice president and director of the American Institutes for Research's Health Program, said, "I think in many ways everyone should agree and do away with this trigger, but I'm not sure that that's what's going to happen." Moon said that general fund revenue has begun to finance a larger share of Medicare costs because of increased health care system spending, higher Medicare Part B spending as a result of a shift from inpatient to outpatient care, and implementation of the Medicare drug benefit.
House Energy and Commerce Committee Chair John Dingell (D-Mich.) has called the Medicare trigger "little more than a scare tactic to promote cuts to the most successful program of our time."
Julie Goon, special assistant to the president for economic policy in the National Economic Council, said that the president's fiscal year 2009 budget request would help address the issue and that his Medicare package complement each other. "Are these numbers somewhat arbitrary? More than likely," Goon said, adding, "But they do sort of give an indication of how much money is coming out of the general revenue basket and being spent on Medicare and other health care programs to the detriment of spending in other parts of the government" (Grimaldi, CQ HealthBeat, 3/6).
A webcast of the policy workshop held by the Kaiser Family Foundation is available online at kaisernetwork.org.
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