Many news sources have reported a projected increase in the Medicare Part B premium in 2016: from $104.90 to $159.30 per month, a 52% increase. Many articles then explained, as if assuring readers, that 70% of beneficiaries would not have to pay the increase, but their premium would remain at $104.90 because of the “hold harmless” provision. The purpose of the “hold harmless” provision is to protect Medicare beneficiaries from a reduction in their monthly Social Security benefit. Some articles further explained that the remaining 30% of beneficiaries, who are not protected by the “hold harmless” provision, would have to pay the projected increase.
Few articles mentioned that the Part B annual deductible is also projected to increase in 2016: from $147 to $223, also a 52% increase. Since the “hold harmless” provision does not apply to the deductible, all Medicare beneficiaries with Original Medicare would have to pay more to meet the deductible. But some beneficiaries may have supplemental insurance that may cover the Part B deductible. For example, Medigap Plans F or C would pay the higher deductible for beneficiaries who bought those Medigap policies.
In response to advocacy from many beneficiary organizations, Sen. Ron Wyden (D-OR) introduced the “Protecting Medicare Beneficiaries Act of 2015” (S.2148) and Rep. Dina Titus (D-NV) introduced the “Medicare Premium Fairness Act” (H.R.3693) in early October 2015. The bills would hold the Part B premium stable at $104.90 for the 30% of beneficiaries who would otherwise have to pay $159.30 monthly, and would maintain the annual deductible at $147 for all beneficiaries.
While the bills would certainly benefit beneficiaries who would otherwise have to pay a higher premium as well as higher deductible, it would also benefit all beneficiaries with Original Medicare from having to pay the higher deductible. In particular, it would benefit beneficiaries with incomes not low enough to qualify for Medicaid (or Medi-Cal in California) but also not high enough to afford such a steep increase. In addition, the bill would bring relief to states who would otherwise have to pay the higher premium and deductible on behalf of beneficiaries dually eligible for both Medicare and Medicaid. In California, with an estimated 1.3 million dually eligible beneficiaries, the state would face an increase of $550 million in costs next year without the bill. If a Medicare beneficiary loses Medicaid in 2016, he or she would have to pay the higher premium.
California Health Advocates joins other organizations in supporting these bills and encourages readers to urge their Congressional representatives to vote “yes” on these bills. Another advocacy group, Medicare Rights Center, has set up an online petition to Congress you can sign. Also, please contact your Congress people at: usa.gov/elected-officials.