A group of Democratic senators introduced a new bill Thursday that would create a $5,000 cap on out-of-pocket spending for traditional Medicare beneficiaries.
The Medicare Cost Cap Act was introduced by Senator Lisa Blunt Rochester (D-Delaware), Senate Finance Committee Ranking Member Ron Wyden (D-Ore.), and Senate Democratic Leader Chuck Schumer (D-New York).
The bill aims to “level the playing field” between traditional Medicare and Medicare Advantage, which imposes annual out-of-pocket spending limits (just like employer-sponsored insurance and marketplace-purchased coverage).
Under traditional Medicare, which currently has no out-of-pocket cap, it is estimated that over the next 10 years, 52% of beneficiaries are expected to exceed the proposed $5,000 cap at least once, according to the announcement. The bill would benefit 3.2 million Medicare enrollees in 2028 and save enrollees $1,024 a year on average, the senators said.
In addition to creating a cap on payments, the bill also seeks to protect low-income seniors — who “rely almost exclusively” on Social Security benefits — from rising premiums and cost-sharing. The announcement said Medicare Part B premiums topped $200 for the first time last year.
“Americans spend their entire working lives paying into Medicare, but those in traditional Medicare are the only group unprotected from financial ruin. This bill modernizes Medicare, lowers costs and brings peace of mind to the millions of elderly and disabled people who rely on this program,” Blunt Rochester said in a statement. “No one should be one health emergency away from bankruptcy, and establishing an out-of-pocket cap under traditional Medicare gives more seniors and people with disabilities the same financial protections that nearly every other American enjoys.”
Other co-sponsors of the bill include Senators Jeff Merkley (D-OR), Ben Ray Luján (D-New Mexico), Edward J. Markey (D-Massachusetts), Elizabeth Warren (D-Massachusetts), Jack Reed (D-Rhode Island), Tammy Duckworth (D-Illinois), Peter Welch (D-Vermont), Cory Booker (D-New Jersey), Kirsten Gillibrand (Democrat of New York), Alex Padilla. (Democrat of California), Chris Van Hollen (Democrat of Maryland) and Patty Murray (Democrat of Washington).
Several advocacy groups have endorsed the bill, including Families USA, the National Council on Aging and the Center for Medicare Advocacy.
“This bill would be an important first step toward aligning traditional Medicare with other health insurance coverage by adding an out-of-pocket cap and beginning to rebalance the traditional program with private Medicare Advantage,” David Lipschutz, co-director of the Center for Medicare Advocacy, said in a statement. “Additionally, making it easier to qualify for Medicare savings programs will make Medicare more affordable for more people. »
Photo: Vadzim Kushniarou, Getty Images
About the Author
