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Adding an Out-of-Pocket Spending Maximum to Medicare: Implementation Issues and Challenges

In an effort to simplify Medicare’s cost-sharing requirements, provide beneficiaries with catastrophic protection, and achieve program savings, some have proposed to restructure Medicare’s benefit design. Several recent proposals would create a unified deductible for Medicare Parts A and B, simplify cost-sharing requirements above the deductible, and add an annual limit on beneficiary out-of-pocket spending—a benefit feature typical of larger employer plans, but lacking in traditional Medicare. This issue brief describes the options for adding an out-of-pocket spending limit to Medicare and examines the operational issues that could arise in implementing both a uniform and an income-based out-of-pocket spending limit. Because the implementation of an income-related out-of-pocket maximum would pose somewhat greater complexity for Medicare, the operational issues associated with this approach are discussed in greater detail.

Testimony: Income Security and the Elderly: Securing Gains Made in the War on Poverty

Senior Vice President Patricia Neuman testified before the U.S. Senate Special Committee on Aging as part of its hearing entitled Income Security and the Elderly: Securing Gains Made in the War on Poverty. As part of her testimony, she presented segments from a Foundation-produced video that highlights what it means to be old and poor in our country.

Old and Poor: America’s Forgotten

While the Census Bureau’s official poverty measure shows 9 percent of seniors nationally live in poverty, the share climbs to about one in seven seniors (15 percent) under the Bureau’s alternative Supplemental Poverty Measure, which takes into account out-of-pocket health expenses and geographic differences in the cost of living. Produced by the Kaiser Family Foundation, Old and Poor: America’s Forgotten provides a portrait of seniors who are living in poverty, in both urban and rural areas across the United States.

Summary of Medicare Provisions in the President’s Budget for Fiscal Year 2015

On March 4, 2014, the Office of Management and Budget released President Obama’s budget for fiscal year (FY) 2015, which includes provisions related to federal spending and revenues, including Medicare savings. The President’s budget would use federal savings and revenues to reduce the federal debt and replace sequestration of Medicare and other federal programs for 2015 through 2024. This brief summarizes the Medicare provisions included in the President’s budget proposal for FY 2015.

Medicare and the Federal Budget: Comparison of Medicare Provisions in Recent Federal Debt and Deficit Reduction Proposals

This brief provides a side-by-side comparison of Medicare provisions included in broad-based packages to reduce the deficit and debt put forward by the President and the Chairmen of the House and Senate Budget Committees. In addition, this brief summarizes Medicare provisions included in other deficit- and debt- reduction proposals released since January 2012 and describes recent activities that pertain to Medicare and the federal budget, including Medicare’s role in the Affordable Care Act (ACA), the fiscal cliff and sequestration.

Income and Assets of Medicare Beneficiaries, 2013 – 2030

This data spotlight, co-authored by researchers at the Kaiser Family Foundation and the Urban Institute, describes the income, savings, and home equity of current Medicare beneficiaries, considers variations by race, ethnicity and other demographic characteristics, and examines the extent to which income and assets are projected to be higher among the next generation of beneficiaries.

Visualizing Income and Assets Among Medicare Beneficiaries: Now and in the Future

This interactive tool describes the income, savings and home equity of people on Medicare in 2013, and in 2030. It allows users to break out the data by age, gender, race/ethnicity, marital status and education level, providing insight into the disparities within and across categories of beneficiaries.