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Top Medicare official predicts federal reform will hurt health care

November 19, 2014

In an extraordinary move, an expert in President Obama’s administration has challenged the federal health care law’s mandate to arbitrarily reduce funding for Medicare under as “unsustainable,” “unworkable,” and likely to block some people from seeing their doctors.

Richard Foster serves as chief actuary for the Centers for Medicare and Medicaid Services (CMS), the federal agency that administers Medicare coverage, and his job is to predict future health care costs. His office wrote a memo in August 2010 that objects to key estimates in the annual report about the Social Security and Medicare trust funds. Trustees of those two funds are also Obama administration officials, led by Treasury Secretary Timothy Geithner and Health and Human Services Secretary Kathryn Sebelius.

The trustees’ annual report claims the federal health care bill “improves the financial outlook for Medicare substantially.” But Mr. Foster’s staff strongly disputed that, writing that the report’s projections “do not represent the ‘best estimate’ of actual future Medicare spending.” Even worse, people with Medicare coverage will “almost certainly face increasing severe problems with access to care,” the memo says.

The memo also pointed out the annual report doesn’t consider that required spending cuts for Medicare could stop people who do see their doctors from getting the best possible health care, which could result in more patients falling ill or dying early.

Notably, the chief actuary must predict future growth in Medicare enrollment and spending each year, and give that information to a new federal agency created by health care reform called the Independent Payment Advisory Board (IPAB). That board will have virtually unchecked power to adopt laws setting prices and payments for nearly all medical services.

The Goldwater Institute has identified IPAB as a critical reason why the federal health care bill is unconstitutional and must be struck down. Otherwise, as the chief actuary’s office has predicted, the mandated changes to Medicare likely will result in poorer health care for more people.

Diane Cohen is an attorney with the Goldwater Institute Scharf-Norton Center for Constitutional Litigation.

Learn More:

Centers for Medicare and Medicaid: Memo on projected costs for Medicare under federal health care reform

Powell Center for Medical Ethics: New Medicare Report Signals Trouble



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