01 Jan 2003 Medicare Perspective Index (With a Nod to Harper’s Index) – by Edmund F. Haislmaier (PDF file)

MEDICARE PERSPECTIVE INDEX COMPILED BY EDMUND F. HAISLMAIER Pages in the House passed Medicare bill.1 747 Pages in the Senate passed Medicare bill.2 1,043 Estimated pages in the Medicare bill reported out of Conference Committee.3 1,100 Pages in the Clinton Health Security Act of 1993.4 1,364 Pages relating to Medicare in the Clinton Health Security Act.5 179 Days House Leadership has promised Members can have to read the final Medicare bill before voting on it.6 3 Seconds available to read and comprehend each page of the final Medicare bill if devoting eight hours a day for three days to reading the bill. 78 Number of Medicare enrollees in 20027 40,600,000 Number of uninsured persons in 20028 43,574,000 Dollars of total Medicare spending in 20029 246,800,000,000 Total dollars paid in Medicare premiums by enrollees in 2002.10 25,600,000,000 Dollars of net taxpayer subsidy to Medicare in 2002.11 221,200,000,000 Total dollars paid in 2001 by federal, state and local governments to hospitals and clinics for providing care to the uninsured.12 30,600,000,000 Dollars spent per enrollee by Medicare in 2002. 6,079 Dollars of net taxpayer subsidy per Medicare enrollee in 2002. 5,448 Dollars of net taxpayer subsidy per uninsured person in 2002. 743 Number of uninsured adults who worked full or part time in 2002 and thus paid the Medicare tax of 2.9 cents on every dollar they earned to fund health insurance for someone else.13 25,679,000 Number of working uninsured adults with incomes below the poverty level in 2002 who paid the Medicare tax of 2.9 cents on every dollar they earned to fund health insurance for someone else.14 4,080,000 Additional dollars budgeted by Congress for FY 2004 through FY 2013 to pay for expanding Medicare to include prescription drugs.15 400,000,000,000 Additional dollars budgeted by Congress for FY 2004 through FY 2013 to pay for providing health insurance to the uninsured.16 49,965,000,000 Annualized amount (in dollars) of additional federal spending per Medicare enrollee authorized in the budget resolution. 985 Annualized amount (in dollars) of additional federal spending per uninsured person authorized in the budget resolution. 115 Bills passed by either the House or Senate this year to spend authorized funds to expand Medicare coverage. 2 authorized funds to expand Medicare coverage. Bills passed by either the House or Senate this year to spend authorized funds to provide the uninsured with vouchers or tax credits to help buy coverage. 0 Percent of Medicare beneficiaries with no current prescription drug coverage.17 25 Percent of Medicare beneficiaries with current prescription drug benefits provided by a former employer.18 30 Days it took Congress to respond to angry seniors and repeal the Medicare drug benefit the last time it passed one.19 530 Number of Metropolitan Statistical Areas (MSAs) in the U.S. as defined by Office of Management and the Budget.20 370 Maximum number of MSAs permitted under the final legislation to be premium support demonstration sites between 2010 and 2016.21 6 Percentage of MSAs in which premium support could be tested under the bill. 1.62 Senators who, in a letter to the President, characterized Federal Employee Benefit Program (FEHBP) style premium support as, “a vast social experiment that would raise premiums for Medicare and victimize the oldest and sickest senior citizens.”22 37 Retired federal workers age 65 and older without Medicare and with only FEHBP coverage, who choose their own health insurance plan each year.23 172,757 Retired federal workers over age 99 with no Medicare and with only FEHBP coverage.24 1,870 1 108th Congress, H.R. 1 2 108th Congress, S. 1 3 CongressDaily, November 19, 2003. 4 103rd Congress, S. 1757 5 Ibid., Title II, Subtitle A, and Title IV, Subtitles A&B 6 CongressDaily, November 14, 2003. 7 U.S. Department of Health and Human Services, 2003 CMS Statistics, Table1, “Medicare enrollment/trends,” at: http://www.cms.gov/researchers/pubs/03cmsstats.pdf 8 U.S. Census Bureau, Health Insurance Coverage in the United States: 2002, September, 2003, Table 1, “People Without Health Insurance for the Entire Year by Selected Characteristics: 2001 and 2002” at: http://www.census.gov/prod/2003pubs/p60-223.pdf 9 Op. Cit., 2003 CMS Statistics, Table 25, “CMS and total Federal outlays” 10 Ibid. 11 Total expenditures minus premiums paid by enrollees. 12 Hadley, Jack and Holahan, John, “How Much Medical Care Do The Uninsured Use, And Who Pays For It?” Health Affairs Web Exclusive, W3-81, February 12, 2003, at: http://content.healthaffairs.org/cgi/reprint/hlthaff.w3.66v1.pdf 13 Op. Cit., Health Insurance Coverage in the United States: 2002, Table 1. 14 Ibid., Table 2, “People in Poverty Without Health Insurance for the Entire Year by Selected Characteristics: 2001 and 2002” 15 108th Congress, H.Con.Res. 95, Sec. 401. 16 108th Congress, H.Con.Res. 95, Sec. 405. 17 Douglas Holtz-Eakin, Director, Congressional Budget Office, Prescription Drug Coverage and Medicare’s Fiscal Challenges, testimony before the Committee on Ways and Means, U.S. House of Representatives, April 9, 2003. 18 Ibid. 19 The “Medicare Catastrophic Coverage Act of 1988”, (100th Congress, H.R. 2470), was signed into law July 1, 1988. The “Act to Repeal the Medicare Provisions in the Medicare Catastrophic Coverage Act of 1988,” (101st Congress, H.R. 3607), was signed into law December 13, 1989. 20 OMB BULLETIN NO. 03-04 at: http://www.whitehouse.gov/omb/bulletins/b03-04.html 21 Committee on Ways and Means, U.S. House of Representatives, “Summary of Medicare Conference Agreement,” November 17, 2003, at: http://waysandmeans.house.gov/media/pdf/healthdocs/confagreement.pdf 22 Letter of July 8, 2003 to the President from Senators: Kennedy, Daschle, Stabenow, Feingold, Dodd, Akaka, Kohl, Corzine, Murray, Bayh, Carper, Bingaman, Reid, Jeffords, Hollings, Johnson, Dayton, Wyden, Cantwell, Clinton, Boxer, Durbin, Mikulski, Inouye, Rockefeller, Dorgan, Schumer, Pryor, Lautenberg, Lincoln, Levin, Kerry, Leahy, Bill Nelson, Biden, Conrad and Lieberman. 23 Office of Personal Management data on enrollment in FEHBP by age, sex employment status and Medicare coverage status. 24 Ibid. EDMUND F. HAISLMAIER IS A MEMBER OF THE BOARD OF DIRECTORS OF THE NATIONAL CENTER FOR PUBLIC POLICY RESEARCH AND A VISITING RESEARCH FELLOW, CENTER FOR HEALTH POLICY STUDIES, AT THE HERITAGE FOUNDATION. HE FREQUENTLY TESTIFIES BEFORE CONGRESS ON HEALTH POLICY ISSUES. MEDIA INQUIRIES: DAVID ALMASI AT (202) 371-1400 X106 OR [email protected] AN ONLINE VERSION OF THIS DOCUMENT IS AVAILABLE AT WWW.NATIONALCENTER.ORG/HEALTH.HTML PUBLISHED BY: THE NATIONAL CENTER FOR PUBLIC POLICY RESEARCH NOVEMBER 20, 2003 777 N. CAPITOL ST. NE, SUITE 803 • WASHINGTON DC 20002 (202) 371-1400 • FAX (202) 408-7773 [email protected] • WWW.NATIONALCENTER.ORG