Supercommittee members examine Medicare voucher proposal

{mosads}Senate Finance Committee Chairman Max Baucus (D-Mont.) asked about the possibility that private plans would attract the healthiest seniors, sending Medicare as it currently exists into a “death spiral” in which it only covers an increasingly sick — and increasingly expensive — population.

“We think we have avoided that possibility” by requiring private plans to cover everyone and compensating plans that take on sicker patients, Rivlin said.

Sen. John Kerry (D-Mass.) asked the panelists to list “structural” Medicare reforms that wouldn’t involve premium support. And Sen. Pat Toomey (R-Pa.) questioned whether a full-scale transformation would be possible with the existing Medicare structure still in place.

“In my view, meaningful structural reform means getting away from fee-for-service,” he said.

There are other, smaller proposals on the table to generate healthcare savings, some of which have attracted bipartisan support at least in the context of the supercommittee’s negotiations. Sen. Rob Portman (R-Ohio) said both parties should be able to agree to ask wealthy seniors to pay for a greater share of their Medicare benefits.

AARP opposes more means-testing, saying it would simply shift costs to seniors without addressing the underlying drivers of healthcare spending. But it was part of the White House’s proposal for deficit reduction.

Erskine Bowles, the co-chairman of President Obama’s fiscal commission, offered a range of possible cuts, ranging from potentially doable policies like provider cuts to highly charged proposals such as a public insurance option.

“I don’t know why in the world you wouldn’t have Medicare negotiate” prescription drug prices, Bowles said, while also calling for aggressive tort reform. He also said he would support raising the Medicare eligibility age, which the fiscal commission did not recommend. The healthcare law’s insurance exchanges would give people between 65 and 67 a reasonable alternative to Medicare, he said.