More troubling was the report’s assessment that the Democrats’ plan to squeeze Medicare for $493 billion over 10 years in savings relies on specific policy changes that “may be unrealistic’’ and could lead to cuts in services. The Medicare savings are expected to cover about half the nearly $1 trillion, 10-year cost of expanding coverage to the uninsured.
In still more bad news, the report starkly warned that a new long-term care insurance plan included in the legislation could “face a significant risk of failure’’ because it would attract people in poor health, leading to higher and higher premiums, and eventually triggering an “insurance death spiral.’’
Senator Christopher Dodd, Democrat of Connecticut, brushed that aside, pointing to an analysis by the Congressional Budget Office that found the program would be solvent for 75 years.
The one bright note: The bill would provide coverage to 93 percent of US residents, reducing the number of uninsured people by about 33 million, the report said.
The analysis from the Office of the Actuary, which does long-range cost estimates for Medicare, was prefaced by a disclaimer saying it does not represent the official position of the Obama administration. Unlike estimates from the budget office, which have mainly focused on the legislation’s impact on the federal deficit, the actuaries looked at total public and private costs over the next 10 years.
The analysts also used their years of experience with Medicare’s finances to make a judgment call on whether the cuts proposed in the Democratic bills are politically sustainable. When previous Congresses have cut Medicare too deeply, providers have usually convinced lawmakers in subsequent years to restore at least some of the money. That same scenario is playing out this year as doctors try to persuade Congress to permanently repeal automatic spending cuts that would reduce their Medicare fees 21 percent next year.
The actuaries’ analysis of the Senate bill echoes their previously released reports about the House bill. It addresses core provisions of both bills, and is unlikely to be affected by the latest changes Senate Democrats are proposing.
Republicans seized on the report as validation of their concerns that the overhaul bill is both unaffordable and unrealistic.
“This report confirms what we’ve long known - the Democrat plan will increase costs, raise premiums, and slash Medicare. That’s not reform. This analysis speaks for itself. This bill is a sham,’’ said Senate Republican leader Mitch McConnell of Kentucky.
Senator Pat Roberts, Republican of Kansas, said release of the report was “almost like Pearl Harbor - a day of infamy.’’
Meanwhile the White House agreed yesterday to help close a loophole in the Senate health care bill allowing annual dollar limits on their care.
“The president has made it clear that health insurance reform legislation should prevent insurance companies from placing annual limits on health expenditures that can force families into financial ruin,’’ said White House spokesman Reid Cherlin.
“We will continue to work with Congress on this policy.’’
