President Obama Calls For Two 'Modest Reforms' To
Obama suggests two specific changes in Medicare:
drug-makers should go back to giving rebates for
dual-eligibles, having wealthiest seniors pay more
Feb. 14, 2013 - Jackie Judd and Kaiser Health New's Mary
Agnes Carey examine the health care issues
in Tuesday night's State of the Union
address - and Sen. Rubio's Republican
response - in this Health on the Hill
JACKIE JUDD: Good day,
this is Health on the Hill. I’m Jackie Judd.
President Obama did not spend a lot of time
on health care during his State of the Union
address. Still, there were some hints about
what the coming months may bring. Senior
correspondent for Kaiser Health News, Mary
Agnes Carey, is here to help us analyze Mr.
Obama’s speech. Welcome, Mary Agnes.
JACKIE JUDD: When the president
did talk about health care, it was mostly
about Medicare. He highlighted two specific
reforms that he’d like to see. What are the
details of those?
MARY AGNES CAREY: These are two
ideas the president has previously advanced.
One deals with the idea of prescription drug
rebates from the pharmaceutical industry for
the approximately nine million dual eligible
beneficiaries. These are folks who qualify
for Medicare and Medicaid. The drug industry
used to pay rebates on these people when
they received their drugs from the Medicaid
program. When the prescription drug program
was created in Medicare, they shifted to
Medicare for that drug coverage and the
rebates went away. The president wants to
bring those back.
A second item that he
talked about was charging wealthier Medicare
beneficiaries more for their coverage. This
is already in current law, but he wants to
make some changes to raise more money by
JACKIE JUDD: And where do
Republicans stand on each of these?
MARY AGNES CAREY: I believe that
most Republicans are going to fight him on
the drug rebates for the prescription drug
program for the dual eligibles. They will
say -- and the drug industry has already
said: “This is going to interfere with the
Medicare drug program’s ability to negotiate
prices.” They feel that it is really going
to hurt Medicare Part D. But he may get some
support on the idea of charging the
wealthier beneficiaries even more for their
JACKIE JUDD: The president also
said that he’s open to what he called
"additional reforms," as long as they didn’t
violate what he called the "guarantee of a
secure retirement." He wasn’t very precise.
What do you think he was referring to there?
MARY AGNES CAREY: I don’t think
he’s taking about an increase in the
Medicare eligibility age. That was taken off
the table earlier this week by Jay Carney,
the White House spokesman. But the president
talked about modest reforms, so there may be
some tinkering around the edges, but nothing
radical that would have a major overhaul of
JACKIE JUDD: After the president
spoke, the Republicans put forward Sen.
Marco Rubio from Florida. In his speech, he
suggested that whatever the president wants
to do, he’s not going to go far enough --
that he’s going to risk bankrupting
Medicare. What do you take from his remarks
about the future of bipartisanship on the
MARY AGNES CAREY: Sen. Rubio,
along with many Republicans, have felt that
the current structure of Medicare is not
sustainable for the future. Sen. Rubio took
great pains last night, as many Republicans
have, to say that they don’t want to change
the program for [current] beneficiaries, but
looking into the horizon, the millions of
baby boomers coming into the program -- they
want a major overhaul. Many Republicans have
advanced the idea of premium support, which
would have a limited amount of money per
beneficiary. The president and Democrats
have fought him on this.
But I think this is another reminder to
the public that Republicans are still going
to embrace bigger, broader reforms to
Medicare -- premium support and so on -- in
the years ahead.
JACKIE JUDD: Thank you so much,
Mary Agnes Carey of Kaiser Health News. I’m
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