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Wyden Seeks to Lower Out-of-Pocket Medicare Costs for Seniors

By Kerry Young, CQ Roll Call

September 21, 2016 -- The ranking Democrat on the Senate Finance Committee recently unveiled a bill that would take several steps to ease the financial hit of Medicare for senior citizens and people with disabilities. These include caps on out-of-pocket spending and a limit on what's now a lifetime penalty for people who enroll late.

The measure from Sen. Ron Wyden, D-Ore., also would end the two-year waiting period that those with disabilities face to join the giant federal health program.

"Today, the promise of Medicare falls short for too many who find their health costs becoming more and more unaffordable," said Wyden in a statement.

A longtime advocate for senior citizens, Wyden is poised to regain the gavel of Senate Finance if the Democrats gain control of the chamber through the November election. His bill, titled the Medicare Affordability and Enrollment Act, serves as a preview of issues he likely would pursue in the next session of Congress. No major revisions to Medicare are expected in the remaining months of this year.

Among Wyden's priorities is streamlining the Medicare enrollment process and reducing penalties for those who delay signing up for the program. Wyden called the current enrollment process "outdated and confusing," with delays triggering higher premium costs for a lifetime. Monthly premiums for Part B outpatient care may go up 10 percent for each full 12-month period that an eligible person delayed signing up for the program, according to Medicare information. Wyden is calling for limiting the Part B late enrollment penalty to 10 percent per month for twice as long as the time that an eligible person waited to enroll. The bill would allow for special enrollment periods for Medicare due to exceptional circumstances, such as a natural disaster. 

Wyden's bill also would set a maximum out-of-pocket cap for medical services under traditional Medicare, which exists today for Medicare Advantage and most commercial insurance plans. The bill calls for setting the total amount of out-of-pocket costs, including deductibles and copays, for Medicare Part A and B programs at $5,500 for 2018. It would then be increased or decreased in subsequent years by a percent change pegged to the Consumer Price Index. The cap would apply only to covered services, according to a summary of the bill.

Among the groups that endorsed his bill, according to his office, are:  American Federation of State, County and Municipal Employees; The Arc; Center for Medicare Advocacy' Dialysis Patient Citizens; Families USA; Justice in Aging; Medicare Rights Center; National Coalition on Aging; and the National Committee to Preserve Social Security and Medicare.

Rep. Frank Pallone Jr. of New Jersey, the ranking Democrat on the House Energy and Commerce Committee, and Rep. Sander M. Levin of Michigan, the ranking Democrat on the House Ways and Means Committee, will lead the introduction of a counterpart in their chamber, Wyden's office said. In the Senate, cosponsors of Wyden's bill are Democrats  Debbie Stabenow of Michigan, Michael Bennet of Colorado, Bill Nelson of Florida, and Sherrod Brown of Ohio.

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