REFORM- Are Medicare and Medicaid too bloated to survive without changes?

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[MM Curator Summary]: Spoiler- Lasure says the plan is to not make any cuts. So keep spending. But somehow magical thinking on pharmacy financing will let us kick the can a little longer.



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NPR’s A Martinez speaks with Chiquita Brooks-LaSure, the administrator for the Centers for Medicare and Medicaid Services, about the future of both programs.


All right. Next, we talk about one of the moments of this week’s State of the Union address, where President Biden claims some Republicans want to sunset Social Security and Medicare. Medicare is a federal health program for people ages 65 and older, as well as younger people with long-term disabilities. The program accounts for 10% of the federal budget. Some members of the GOP have openly called for funding cuts or changes, which they cannot do without Democratic support. But the political debate raises questions about the future of the government-funded programs, such as Medicare. I’m joined now by Chiquita Brooks-LaSure, administrator of the federal office that runs the program. That’s the Centers for Medicare and Medicaid Services. All right. Now, more than 60 million Americans are enrolled in Medicare. If there were any changes, Chiquita, to the program, who among them would be affected the most?

CHIQUITA BROOKS-LASURE: Well, the president is committed to making sure that we support Medicare and the health care programs. There are over 65 million people who are covered by Medicare. And these are our parents, our grandparents, our loved ones, and they’re young people, people who have had a disability in their life that have caused them to be dependent on the Medicare program. And the president has really worked hard over the last year, working with Congress to pass legislation to make Medicare program stronger than ever. And as you can hear, he wants to continue to make sure that there is support for the program and that we continue to make it sustainable for future generations.

MARTÍNEZ: So on that sustainability because Medicare spending is expected to more than double from the $829 billion it was in 2021 to $1.8 trillion in 2031, so given what – that definitely seems and looks like a massive cost increase. How would you describe the program’s long-term viability?

BROOKS-LASURE: I would say that this is something, Medicare spending, that we always have to look at. Every couple of years, it’s important for Congress to continue to make adjustments. And we made, as I mentioned, some real down payments on improving the program last year. The most important of that would be the Inflation Reduction Act or, as I like to call it, the new prescription drug law because it had really important protections not only for the people who depend on the program but also for the program’s sustainability itself – so changes to make sure that we hold companies responsible if they increase their prices above inflation on prescription drugs, which helps the Medicare program. And we saw some changes at the end of the year to the program that really help make sure it’s sustainable, like including mental health services. And the president will continue to put out more information as he releases his president’s budget.

MARTÍNEZ: But, Chiquita, let me ask you this really quick in the time we have left. Is it possible to streamline the spending without streamlining the services?

BROOKS-LASURE: There are changes that are important and necessary, so – that don’t lead to decrease in services. So we are absolutely looking at ways to make sure that we are paying appropriately. We’ve put out a number of administrative proposals to make sure that people are getting the care that they need. And that’s been a real priority, of making sure that the dollars are spent wisely. But we do need to continue to make changes that don’t cut benefits. But there are changes that will cut benefits, and that’s why the president was so emphatic about saying we have to protect the program and not put in arbitrary rules about how Medicare spending will operate so that it doesn’t end up hurting the people that depend on it every day.

MARTÍNEZ: I want to try and squeeze in Medicaid because enrollment spiked in the pandemic. And the Biden administration is ending the COVID-19 public health emergency May 11. A lot of low-income people could lose their coverage. What is your agency doing about that?

BROOKS-LASURE: We have been so thrilled to see the enrollment in Medicaid, CHIP and Affordable Care Act – or the Obamacare – rise to record levels. And we are working very hard with states as people transition, and maybe if their incomes have increased, that we make sure that they get coverage through either the Affordable Care Act coverage or get to employer-sponsored insurance. One of the key roles is making sure that states can find people and – if they’ve moved or things have changed. So one of the things we encourage everybody who is on Medicaid is to make sure they’re looking at the information that their states are sending to them…


BROOKS-LASURE: …About updating their information. And that’s one of our top priorities this year.

MARTÍNEZ: Chiquita Brooks-LaSure is the administrator for the Centers for Medicare and Medicaid Services. Thanks a lot for your time.