News

  • Fate Of Lowering Drug Prices Is Up In The Air

    What is it going to cost? Is there a less expensive alternative? .At a seven-hour Senate Judiciary Committee hearing this week, Homeland Security Secretary Janet Napolitano praised the Gang of Eight for their comprehensive plan, while members of the committee picked it apart and discussed potential amendments. Secretary Napolitano called the plan "realistic" and "achievable" and she said the department would be ready to implement border security provisions within the outlined timeframe. However, committee members seemed wary, and Ranking Member Charles Grassley (IA) said: "This bill would put no pressure on this secretary or any future secretary to secure the borders." .Increasing the payroll tax cap. Under current law, the 12.4 percent payroll tax is applied only to the first 7,200 in earned annual income. Individuals earning more than that pay nothing in Social Security taxes on the rest of their earnings. Several proposals now before Congress would modify this policy so that higher income workers contribute more fairly to the program. … Continued

  • Legislation Would Allow Some Medicare Services To Be Given At Pharmacies

    TSCL Supports New Legislation .Understand how much risk the insurer shifts to you. Deductibles can commonly range from 0 to ,500, but claims for severe weather disasters can find you responsible for paying as much as 5% of your home's insured value (up to 10 percent in Florida) before your insurer covers damage expenses. Example: Your home is insured for 0,000 and your policy calls for a 5% deductible for hurricanes. You would pay ,500 out-of-pocket on any storm claim prior to your insurer covering the rest. .Susan's son Andrew requires an expensive anti-convulsive medication, Depakote Sprinkles. None of his Part D plan choices covers the brand drug — which can cost ,099 a year retail — only the generic version. But for Andrew, the generic doesn't work, and he has suffered seizures while using it. Susan learned, however, from Advisor editor Mary Johnson, that because Andrew receives Medicare Extra Help, his doctor can ask his drug plan for a coverage exception. Since starting Medicare, Andrew has received coverage for Depakote in each of his Part D plan choices. … Continued

While the provision is valuable protection, it doesn't apply to all Medicare Part B enrollees. Roughly 30% of all Part B beneficiaries will not be protected in 201Those people are facing a Part B premium increase of about 22.3%, from 1.80 per month to 9.00, the highest increase in 27 years. People who are not protected by the hold harmless provision include: .Recently we received the following from one of our readers: .Dr. Conway assured lawmakers on the Finance Committee that CMS is carefully reviewing comments from the public about the proposed program, and that the Administration is committed to working closely with stakeholders to improve the proposal. He said, "Our goal is to be responsive to the public comments and input from Congress while preserving the integrity and effectiveness of the model." .Finance Committee Questions HHS Nominee .Sen. Conrad's budget proposal is expected to spur serious negotiations on a long-term solution, but it is not expected to win passage. In fact, the Senate will not even vote on or make amendments to the proposal. Sen. Conrad has said that "the timing is not yet right" for a vote, but most have blamed Majority Leader Reid (NV) for refusing to bring a budget proposal to the floor in the midst of an election year. Many Senators, it seems, are beginning to look at the post-election, lame-duck session as the prime opportunity to tackle the deficit. As Sen. Conrad said this week, "That may be the only time members on both sides of the aisle will be willing to move off their fixed positions." TSCL will continue to monitor these negotiations in the meantime. .The CBO estimates that replacing Medicare with a premium support system would save the federal government as much as 5 billion over ten years.[3] The CBO also estimates that premiums paid by affected beneficiaries, however, would be about 30 percent higher on average by 2020 than the current projected Part B premium. In addition, the CBO said that shifting seniors to private plans would affect access to providers, a problem that many seniors are experiencing with Medicare Advantage plans now. .At the time of writing this update on Friday morning, the vote had not yet occurred. It is expected to take place on Friday afternoon, before the non-partisan Congressional Budget Office has a chance to evaluate the final version. It remains unclear whether or not the AHCA will gain the support needed to win passage. If adopted, the AHCA will move to the Senate, where its future remains even more uncertain. If it fails, Republican leaders on Capitol Hill have said they will move on to other legislative priorities, like tax reform. .You may be surprised to learn that Members of Congress, and their congressional staff, receive their employer-sponsored insurance through Obamacare. Their health benefits would also be affected by an Obamacare repeal as well — but unlike your sister and millions of other Americans, Members of Congress already have high quality health insurance to replace their Obamacare plans. In fact, the premium costs of some Members of Congress could go down as they transition back to getting insurance through the Federal Employees Health Benefits Program (FEHB). .You will still need to follow guidance at your workplace.