- The Washington Times - Thursday, March 23, 2006

Starting next year, wealthier seniors will have to pay a greater share of the cost of their doctor visits because of a provision in the 2003 Medicare prescription drug legislation.

“It’s a change from traditional social insurance, there’s no question about that,” said Robert Moffitt, a health care policy analyst at the Heritage Foundation.

Medicare Part B covers outpatient services such as doctor visits, physical therapy and X-rays. All seniors who choose the coverage pay 25 percent of their monthly Part B premium, with the government picking up the remaining 75 percent. The seniors’ monthly portion was $78.20 last year and rose to $88.50 this year.

Beginning next year, wealthier seniors will have to pay an increasingly higher percent of their Part B premium costs. Singles with annual incomes of $80,000 to $100,000 and couples with annual incomes of $160,000 to $200,000 will have to pick up 28 percent of the monthly premium cost. That share will rise to 35 percent by 2009. Singles with annual incomes more than $200,000 and couples with annual incomes more than $400,000 will pay 43 percent of the cost next year and 80 percent in 2009.

Supporters of the change say it is a matter of economics: Rising health care costs and retirements of baby boomers will strain the Medicare and Social Security systems, and it doesn’t make sense for the government to pay the tab of the wealthy.

“The financial pressures facing Medicare are so severe that we cannot afford to treat everyone the same,” Mr. Moffitt said.

The government now picks up the same tab for a retired librarian and billionaire developer Donald Trump, and there is simply “no way we can do that anymore,” he said.

Some seniors groups oppose the change.

“Now that it has been legitimized, Medicare means-testing thresholds could be lowered by future Congresses, affecting a growing number of beneficiaries,” said the National Active and Retired Federal Employees Association.

“It would significantly alter a founding principle of the program — equality in Medicare benefits,” said Sharon Benton, executive director of the Retired Enlisted Association’s Senior Citizens League. “[It] opens the door for more means testing and much higher premium costs for retirees in the future.”

Brookings Institution economist Gary Burtless said it will be difficult for the government to calculate seniors’ annual incomes and that American workers pay taxes into Medicare based on how much they earn. Discovering upon retirement that they must pay a greater share for their doctor visits “may seem to a lot of people as sort of a double whammy,” he said.

Mr. Burtless noted that a backlash of anger forced Congress to repeal a program created during the Reagan administration that provided catastrophic health coverage for seniors but applied means testing for wealthier Americans.

Part B means testing originally was to be phased in over five years, but Congress approved a budget-trimming bill late last year that expedited the plan.

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