Prescription drug protection is only one a part of Medicare, the federal authorities’s medical insurance program for individuals age 65 and over.

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Prescription drug protection is only one a part of Medicare, the federal authorities’s medical insurance program for individuals age 65 and over.

d3sign/Getty Pictures

The White Home launched President Biden’s $6.8 trillion proposed finances final week, itemizing his priorities for the upcoming fiscal yr. Amongst different issues, Biden singled out Medicare — the federal medical insurance program for individuals aged 65 or older. Republican leaders insist they will not be threatening cuts to Medicare in upcoming finances negotiations, however others within the get together have floated the thought of constructing adjustments over time to this system — together with profit cuts they are saying might be essential to preserve Medicare solvent.

NPR’s Michel Martin, as co-host of All Issues Thought of, sat down this week with veteran well being care journalist Julie Rovner, of Kaiser Well being Information, to get a greater sense of the place the talk is headed over easy methods to fund Medicare, an costly, however fashionable program. The next excerpt of their dialog has been edited for size and readability.

MARTIN: So, what’s the difficulty right here?

ROVNER: Medicare’s trustees say that inside six years, the belief fund goes to expire of reserves, and so it will not have the ability to pay all the present advantages. So mainly, with the intention to convey down the price, you may have three choices: You may make the people who find themselves on this system pay extra, you may make taxpayers who assist assist this system pay extra, or you may pay well being care suppliers — medical doctors and hospitals and all these of us — much less.

All people considers any of these issues, “cuts,” though paying suppliers much less is often solely thought-about a minimize to the suppliers. If the cuts get too massive, and the well being care suppliers say “We’ll stroll away from this system,” that is an issue too.

However Medicare may be very fashionable, and I believe within the State of the Union, when the president stated he wasn’t going to do something to Medicare, individuals kind of slapped again and stated, “However Medicare goes to go broke if we do not do something.” So within the finances, Biden stated, effectively, listed below are a few issues that we might do, none of which have an effect on how a lot beneficiaries pay.

MARTIN: What are the highest traces of what President Biden’s proposing, with reference to Medicare?

ROVNER: It is truly pretty small. Final yr, for the primary time, Medicare was given authorized permission to barter the value of medication. There’s a quick checklist of medication. This finances would make the checklist longer, and it will have these negotiations occur quicker. It will additionally increase a tax on very high-income earners — these incomes over $400,000. The Biden finances would increase that Medicare tax from 3.8% to five% on these excessive earners.

MARTIN: Republicans have stated that they’ll stability the finances over the subsequent decade, however will not contact Medicare. Is {that a} credible stance?

ROVNER: It’s, however provided that they go after Medicaid — the truly bigger public medical insurance program for individuals with low incomes — and the subsidies on the Reasonably priced Care Act, which the president has now additionally stated he will not go after. It’s attainable to stability the finances with out touching Medicare or Social Safety or elevating taxes, however you would need to minimize a lot from the remainder of the finances. That is why we have not seen a Republican plan but. They’re nonetheless making an attempt to determine it out.

MARTIN: Senate Minority Chief Mitch McConnell has already stated publicly that Biden’s plan to extend the Medicare tax on excessive earners, “won’t see the sunshine of day.” So what are we prone to see subsequent?

ROVNER: Properly, sooner or later, , the 2 events are going to have to come back collectively earlier than the Medicare belief fund runs out of cash. This isn’t the primary time we have been inside this shut interval the place the belief fund might run out of cash. It is occurred a number of instances prior to now. Ultimately, the events do get collectively and work out some technique to shore it up. And I am certain that may occur this time, too, however I think this yr goes to be extra of a struggle main as much as the 2024 elections.

MARTIN: The talks over the debt ceiling are approaching. The leaders of each events have stated that Medicare is off the desk. However is it conceivable that Medicare will not be implicated sooner or later in these talks?

ROVNER: No. After all Medicare goes to be implicated sooner or later in these talks. Initially, what Republican leaders say will not be essentially what all the Republican rank and file will do. That is true of the Democrats, too, so it is onerous to think about that Medicare will not be placed on the desk indirectly, form or type.

MARTIN: So, what’s going to you be being attentive to as these discussions proceed over the subsequent couple of weeks and months?

ROVNER: One thing must be performed to Medicare, lest it run out of cash. So I believe that just about your complete federal panoply of well being applications goes to be up for dialogue — and that is what I will be watching.

MARTIN: I am simply questioning, is that this the form of topic that the general public actually can deal with, can actually get galvanized round?

ROVNER: It may well and it may possibly’t. The trick is how this will get negotiated and the way it will get offered to the general public as as to whether it can truly have an effect on their well being care.

Julie Rovner is the Washington correspondent for KHN and host of “What The Well being?” — KHN’s weekly well being coverage information podcast. After practically eight years of internet hosting Weekend All Issues Thought of, Michel Martin is taking over a brand new internet hosting function on NPR’s Morning Version.