The White House unveiled Tuesday a plan to shore up a key Medicare trust fund by raising taxes on those earning more than $400,000 a year and by allowing Medicare to negotiate prices for even more drugs.
Medicare, which covers more than 65 million senior citizens and people with disabilities, is in dire financial shape. Its hospital insurance trust fund, known as Part A, will only be able to fully pay scheduled benefits until 2028, according to the most recent forecast by its trustees.
President Joe Biden’s proposal would extend Medicare’s solvency by 25 years or more, though it is expected to run into a wall in the Republican-controlled House, which opposes tax increases.
The president, who promised in his State of the Union address last month that he would extend Medicare’s trust fund by at least two decades, will include the measures in his 2024 budget proposal set to be released Thursday. Biden has emphasized that he will protect Medicare and Social Security, while accusing House Republicans of seeking to cut the popular programs as the two sides square off over addressing the debt ceiling crisis.
“The budget I am releasing this week will make the Medicare trust fund solvent beyond 2050 without cutting a penny in benefits. In fact, we can get better value, making sure Americans receive better care for the money they pay into Medicare,” Biden wrote in an op-ed in The New York Times on Tuesday.
What’s in the proposal
The plan would increase the net investment income tax rate on earned and unearned income above $400,000 to 5%, up from 3.8%, according to a fact sheet released by the White House. Also, it would be levied on the owners of certain pass-through firms who include business income on their personal tax returns and aren’t currently subject to the tax.
In addition, it would dedicate the revenue from the tax, which was created by the Affordable Care Act, to Medicare’s hospital insurance trust fund.
Plus, it would build on the Inflation Reduction Act, which congressional Democrats passed last summer, by allowing Medicare to negotiate the prices of more drugs and bringing drugs into negotiation sooner after they launch, according to the fact sheet. And it would extend the law’s requirement that drug companies pay rebates to Medicare if they increase prices faster than inflation to commercial health insurance.
The plan also would reduce costs for Medicare beneficiaries by capping out-of-pocket costs for certain generic drugs, such as those used to treat hypertension and high cholesterol, to $2 per prescription per month.
In addition, it would lower the cost of mental health and other behavioral health treatment by eliminating out-of-pocket costs for three visits per year and requiring parity between physical health and mental health coverage in Medicare. And it would require Medicare to cover additional providers, such as peer support workers, certified addiction counselors and certain digital applications and platforms.
Also, allowing Medicare to negotiate the prices of more drugs will cut beneficiaries’ out-of-pocket costs by billions of dollars, according to the fact sheet.
The president’s plan makes no mention of Social Security, which is also facing severe funding problems. Its trust funds are scheduled to be depleted within 12 years, according to projections. At that time, recipients would face a benefit cut of 20% or more.
