Last week an expected, but still alarming, report was issued by Medicare’s board of trustees that showed the Medicare hospital insurance trust fund will run out of cash by 2026. After that, the fund will only cover about 91 percent of costs, meaning that doctors, hospitals, and other medical providers will almost certainly face cuts in Medicare payments.
It should be pointed out that trying to cut payments to doctors and hospitals — two very powerful lobbies in Washington — has proven to be impossible in the past. Congress has simply overridden the cost savings to satisfy the doctors, making Medicare financing even more problematic.
You might think that this grim report would force the Democrats to slam on the brakes for their Medicare expansion plans. But like a crazy person running toward a gasoline dump with a lit match, Democrats are mindlessly moving forward, full speed ahead.
The Medicare expansion would add vision, dental, and hearing benefits, a longtime goal for congressional Democrats. There’s no current cost estimate, but in 2019, the Congressional Budget Office estimated that a similar expansion of coverage (as part of a larger health care bill proposed by House Democrats) would cost $358 billion, the majority of which would go to dental care. The new expansion will almost certainly cost even more, although it is possible that the on-paper score will come in lower if the expansion is structured to push costs outside of the 10-year budget window, by, for example, delaying the start of the dental benefits until the end of the decade.
It’s not just Medicare expansion that’s going forward. Democrats are looking at an array of subsidies for Obamacare that would jack up expenditures by as much as $120 billion. And their Medicare expansion includes bringing Medicaid recipients into the Medicare program by creating an entirely new federal healthcare program to service them.
The Democrats are contemplating the largest expansion and most extensive growth in government healthcare programs in history. And they’re doing it in a time of $2 trillion budget deficits and a national debt topping $30 trillion.
It is possible that none of this will come to pass. Even if the entire package does become law, it will probably change in a variety of ways before it does.
But it is nonetheless telling that in the face of a looming shortfall in the nation’s largest federal health care program, congressional Democrats, rather than debating ways to control costs in the program that is already running out of money, are contemplating an expensive expansion of that same program; the permanent extension of a supposedly temporary health care subsidy in a separate health care program; and the creation of an entirely new federal health care program.
The system is obviously unsustainable. Both parties have been told that by the GAO as far back as the 1990s. And yet Republicans and Democrats both throw up their hands and claim the problem is just too difficult to deal with. Let the next Congress wrestle with it.
Soon, the politicians are going to run out of “next Congresses” to accept the responsibility. Far sooner than they might think, the problem will be theirs to solve.
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