Thank you, Chairman Tiberi for holding this hearing. I would also like to thank our witnesses for joining us today. We have an impressive panel that has prepared a number of thoughtful comments and recommendations. I am also pleased to see that it includes a fellow Michigander.
This hearing is about new models to coordinate and integrate care for Medicare beneficiaries, especially those who are dually eligible for Medicare and Medicaid. These 11 million Americans are among the most vulnerable members of our society. More than 40 percent are under 65 and live with disabilities, and many have very complex health care needs. In the past, we have had a bipartisan commitment to providing high-quality care for this population.
Unfortunately, the recent actions of my Republican colleagues suggest that this may no longer be the case. Last month, the House passed an ACA repeal bill that would slash Medicaid by more than $800 billion over the next decade. And two weeks ago, President Trump proposed a budget that would further cut Medicaid by $600 billion. These cuts would have a major impact on the people who are the subject of this hearing.
Cutting Medicaid will hurt those 11 million Medicare beneficiaries who are dually eligible for both programs and who depend on Medicaid to provide services and cover expenses that Medicare doesn’t. For example, Medicaid reduces out-of-pocket-costs for low-income beneficiaries and pays for important services that Medicare does not cover, including long-term care.
Ending the ACA’s Medicaid expansion and switching to per capita caps or block grants would shift health costs onto beneficiaries - and leave many without Medicaid coverage at all. This will reduce access to care and put financial strain on low-income seniors and people with disabilities. I hope we spend time this afternoon discussing this important issue.
We are also here to examine three specific models for delivering care to Medicare Advantage enrollees. Special Needs Plans are the most prominent of the models we will discuss today. Currently, nearly 2.3 million Americans receive coverage through these plans, which are tailored to the needs of specific populations of beneficiaries. Special Needs Plans are particularly important to those who are eligible for both Medicare and Medicaid.
Authorization for the program expires next year, and I look forward to working in a bipartisan way on an extension that maintains quality while promoting better care and stronger protections for beneficiaries.
We will also discuss PACE, or Programs of All-Inclusive Care for the Elderly. This model has shown promising results by providing coordinated care to frail elderly populations. Although its footprint is small, PACE has allowed thousands of Americans to maintain their independence by providing nursing home level care in community settings.
As we consider the future of this model, our focus must be on ensuring that quality remains high and that we do not sacrifice our standards in the interest of expansion. This is particularly important now that for-profit enterprises are eligible to participate in PACE.
Both of these models, Special Needs Plans and PACE, help provide care for beneficiaries who rely not only on Medicare but also Medicaid.
Although this hearing is about Medicare, the future of both programs is directly linked. We cannot have a complete discussion of one without considering the other.
Finally, we will discuss value-based insurance design, or V-BID, a proposal to reduce health care costs by promoting high-value care. The model is in its infancy in Medicare, and we still need to learn more about its impacts on the program and on beneficiaries. To be a success, V-BID must show meaningful improvements in efficiency without reducing access to necessary services. I hope to hear more from our witnesses about our options for this model moving forward.
I again thank the panel for joining us, and I look forward to a constructive conversation.
