Democrats have promised to protect and expand Medicare if they win control of Congress and Vice President Kamala Harris is elected President. ♚They would build on recent efforts to save seniors money on prescription drugs, but they’re facing a growing funding crunch for the massive federal health program.

We spoke with two health policy experts (one progressive and one 😼bipartisan) and reviewed proposals and Biden-Harris administration policies to learn more about what Democrats might do if they take control in No𝔉vember.

Will Kamala Harris Cut Medicare?

Each presidential candidate accuses the other of attempting to cut Medicare, though fact-checking organization Politifact has deemed these accusations false.

Regardless of who wins the election, Medicare beneficiaries can likely feel reassured that their Congressional representatives and the newly elected presideಞnt will support their health coverage. 

"In the last State of the Union Address, when Joe Biden said, 'Hey, we're not touching Medicare.' It was the one moment both parties stood and applauded," said Marilyn Serafini, health program executive director at the Bipartisan Policy Center, a Washington, D.C.-based think tank that promotes bipartisanship. 

Election outcomes can result in Medicare changes, but “without a supermajority, it limits what any president or ruling party can do," Serafini said.

A divided Congress is the most likely out🧔come of the upcoming election, according to Serafini.

If Harris wins with a split Congress or Democratic majority, Serafini said "we'll see more in the way of protecting Medicare and less attention on entitlement reforms, but both parties would like to see the program work better." 

The Democratic Plan for Medicare

The 92-page 2024 Democratic party platform promises to protect and expand Medicare and oppose actions to cut Medicare benefits. The pla🐈tform says paying for increased benefits and maintaining Medicare’s health is critical. Democrats say Medicare is in a stronger fiscal position than when the Biden administration took office. 

Still, without interventions, the 澳洲幸运5官方开奖结果体彩网:Medicare Part A (hospital insurance) fund will become insolvent by 2034, and Medicare spending will double, according to the Congressional Research Service.

Among Americans under 65, 73% worry Medicare won’t be available when they need it, according to a recent West Health-Gallup poll.

“We know that the aging population and fewer working people are paying what existing retirees will cost into the system,” Serafini said. “So even if we become extremely efficient, we could get to a place where we have an insolvency sometime in the foreseeable future. We don’t know when, but it’s coming."

Allowing Medicare to Cover In-Home Health Care

In 澳洲幸运5官方开奖结果体彩网:an appearance on “The View" today, Harris proposed to ꦫallow Medicare to cover in-home health care. She said allowing people who need long-term care to receive it at home helps preserve their independence.

“They want to stay in their home,” Harris 💫said. “They don’t want to go somewhere else. Plus, for the family to send them to a residential 🦩care facility to hire somebody is so expensive.”

Harris said on "The View" that Medicare would pay for the new benefit by using the savings from drug price negotiations. The Inflation Reduction Act of 2022 allows the government to bargain with drug companies for drugs covered under Medicare Part D (starting in 2026) and Part B (starting in 2028).

Paying for Medicare Solvency

The Medicare Board of Trustees estimates that a 0.35% increase in the payroll tax or an 8% cut in spending would close Medicare's deficit. Harris’s campaign favors the former approach.

According to the Democratic Party platform, Medicare could be bolstered or offer expanded benefits by “making the wealthy pay their fair share in Medicare taxes.” The Harris campaign, Biden’s 2025 Budget, and Congressional Democrats propose assessing Medicare taxes on some business profits and increasing the Net Investment Income Tax on incomes above $400,000 would “extend the solvency of the Medicare Hospital Insurance Trust Fund indefinitely.”

Medicare Advantage Overpayments

Medicare Advantage spending is projected to grow to 62% of 2025’s Medicare Part A and Part B costs, according to the U.S. This is due to increasing enrollment in 澳洲幸运5官方开奖结果体彩网:Medicare Advantage plans and higher per-person spending than 澳洲幸运5官方开奖结果体彩网:original Medicare. Medicare Advantage (or Medicare Part C) plans, which are offered by private companies, include Medicare Parts A, B, and usually 澳洲幸运5官方开奖结果体彩网:D (prescription drugs). They may also include additional benefits, such as dental, vision, and hearing coverag𝐆e. Beneficiaries generally must receiveꦿ care within the insurer’s network of physicians.

Andrea Ducas, vice president of health policy at the Center for American Progress, a progressive-leaning policy institute, said Medicare Advantage (MA) was initially des🍃igned to be competitive, efficient, and provide higher-quality care than traditional Medicare.

"There are mixed indicators," she said. "In some ways, MA does better, and in some ways, it does worse, but it's not delivering better care despite spending a ton of money."  

Both the New York Times and Wall Street Journal have reported ways Medicare Advantage insurers allegedly seek questionable diagnoses for their plan members to collect higher Medicare payments. According to a 2023 report from the left-leaning Physicians for a National Health Program, overpayments may range between $88 billion and $140 billion.

Ducas said overpayments to Medicare Advantage companies mean ▨the government pays 22% more than it would have spent on original Medicare to cover the same population. 

 "Instead of throwing money at the program, we can make different policy choices," Ducas said. 

Medicare Advantage Changes

So far, the Biden-Harris administration said its successes regarding Medicare Advantage include attempts to crack down on marketing and agent compensation for Part D🅺 plans, increase behav🉐ioral health access, and changing prior authorization policies. 

But more could be done, according to Ducas. Medicare Advantage enrollees should understand more clearly that they may not be able to buy a Medigap policy after⛄ the initial enrollment period, she said.

 More transparency and disclosure about each plan’s network size, statistics on how often the plan uses prior authorization, and the average out-of-pocket expense people in the plan experience annually would be ideal, Ducas said.

Original Medicare vs Medicare Advantage

"A lot of people don't realize until turning 65 and becoming eligible that Medicare isn't one program, but that you can choose between traditional and MA," Ducas said.

To get original Medicare requires cobbling together Parts A, Part B and Part D, and sometimes a Medicare supplement plan (also known as Medigap).

"Some Medicare recipients get dental, vision, and gym memberships, and others do not," Serafini said, referring to the comparison between Medicare and Medicare Advantage plans. "Democrats might look to create more equitable benefits.” 

The Democratic party platform has called for an expansion o𓆏f original Medicare to include ౠdental, vision, and hearing services.

A July 2021 KFF study found that almost half of all Medicare beneficiaries don’t have any dental coverage. Adding dental benefits to Medicare enjoys broad support among the public, with 72% “very much” supporting the idea, including 64% of voters loyal to former President Donald Trump, according to a July 2024 CareQuest-OPEN poll.

Part D and IRA Successes

Harris cast the tie-breaking Senate vote on the澳洲幸运5官方开奖结果体彩网: Inflation Reduction Act (IRA). The IRA’s provisions to cap out-of-pocket spending, limit the price of insulin, and allow Medicare to negotiate drug prices have been popular with Democrats and Republicans alike. The legislation also makes rꦦecommended vaccines free and requires drug companies to pay Medicare rebates if they raise prices faster than inflation.

"Medicare enrollees can realize savings quickly, and it's heartening to see how successful the IRA has been so far," Ducas said. 

In the 2024 party platform, Democrats said they will “expand the number of drugs subject to price caps and negotiation under the Inflation Reduction Act, saving taxpaꦓyers nearly $160 billion over the next 10 years, as Medicare will no longer have to pay Big Pharma exorbitant prices.”

The long-term effects of these price caps aren’t clear. In response to Part D spending limits, insurers appeared poised to raise the standard premiums. The 澳洲幸运5官方开奖结果体彩网:Centers for Medicare and Medicaid Services (C𝄹MS) then introduced a temporary measure, known as a “demonstration,” in mid-2024 to limit premium changes. As a result, beneficiaries haven’t yet felt the sting of premium changes.

“There could be more pressure when the demonstration ends,” Serafini said. “Neither Democrats nor Republicans want to see what happens if some people see major drug increases, so they will probably renew or otherwise deal with the premium issue."

However, Serafini said drug coverage will likely be revisited, particularly ar🦩ound concerns such as transparency for drug pricing and value, how the Food and Drug Administration and CMS work togetherཧ on drug coverage, and further negotiations over drug pricing.  

Part D changes c🏅ould also impact Medicare Advantage plans, which aren’t part of the demonstration program.

"It's one thing to say premiums are staying the same or going down,” Serafini said, “But it's something else if your Medicare Advantage plan is losing hearing, vision, or dental benefits."