Proposals Related to: Premium support
Currently, Medicare pays MA plans using a system that compares plans’ bids to administrative benchmarks that reflect the maximum amount Medicare will pay for an enrollee based on spending in original Medicare. This category of proposals would, instead, base Medicare’s payments on a competitive bidding system among MA plans as well as a “bid” that reflects the average cost of a beneficiary of average health who uses original Medicare. Under these proposals, Medicare would use a bidding process (such as taking the weighted-average bid, lowest bid, or second-lowest bid) for each service area to determine how much the program would pay plans to provide Medicare Part A and Part B benefits. Some proposals would also include Part D benefits when offered by MA plans. Notably, premium-support proposals differ from other versions of competitive bidding because they include original Medicare in the bidding process, including the cost of a Part D plan when appropriate. Under premium support, beneficiaries in original Medicare would pay higher premiums if original Medicare’s “bid” was higher than bids of competing MA plans, and they would pay lower premiums if the “bid” was lower.
NOTE: Entries with grey backgrounds are Georgetown estimates. Entries with white backgrounds are either descriptive information or analysis made by or for the proposal authors.
| Proposal | Effects on beneficiaries | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Short description | Category | Author | Federal savings (-$) or costs (+$) | Access to plans | Enrollee costs | Supplemental benefits | Part B premiums | Other affected stakeholders | |
Key:
- Federal savings or costs. When available, we provide original estimates from source materials by the proposal author(s) or from the Congressional Budget Office. Authors prepared estimates for some proposals at a time when plan enrollment and payments differ from today, and thus estimates of savings or costs should be interpreted cautiously. When no author’s estimate was available, Georgetown provided an estimate, as indicated by grey highlighting. Click Details for more information about savings or costs for a specific proposal.
Estimates in source materials prepared by the author(s) cover different numbers of years and windows of time. To give website users a consistent sense of magnitude, we categorized proposals by whether its estimate was approximately less than $10 billion over 5 years or greater than or equal to that amount. Thus, in this column,- +$ indicates anticipated costs to the federal government of less than $10 billion over 5 years.
- +$$ indicates anticipated costs of $10 billion or more over 5 years.
- –$ indicates anticipated savings to the federal government of less than $10 billion over 5 years.
- –$$ indicates anticipated savings of $10 billion or more over 5 years.
- We list a question mark for proposals in which the author(s) would need to specify more detail to estimate federal spending.
- Effects on beneficiaries. When available, the estimate was provided by the proposal author(s) within the cited source materials. When no author’s estimate was available, Georgetown provided an estimate, as indicated by grey highlighting. In the four columns under this header,
- Up arrows indicate anticipated greater access to plans, higher costs (premiums and cost sharing) for plan enrollees, more availability of extra benefits, or higher Part B premiums applicable to all beneficiaries.
- Down arrows indicate the reverse effects.
- Combined up and down arrows indicate mixed effects, such as up for some categories of beneficiaries and down for others.
- Categories may also be reported as “minimal or no effect” or “not applicable.”
- We list a question mark for proposals in which the author(s) would need to specify more detail to estimate effects on beneficiaries.
- Click Details for more information about beneficiary effects for a specific proposal.
- Other affected stakeholders. This column reports any stakeholders other than Medicare beneficiaries likely to be affected significantly by the proposal. Click Details for more information about a specific proposal.