What We're Reading: Medicare Will Become Insolvent 2 Years Sooner Than Expected

What we're reading, June 23, 2016: Medicare's fund will be insolvent 2 years earlier than estimated last year; nearly 1 in 3 Medicare beneficiaries received an opioid prescription in 2015; House Republicans' health plan calls for greater use of value-based insurance design; and the Democrats urge the Department of Justice to block Anthem-Cigna and Aetna-Humana mergers.

The annual report from Medicare’s trustees found that the program will exhaust its reserves by 2028, which is 2 years earlier than was estimated last year. According to The Wall Street Journal, Medicare and Social Security will both begin to spend more than they earn by the end of this decade. However, although the projected timeline for Medicare to deplete its funds was reduced by 2 years compared with last year’s estimate, falling healthcare costs have extended the life of the fund significantly. In 2009, trustees had estimated the fund would be depleted by 2017.

In other Medicare news, HHS’ Office of the Inspector General found that nearly 1 in 3 Medicare beneficiaries received an opioid painkiller last year. The cost of nearly 12 million beneficiaries receiving at least 1 opioid prescription is $4.1 billion, reported the AP. The most commonly prescribed opioids taken by Medicare patients were OxyContin, Percocet, Vicodin, fentanyl, or their generic equivalents. Overdose risk is heightened for older Americans.

House Republicans’ health plan outlines a number of policy proposals that include a recommendation for allowing the implementation of value-based insurance design (VBID) throughout Medicare Advantage. Currently, CMS is set to begin a demonstration of VBID in Medicare Advantage in 7 states as of January 2017. The plan calls for allowing more benefit design flexibility and doing away with the “one-size-fits-all” policy in Medicare Advantage.

As the Department of Justice reviews 2 major health insurance mergers, Democratic senators are urging the department to block the deals. The senators are concerned that the deals would lead to higher premiums and lower-quality healthcare and reduce competition, according to Reuters. If the department approves the Aetna-Humana and Anthem-Cigna deals, the number of large, national health insurance carriers would decline from 5 to just 3.