Bill Overview
Title: Protecting Medicare Patients and Physicians Act
Description: This bill extends a payment increase under Medicare's physician fee schedule through the end of 2023 (currently set to expire at the end of 2022) and temporarily exempts Medicare from sequestration.
Sponsors: Sen. Kennedy, John [R-LA]
Target Audience
Population: People enrolled in Medicare and physicians who provide services to them
Estimated Size: 65000000
- Medicare is a federal health insurance program primarily for Americans aged 65 and older, but it also covers younger people with certain disabilities and conditions like End-Stage Renal Disease.
- The main beneficiaries impacted by the payment increase under the physician fee schedule will be elderly Americans who rely on Medicare-funded services.
- Physicians who provide services to Medicare patients will also be directly impacted, as their compensation from these services is affected by the fee schedule.
- In 2020, approximately 62 million people were enrolled in Medicare, a number that can be expected to have increased to potentially around 65 million by 2023.
Reasoning
- The Protecting Medicare Patients and Physicians Act primarily impacts older adults covered by Medicare, as well as healthcare professionals offering services to these individuals. Given the budget constraints, the policy cannot fundamentally transform the entire Medicare system but can alleviate some financial pressures within the set limits.
- Around 65 million Americans are enrolled in Medicare; thus, the policy targets a population already benefiting from Medicare but seeks to stabilize a part of their health service financing.
- The policy can be expected to have variable impacts depending on individuals' reliance on Medicare, healthcare needs, and the financial pressures they face.
- There will be more perceptible improvements for segments deeply reliant on specialist and frequent healthcare services while potentially having negligible direct effects on others.
- Given the scale of the program and its budget, effects on healthcare providers might translate to higher patient satisfaction and slight financial relief for some, stabilizing their wellbeing scores over time.
Simulated Interviews
Retired teacher (Florida)
Age: 70 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 15/20
Statement of Opinion:
- I appreciate that my doctors will receive fair payments. It means I can continue seeing him without worrying, but I hope Medicare covers more services soon.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 4 |
Retired engineer (Texas)
Age: 68 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 3.0 years
Commonness: 12/20
Statement of Opinion:
- This helps ensure I don't get unexpected cost increases for my care. It's a relief knowing my visits to the physician will continue smoothly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Part-time retail worker (California)
Age: 72 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 14/20
Statement of Opinion:
- I'm glad there won't be sudden extra medical expenses. I'm worried about other costs, but this helps a bit.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 5 | 3 |
Retired (New York)
Age: 85 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 2.0 years
Commonness: 10/20
Statement of Opinion:
- I don’t fully understand these healthcare things, but it seems good my checkups have no extra charges.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 3 |
| Year 3 | 5 | 3 |
| Year 5 | 4 | 3 |
| Year 10 | 4 | 3 |
| Year 20 | 3 | 2 |
Physician (Illinois)
Age: 48 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- This is critical for keeping my practice stable and ensuring I can serve my patients without increased financial pressure.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 6 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Retired factory worker (Ohio)
Age: 66 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 15/20
Statement of Opinion:
- It's a bit complicated, but I'm glad there won't be additional payment issues while I figure this new stage life out.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 4 |
Retired pharmacist (Arizona)
Age: 74 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 12/20
Statement of Opinion:
- I feel a bit more at ease knowing no sudden changes in my doctor's costs for now.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 4 | 4 |
Retired (Michigan)
Age: 80 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 8/20
Statement of Opinion:
- I hope this means I won't lose my doctor if they decide to move or cut services.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 5 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 4 | 3 |
Primary care physician (Georgia)
Age: 55 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 2.0 years
Commonness: 11/20
Statement of Opinion:
- This allows me to continue offering comprehensive services to my patients without immediate financial strain on my practice.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 5 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 5 | 3 |
Retired accountant (Pennsylvania)
Age: 67 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 13/20
Statement of Opinion:
- It's a relief as it means fewer worries about sudden medical bill increases.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Cost Estimates
Year 1: $15000000000 (Low: $14000000000, High: $16000000000)
Year 2: $0 (Low: $0, High: $0)
Year 3: $0 (Low: $0, High: $0)
Year 5: $0 (Low: $0, High: $0)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- The extension of the payment increase is temporary, only affecting government spending for one year (2023).
- There might be pressure to extend these provisions indefinitely, which could lead to larger fiscal implications beyond 2023.
- The immediate focus is maintaining service levels and provider participation in Medicare without facing the barriers from payment reductions or sequestration.