WASHINGTON — As Vice President Joe Biden and congressional negotiators hunted for budget cuts this week, major Medicare changes that could squeeze billions in savings got a boost Wednesday from a nonpartisan panel of experts that advises lawmakers.
One idea would revamp Medicare's co-payments and deductibles to provide better protection against catastrophic expenses, but it could lead to seniors paying a bigger share of the cost for some everyday services. The goal is to save taxpayers money by discouraging overtreatment.
The impact on individual seniors is less clear. Few details are available, but such changes could create winners and losers.
Seniors with high medical costs would gain from having a limit on their financial exposure, protection that Medicare doesn't now provide. Those who see the doctor often for more manageable problems could end up paying more. But premiums for private insurance that many seniors get to fill in Medicare's gaps could become more affordable.
The other idea under consideration would shift nearly 9 million high-cost beneficiaries with both Medicare and Medicaid into managed-care insurance plans, to better coordinate services and cut duplication.
The Medicare Payment Advisory Commission did not endorse any specific approach, but its traditional midyear report to Congress made clear that both issues are overdue for a fix.
The aim should be "to give beneficiaries better protection against high (out-of-pocket) spending and to promote incentives for them to weigh their use of discretionary care, without discouraging needed care," said the report from MedPAC, as the commission is known.
Officials familiar with the negotiations between Biden and leading lawmakers of both parties said the two Medicare options are under consideration. The officials spoke on condition of anonymity because the budget talks are confidential.
Biden's goal is to find savings that will help the administration reach a deal with congressional Republicans to increase the nation's $14.3 trillion debt ceiling. That's needed to prevent the government from lurching into an unprecedented default on its interest payments to creditors, which could destabilize the already wobbly economy.