Congress must act, medical group says. Or seniors will have to pay a health insurance tax.


By Nancy Fitterer

Few need a reminder about the number of politicized debates over health care happening today. But there is one issue on which an overwhelming majority of Americans, and our lawmakers in Washington, agree — taxing health insurance is not a good idea.

Somehow a tax on health plans wormed its way into the Affordable Care Act, and since then, federal elected officials have acted together several times to protect Americans, particularly our senior citizens, from its impacts. Now they must do so again. The Health Insurance Tax, or “HIT” as it’s commonly called, will soon affect Medicare Advantage beneficiaries unless Congress can keep it on hold.

My organization’s membership is concerned about this issue because the HIT would harm the seniors and disabled people we serve. Home care provides the support many individuals need to retain their independence and age in their own homes. We believe one’s dignity cannot be measured by the dollars in a bank account, and we are worried that by raising health insurance costs, the HIT will reduce access to essential care for lower income New Jerseyans.

The fact is, most seniors worry that their retirement savings will eventually run short, but having Medicare Advantage can be reassuring. Over 90% of seniors have access to a Medicare Advantage health plan charging no premium, and co-pays for doctors’ appointments and other services are usually only a few dollars. Moreover, there is an annual cap on the amount seniors can be asked to pay out of their own pocket for care.

These are important financial protections, but the HIT upends this carefully constructed program by imposing additional costs, which must be accommodated somehow. One way is with higher premiums, and research by Oliver Wyman suggests these costs will increase by hundreds of dollars annually, per beneficiary, over the next few years.

Some seniors will not be able to pay more and will fall back on traditional Medicare, but this coverage leaves them responsible for 20 percent of the cost of any care and incorporates no cap on their annual spending. Faced with rising expenses, many seniors will go without necessary care—without an essential prescription refill, without a checkup to adjust their treatment, or without in-home assistance they truly need, just to name a few possibilities.

Other impacts are likely as well. Some insurers may try to keep premiums as stable as possible by raising co-pays instead, which will harm seniors with multiple health problems. Patients who need an array of medications, rely on various specialists, or require intense treatment for cancer or other diseases would have more difficulty affording this care.

Seniors may lose access to benefits, such as programs to manage chronic illnesses or free group fitness memberships. But how much less vibrant a life will our seniors lead if we do less to help them maintain their health? And how much more will the U.S. ultimately spend on care if we derail initiatives that are currently reducing diabetes, minimizing emergency room visits, and avoiding unnecessary hospital admissions, as Medicare Advantage is today?

Medicare Advantage has expanded the health care choices available to New Jersey’s seniors and disabled people, and has also enhanced their ability to access quality care. It is a program America should be proud of, not one we should tax into obsolescence. Hopefully, our elected leaders still recognize the value of Medicare Advantage and will pass H.R. 1398 in the House and S.172 in the Senate to renew the suspension on the HIT to protect seniors yet again.

Nancy Fitterer is president and CEO of the Home Care and Hospice Association of New Jersey.

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