One of the programs left hanging by the high-stakes game of chicken that Congress is playing is a fund called QI, short for Qualified Individual, that pays Medicare Part B premiums for Medicare beneficiaries with incomes between 120 percent and 135 percent of the federal poverty level and limited resources. The limit for this group is $1,225.13 per month ($14,701.50 per year) for an individual; $1,654.88 per month ($19,858.50 per year) for a couple. About 1.5 million people are eligible for this program.
Qualifying to receive the QI benefit saves beneficiaries $99 a month in Part B premiums. Qualifying also automatically entitles individuals to the full Medicare Part D prescription drug low-income subsidy known as LIS, or Extra Help, which has an average value of about $4,000 in 2011. In total, the QI benefit represents an average savings of $5,199 per year for these low-income beneficiaries. The savings are significantly more for those with high prescription drug use, the National Council on Aging says.
As it is now, if a low-income senior has to see the doctor in January, they may not be able to," says Howard Bedlin, vice president of policy and advocacy for the National Council on Aging. "Maybe Congress will come back the first week in January and reach an agreement, but it's unclear now what’s going to happen, and we’re quite worried."
The Congressional standoff would also allow a 27.4 percent cut to Medicare physician payments in 2012 to go through. This decrease in reimbursements is likely to make it more difficult for Medicare recipients to find doctors willing to treat them. The Centers for Medicare & Medicaid Services has announced that it will hold physician claims for 10 business days starting Jan. 1. to avoid paying out claims at reduced rates and to give Congress more time to agree on legislation.
"The [Obama] administration is disappointed that Congress has failed to pass a solution to eliminate the sustainable growth rate formula-driven cuts and has put payments for health care for Medicare beneficiaries at risk," CMS said in a statement. "We continue to urge Congress to take action to ensure these cuts do not take effect."
Or, as House Speaker John Boehner (R, Ohio) says, "It's time to stop the nonsense."