The Senate will make approximately $25 billion cuts in Medicare.
"The Medicare cuts aren’t part of the tax bill itself. Instead, they are mandatory spending cuts that would occur because the tax bill’s $1.5 trillion increase to the deficit. These spending cuts are known as a sequester — and we know what happens to Medicare in a sequester, because it happened just a few years ago.
Across-the-board cuts often have outcomes that are tricky to predict. Because they aren’t targeted, they often hit programs no legislators would want to cut.
The last sequester in 2013 unexpectedly caused cancer clinics to turn away thousands of Medicare patients. I wrote about it at the time, when I worked for the Washington Post:
Oncologists say the reduced funding, which took effect for Medicare on April 1, makes it impossible to administer expensive chemotherapy drugs while staying afloat financially.
Patients at these clinics would need to seek treatment elsewhere, such as at hospitals that might not have the capacity to accommodate them.
In that particular case, Congress had actually tried to shield Medicare from some of the deepest cuts. But because of some quirks in how Medicare pays for cancer drugs, it didn’t work — and clinics were left with incredibly difficult choices.
I talked to one Long Island oncologist who said he and his staff held an emergency meeting earlier this week and decided they would no longer see one-third of their 16,000 Medicare patients. “It’s a choice between seeing these patients and staying in business,” Jeff Vacirca, chief executive of North Shore Hematology Oncology Associates, told me.
The Senate could pass separate legislation to
skirt these rules that would require the automatic budget cuts — but as my colleague Tara Golshan
notes, the politics of Republicans voting to undermine a deficit-management law won’t be easy.
And if they don’t, the fears of cancer clinics turning patients away could become real again. The tax bill could, for some seniors, become a bill that sharply limits their access to health care.
The Senate tax bill is also a health care bill
As the tax bill slides to a vote (with the expectation it will clear the Senate), we should also be talking about health care. When Obamacare faced repeal this spring, many groups mobilized to demand clarity on what the bill would really do. We need those answers now, too.
Because the tax bill isn’t just a tax bill.
It is a bill that has sweeping consequences for the American health care system — that could stand to affect the health care of vulnerable and elderly citizens."
The Senate's tax bill is a sweeping change to every part of federal health care
The Senate's tax bill is a sweeping change to every part of federal health care
Plutocracy in action.