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Dave Camp, R-Mich, said, 'the IRS could have to hire more than 16,000 additional agents, auditors and other workers just to enforce all the new taxes and penalties.' Camp called such an increase in personnel, 'a dangerous expansion of the IRS' power.' The IRS currently has about 93,000 employees. House Ways and Means Committee Republicans used the CBO estimate in a report on the bill's effect on the IRS. The Congressional Budget Office said the number of new employees the IRS will need has not been determined, though it did estimate the agency's cost could reach approximately $10 billion over the next 10 years. The Internal Revenue Service will be tasked with enforcing this provision. This claim arises from a provision of the health care law that would require Americans to purchase health insurance or else face fines. The IRS will be hiring thousands of new agents to check that people have health insurance and people who don't will be sent to jail. 'You are going to start seeing companies dropping out,' said Robert Moffit, a policy analyst at the Heritage Foundation. However, for those in Advantage plans, they may have fewer to choose from. The three-quarters of beneficiaries who receive traditional Medicare benefits would not be affected by the change. Marsha Gold, a health policy analyst for the private research group Mathematica, said, 'Over time, there will be less rich benefits or higher premiums, but it's going to be gradual,' noting that the largest cuts do not begin until 2015. Robert Berenson, a scholar at the Urban Institute and former Medicare official, said some Advantage plan members will notice skimpier benefits, 'but the Republicans have really exaggerated that this will wipe out the Advantage plans.' Some Democrats and analysts have argued the higher rates are wasteful.Įven experts who support the change concede that the impact of the cuts could be evident. Plans use that subsidy to lure members with lower premium costs or extra benefits not normally paid for by Medicare, such as vision care or better prescription drug coverage. The new health law will cut $136 billion in spending on the Advantage program by 2019, which currently pays private plans to administer Medicare benefits and pays them about 14 percent more than the per-patient cost of the traditional Medicare program.

That was the warning in a statement from America's Health Insurance Plans, a lobbying group, days before the health overhaul cleared Congress, echoing a Republican criticism. 'The graveyards of Washington, D.C., are littered with government agencies that tried to do comparative effectiveness research,' said Michael Cannon, director of health policy studies at the Cato Institute, a libertarian think tank in Washington.Ĭuts in the Medicare Advantage plans under the health care overhaul 'will cause massive disruption for the more than 10 million seniors' and many of them will lose coverage. Others say history suggests that's unlikely.

Many experts believe that as health costs continue to mushroom, Medicare and private payers will incorporate the institute's work into their coverage decisions. This is a shift from Congress' position when it created the Medicare Part D drug benefit in 2003 back then it banned any use of comparative effectiveness research in determining what would be covered. Medicare may take the institute's research into account when deciding what procedures it will cover, so long as the new research is not the sole justification and the agency allows for public input. The law states that the institute does not have the power to mandate or even endorse coverage rules or reimbursement for any particular treatment. The institute would be governed by a 19-member board that includes patients, doctors, hospitals, drug makers, device manufacturers, insurers, payers, government officials and health experts. The law creates a nonprofit Patient-Centered Outcomes Research Institute charged with examining the 'relative health outcomes, clinical effectiveness, and appropriateness' of different medical treatments by evaluating existing studies and conducting its own. KHN staff writers checked out some of the claims:Ĭomparative effectiveness research will lead to the rationing of care for the elderly. Some concerns were raised during the congressional debate or have been swirling around the Internet. It's no wonder that some consumers are confused – and perhaps frightened – about how the law might affect them. The sweeping health care overhaul signed into law his month by President Barack Obama is more than 2,000 pages long and has been dissected by analysts, politicians and pundits.

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