Are Medicare and Medicaid too bloated to survive without changes?

 

Are Medicare and Medicaid too bloated to survive without changes?

Transcript¹

NPR's A Martinez speaks with Chiquita Brooks-LaSure, the administrator² for the Centers for Medicare and Medicaid Services, about the future of both programs.

A MART?NEZ, HOST:

All right. Next, we talk about one of the moments of this week's State of the Union address, where President Biden claims some Republicans want to sunset Social Security and Medicare. Medicare is a federal health program for people ages 65 and older, as well as younger people with long-term disabilities. The program accounts for 10% of the federal budget. Some members of the GOP have openly called for funding cuts or changes, which they cannot do without Democratic support. But the political debate raises questions about the future of the government-funded programs, such as Medicare. I'm joined now by Chiquita Brooks-LaSure, administrator of the federal office that runs the program. That's the Centers for Medicare and Medicaid Services. All right. Now, more than 60 million Americans are enrolled³ in Medicare. If there were any changes, Chiquita, to the program, who among them would be affected⁴ the most?

CHIQUITA BROOKS-LASURE: Well, the president is committed to making sure that we support Medicare and the health care programs. There are over 65 million people who are covered by Medicare. And these are our parents, our grandparents, our loved ones, and they're young people, people who have had a disability in their life that have caused them to be dependent on the Medicare program. And the president has really worked hard over the last year, working with Congress to pass legislation to make Medicare program stronger than ever. And as you can hear, he wants to continue to make sure that there is support for the program and that we continue to make it sustainable for future generations.

MART?NEZ: So on that sustainability because Medicare spending is expected to more than double from the $829 billion it was in 2021 to $1.8 trillion in 2031, so given what - that definitely seems and looks like a massive cost increase. How would you describe the program's long-term viability⁵?

BROOKS-LASURE: I would say that this is something, Medicare spending, that we always have to look at. Every couple of years, it's important for Congress to continue to make adjustments. And we made, as I mentioned, some real down payments on improving the program last year. The most important of that would be the Inflation Reduction Act or, as I like to call it, the new prescription⁶ drug law because it had really important protections not only for the people who depend on the program but also for the program's sustainability itself - so changes to make sure that we hold companies responsible if they increase their prices above inflation on prescription drugs, which helps the Medicare program. And we saw some changes at the end of the year to the program that really help make sure it's sustainable, like including mental health services. And the president will continue to put out more information as he releases his president's budget.

MART?NEZ: But, Chiquita, let me ask you this really quick in the time we have left. Is it possible to streamline⁷ the spending without streamlining the services?

BROOKS-LASURE: There are changes that are important and necessary, so - that don't lead to decrease in services. So we are absolutely looking at ways to make sure that we are paying appropriately. We've put out a number of administrative⁸ proposals to make sure that people are getting the care that they need. And that's been a real priority, of making sure that the dollars are spent wisely. But we do need to continue to make changes that don't cut benefits. But there are changes that will cut benefits, and that's why the president was so emphatic⁹ about saying we have to protect the program and not put in arbitrary rules about how Medicare spending will operate so that it doesn't end up hurting the people that depend on it every day.

MART?NEZ: I want to try and squeeze in Medicaid because enrollment¹⁰ spiked¹¹ in the pandemic. And the Biden administration is ending the COVID-19 public health emergency May 11. A lot of low-income people could lose their coverage¹². What is your agency doing about that?

BROOKS-LASURE: We have been so thrilled to see the enrollment in Medicaid, CHIP and Affordable¹³ Care Act - or the Obamacare - rise to record levels. And we are working very hard with states as people transition, and maybe if their incomes have increased, that we make sure that they get coverage through either the Affordable Care Act coverage or get to employer-sponsored insurance. One of the key roles is making sure that states can find people and - if they've moved or things have changed. So one of the things we encourage everybody who is on Medicaid is to make sure they're looking at the information that their states are sending to them...

MART?NEZ: OK.

BROOKS-LASURE: ...About updating their information. And that's one of our top priorities this year.

MART?NEZ: Chiquita Brooks-LaSure is the administrator for the Centers for Medicare and Medicaid Services. Thanks a lot for your time.

BROOKS-LASURE: Thank you.

 

1 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

2 administrator   

n.经营管理者，行政官员

参考例句：

• The role of administrator absorbed much of Ben's energy.行政职务耗掉本很多精力。
• He has proved himself capable as administrator.他表现出管理才能。

3 enrolled   

adj.入学登记了的v.[亦作enrol]( enroll的过去式和过去分词 )；登记，招收，使入伍（或入会、入学等），参加，成为成员；记入名册；卷起，包起

参考例句：

• They have been studying hard from the moment they enrolled. 从入学时起，他们就一直努力学习。 来自《简明英汉词典》
• He enrolled with an employment agency for a teaching position. 他在职业介绍所登了记以谋求一个教师的职位。 来自《简明英汉词典》

4 affected   

adj.不自然的，假装的

参考例句：

• She showed an affected interest in our subject.她假装对我们的课题感到兴趣。
• His manners are affected.他的态度不自然。

5 viability   

n.存活(能力)

参考例句：

• What is required to achieve or maintain such viability? 要达到或维持这种生存能力需要什么？
• Scientists are experimenting to find ways to ensure the viability of seeds for even longer periods of time. 正如我们所说，科学家正在试验努力寻找让种子的生命力更加延长的方法。

6 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

7 streamline   

vt.使成流线型；使简化；使现代化

参考例句：

• We must streamline our methods.我们必须简化方法。
• Any liquid or gas passing it will have streamline flow.任何通过它的液体或气体将呈流线型的流动。

8 administrative   

adj.行政的，管理的

参考例句：

• The administrative burden must be lifted from local government.必须解除地方政府的行政负担。
• He regarded all these administrative details as beneath his notice.他认为行政管理上的这些琐事都不值一顾。

9 emphatic   

adj.强调的，着重的；无可置疑的，明显的

参考例句：

• Their reply was too emphatic for anyone to doubt them.他们的回答很坚决，不容有任何人怀疑。
• He was emphatic about the importance of being punctual.他强调严守时间的重要性。

10 enrollment   

n.注册或登记的人数；登记

参考例句：

• You will be given a reading list at enrollment.注册时你会收到一份阅读书目。
• I just got the enrollment notice from Fudan University.我刚刚接到复旦大学的入学通知书。

11 spiked   

adj.有穗的；成锥形的；有尖顶的

参考例句：

• The editor spiked the story. 编辑删去了这篇报道。 来自《简明英汉词典》
• They wondered whether their drinks had been spiked. 他们有些疑惑自己的饮料里是否被偷偷搀了烈性酒。 来自辞典例句

12 coverage   

n.报导，保险范围，保险额，范围，覆盖

参考例句：

• There's little coverage of foreign news in the newspaper.报纸上几乎没有国外新闻报道。
• This is an insurance policy with extensive coverage.这是一项承保范围广泛的保险。

13 affordable   

adj.支付得起的，不太昂贵的

参考例句：

• The rent for the four-roomed house is affordable.四居室房屋的房租付得起。
• There are few affordable apartments in big cities.在大城市中没有几所公寓是便宜的。