Democrats should defuse debt limit time bomb: Orszag

The week is expected to be fiscally quiet, as Congress is out ahead of Thursday’s Thanksgiving holiday. In a brief, joke-filled ceremony at the White House on Monday, President Joe Biden pardoned the annual Thanksgiving turkeys, named Chocolate and Chip, and took the opportunity to work through a few election-related cracks. “The only red wave this season will be so [my] German Shepard Commander spills the cranberry sauce on our table,” he said. He also urged Americans to get vaccinated against Covid and the flu. “Two years ago we couldn’t even have Thanksgiving with big family gatherings,” he said. Now we can. It’s progress, and let’s keep it that way.”

Overseas, the United States men’s soccer team drew a disappointing 1-1 draw against Wales in their World Cup opener. Next meeting: England on Friday.

Audits Reveal Millions in Extra Medicare Advantage Costs

Recently revealed federal audits show that some Medicare Advantage health plans have overbilled the government millions of dollars.

Audits dating from 2011 to 2013 were made available through a multi-year lawsuit under the Freedom of Information Act by Kaiser Health News which was settled in September. Federal auditors reviewed the records of 18,090 patients and found overbillings of about $12 million, with some plans averaging more than $1,000 overcharge per patient. Applying this rate to a broader range of Medicare Advantage plans suggests surcharges totaling about $650 million.

Officials from the Centers for Medicare & Medicaid Services said they plan to use the scan to recover funds in the Medicare Advantage system, which is operated by large private insurance companies. But the agency failed to do so for nearly 10 years and recently postponed announcing a final adjustment process for surcharges.

KHN’s Fred Schulte and Holly Hacker spoke with Ted Doolittle, a former CMS executive who worked on billing fraud and abuse. “I think CMS failed on that,” Doolittle said, adding that the agency could “be water-bearing” for the insurance industry, which is “making money in spades” from Medicare Advantage. .

“From the outside, it looks pretty smelly,” Doolittle said.

An expert in documenting medical records told KHN that overcharging, driven by insurance companies who pretend patients are sicker than they really are and thus earn higher compensation for services, is ” absolutely endemic” in the Medicare Advantage system. “I don’t think there is enough oversight,” the expert said.

The bottom line: Medicare Advantage has grown rapidly and now covers more than 28 million people at an annual cost of $427 billion. It will soon cover the majority of the Medicare population. But questions remain about the government’s ability to monitor the system while protecting taxpayers from abuse.

Democrats should defuse debt limit time bomb: Orszag

Peter Orszag, the former head of the White House Office of Management and Budget and the Congressional Budget Office, warns in a Washington Post op-ed that the dangers of the debt limit are greater than ever.

Republicans have indicated they will use the need to raise the debt ceiling over the next year as leverage to force Democrats to agree to spending cuts. Orszag warns that the danger of this tactic is heightened “because the political norms that governed past negotiations — in particular, the idea that avoiding default is paramount — may no longer hold.”

In addition, he writes, the US Treasuries market has recently experienced lower liquidity and greater volatility – and “what the Treasury market is definitely doing not need is increased uncertainty about the debt ceiling. Concerns over declining liquidity in Treasuries make debt limit threats more dangerous than in the past.”

Orszag is urging lawmakers to defuse the threat in the current lame session of Congress, either bipartisanly or through a Democratic-led reconciliation bill that would only need 50 votes to pass by the Senate. The first approach seems far-fetched because Republicans are unlikely to cooperate in the needed numbers. Democrats rejected the second approach, with some worried it would take too long given the many other things they have to deal with. The Biden administration reportedly anticipated that some Democrats (read: Senator Joe Manchin of West Virginia) might also not cooperate with a party plan.

Orszag urges congressional Democrats to reconsider: “All Democrats opposed to such a painful vote should now consider how much influence their party will lose once Republicans control the House – and how much higher the risk of default will then be It’s generally not a good idea to enter a negotiation with a ticking time bomb and a counterparty ready to let it explode.”

Along the same lines, Bloomberg columnist Jonathan Bernstein warns that Democrats are making a mistake by not tackling the debt ceiling before Republicans take control of the House. Republicans can be blamed, but Democrats won’t be able to avoid a backlash. “Whatever voters may claim they think is responsible, if the economy collapses, Biden will take responsibility,” he wrote.

Read Orszag’s full article at The Washington Post and that of Bernstein at Bloomberg.

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John A. Bogar