Do you understand Medicare? Of course you don’t. Neither does anybody else. So why would Congress abolish a modest federal program that pays for actual human beings who can explain it to confused consumers?
Last week, the Senate Appropriations Committee essentially voted to abolish the State Health Insurance Assistance Program (SHIP) by quietly eliminating the entire $52.1 million in federal funding that keeps the service going. In 2014, about 15,000 counselors in 3,300 state and local programs provided direct personal assistance to about 3.5 million older adults and younger people with disabilities. More than half of the counselors are unpaid volunteers. SHIP does not subsidize Medicare. It only provides advice.
As more Baby Boomers age, demand for SHIP services is growing, and the program has been struggling for years with a budget that essentially has been flat. But the Senate panel has decided it will no longer slowly starve the program. It will kill it.
The decision was a small piece of the committee’s proposed budget for several federal agencies. Committee Chairman Thad Cochran (R-MS) says the savings would be used to fund other more necessary programs, such as a $400 million increase in Alzheimer’s research. I continue to be baffled by Congress’s enthusiasm for funding drug research for dementia but its reluctance to provide sufficient assistance for those who already have the disease and their families.
Killing the SHIP program is a classic example of this short-sightedness.
Over the years, Congress has made Medicare incredibly complicated. In traditional Medicare, there is Part A for hospital and skilled nursing care, Part B for outpatient care, Part D for drugs, and Medicare Supplemental Insurance or Medigap. Then, there is the Medicare Part C managed care Medicare Advantage program.
Choice is nice, but it leaves seniors and their families befuddled. Should I stick with traditional Medicare or sign up for managed care? If I choose managed care, how do I pick a plan? If I stick with traditional Medicare, should I buy Medigap insurance? If so, how much additional coverage do I need? What do I do if I am still getting retiree health insurance from my job? The questions go on and on. I hear them whenever I talk to consumer groups.
In truth, many members of Congress do not understand how Medicare works. But, of course, they have paid staff to help them comprehend the program. The rest of us are on our own, except for a handful of programs such as the SHIPs.
While, unfortunately, SHIPs vary in quality, they are one of the few places where you can get a human being to answer your questions. Otherwise, you are stuck with websites, many of which are less than objective—or accurate.
Congress could make SHIPs more effective, and perhaps encourage local operators to do a better job training volunteers and staff. But killing the program is the wrong answer.
This vote is not the last word. The full Senate will get a chance to restore the program and, sometime next fall, Congress and the Obama Administration will negotiate final spending numbers for the entire budget. But the committee approved killing SHIP with a big bipartisan majority. It was not a good sign.
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