Bush's Parting Shots to the Old and Sick, Part 1: A Gift to Privatized Medicare

| Wed Jan. 14, 2009 3:05 PM EST

Having spent eight years bypassing the laws of the land via signing statements, executive orders, or just simple denial, the Bush Administration is adding to its grim legacy with a rush of last-minute orders and rule changes. Compiled here by ThinkProgress, these include a number of actions aimed at the elderly, ill, and disabled--including cuts to Medicaid and disabled veterans' benefits. These last-ditch measures are likely to turn into some of the first political and policy challanges faced the Obama administration.

Some of Bush's parting shots are so low-profile that they might easily escape notice. The latest of these arrived on Friday in the obscure form of a "call letter" to private insurance companies that want to contract with Medicare to provide health and drug coverage in 2010. Such calls are issued annually. But this time the call letter was released two weeks earlier than it was last year, and two months earlier than the previous year--ahead of the changing of the White House guard. Medicare advocacy groups view the early release as "an attempt by the Centers for Medicare & Medicaid Services (CMS) to assure continued leniency in the oversight of private plans for at least another year and as a last-ditch effort to promote private Medicare Advantage plans."

Medicare Advantage (MA) plans--which offer managed care run through private insurers, paid for by the federal government--are the point of the stake that conservatives have long been trying to drive into the heart of traditional Medicare (which, for all its shortcomings, is the closest thing to a single-payer program that this country has ever seen). Columnist Saul Friedman recently wrote about the history of of this effort, recalling a 1995 press briefing in which Dick Armey, Newt Gingrich's collaborator on the "Contract With America," announced their intent to "wean our old people away from Medicare." The first step was to introduce private Medicare HMOs--what later evolved into Medicare Advantage plans, with a big boost from the Republicans' 2003 Medicare bill.

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