Summary

In response to a congressional request, GAO reviewed 14 legislative proposals that would provide coverage of catastrophic health care costs to determine the potential effects on Medicare beneficiaries.

GAO found that: (1) the bills would either place a limit on beneficiary liability for Medicare deductibles and coinsurance or attempt to provide for some of the costs not currently covered under Medicare; (2) the bills would apply catastrophic dollar limits only to physician services and hospital care; (3) most of the bills would leave the elderly at risk of high out-of-pocket costs, since they would provide limited protection for nursing home and home health care; (4) supplemental Medigap insurance policies cover only deductible and coinsurance for Medicare-covered services at the Medicare-approved rate; (5) most of the proposals would not relieve Medicare beneficiaries of their out-of-pocket physician charges; (6) of the 14 proposals, 9 would establish a catastrophic dollar limit above which the beneficiary would no longer be liable for Medicare deductibles; (7) although increasing health insurance coverage for the elderly would provide relief from high out-of-pocket expenses, it would also increase Medicare payments; and (8) the bills that would provide extensive protection propose a variety of methods to spread the costs over either all Medicare beneficiaries or all taxpayers.