Summary

In response to a congressional request, GAO reviewed proposed legislation for providing catastrophic illness insurance coverage for the elderly.

GAO found that the proposed legislation would: (1) increase the number of hospital days for long-term care; (2) either eliminate or considerably decrease deductibles or coinsurance payments for those covered by Medicare; (3) only partially protect the elderly from catastrophic expenses; and (4) lower the copayment cap to $1,043. GAO also found that: (1) 91 percent of Medicare enrollees who apply for benefits would not exceed the cap and, therefore, would be ineligible for benefits; (2) the proposed legislation did not address long-term services, such as help in dressing, eating, and moving about; and (3) the legislation addressed issues such as prescription drugs, protecting sick persons or their spouses from impoverishment, and providing in-home personal care.