Medicare spending cap would reduce members' expenses, increase overall spending, study finds

A $5,000 out-of-pocket spending cap on Medicare would result in major savings for enrollees, but would also increase federal Medicare spending by $38.8 billion in 2023, according to a study published June 6 by the Urban Institute.

Five key takeaways:

  1. In 2023, 4.5 million Medicare members will face more than $5,000 in cost-sharing expenditures for care.

  2. Medicare members who spend more than $5,000 are estimated to see average cost sharing at $10,500 in 2023.

  3. If a $5,000 spending cap was implemented under current law, it would increase federal Medicare spending by 7.8 percent, or $38.8 billion. Part B and D premiums would likely be increased to fund the cap.

  4. Supplementary plan spending would likely decrease by $12.3 billion with a cap in place.

  5. Total spending on services for Medicare enrollees is estimated to increase by $14 billion, or 2.3 percent, in 2023.

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