The idea was floated among lawmakers during a closed-door meeting on Wednesday and then again when Senate Finance Committee members met with President Trump late Wednesday afternoon.
The Congressional Budget Office released a report this week estimating that the House-passed 1,116-page bill would add $2.4 trillion to the national debt over the next decade, and senators are looking for ways to save more money.
Changes to Medicaid have proven contentious, and Medicare is often considered a political third rail.
Sen. Josh Hawley (R-Mo.) said Senate Republicans would be crazy to seriously consider Medicare changes to help offset more of the cost of the sweeping tax and spending bill currently being debated.
“No. Why would we?” Hawley told reporters Thursday. “If you never want to win another election again, sure, let’s do that. After George W. Bush tried to privatize Social Security in 2004 Republicans didn’t win the popular vote for 20 years. Let that sink in.”
But senators said they are looking for ways to root out waste, fraud and abuse, without cuts to beneficiaries.
One possibility? Bipartisan legislation sponsored by Sens. Bill Cassidy (R-La.) and Jeff Merkley (D-Ore.) that aims to reduce overpayments to private Medicare Advantage plans.
The legislation would crack down on a practice called “upcoding” where insurers classify patients as sicker so the government will reimburse them at a higher rate.
Sen. Lisa Murkowski (R-Alaska) said targeting Medicare Advantage shouldn’t negatively impact beneficiaries.
“There’s been some discussion about upcoding and Medicare Advantage. Is that ‘touching’ Medicare? Yeah, but is it something that would cause alarm to a Medicare recipient?” she said.
There’s bipartisan interest in going after Medicare Advantage plans for upcoding; Sen. Elizabeth Warren (D-Mass.) highlighted the issue in March, during Mehmet Oz’s confirmation hearing to become administrator of the Centers for Medicare and Medicaid Services.
But using it to pay for Trump’s tax cut extension won’t get much applause from Democrats. And it’s likely to invite the ire of the health insurance industry.
