Tuesday’s Journal ran an unsigned editorial about the federal budget. Buried in the middle was one sentence about Medicare. One sentence is all it is.
Here is the whole proposal, quoted in full: “As for Medicare, Republicans could make privately managed Advantage plans the default.” Medicare Advantage — private insurance plans that deliver your Medicare benefits — would become the automatic choice.
Before that ruins anyone’s morning, read the editorial’s own next thought. It says Republicans “appear to lack ideas and the political will for reform.” The piece is not reporting a change. It is complaining that nothing is changing. There is no bill. There is no vote. This is an idea on an opinion page.
The deficit behind it
The editorial’s real subject is the deficit, not your Medicare card. The board was reading the Congressional Budget Office’s latest monthly budget review, and the numbers are not pretty.
The deficit for the first nine months of this fiscal year ran $35 billion above the same period last year. Medicare outlays rose $58 billion, or 8%. Medicaid rose $49 billion, or 10%. Net interest on the federal debt rose $98 billion — 13%. That is the pressure behind the sentence.
The board argues Advantage plans “do a better job of limiting wasteful and abusive spending” and “are popular among lower- and middle-income seniors because they offer more benefits at lower cost than traditional Medicare.” That is an opinion, offered in one paragraph. It is not a study, and the editorial never explains how a default would actually work.
The real homework
The same paper carried a second piece, and the byline matters. It was signed by Robert F. Kennedy Jr., the health secretary, and Dr. Mehmet Oz, who runs the Centers for Medicare and Medicaid Services.
That is not neutral reporting. It is two sitting officials defending a policy they themselves adopted, in a lawsuit where Kennedy is the named defendant — City of Columbus v. Kennedy. Read it as their side of an argument, because that is what it is.
Their subject is the marketplace health plan many people use in the years before Medicare starts. Enrollees take advance premium tax credits — money paid out during the year to shrink your monthly premium, based on the income you expect to earn.
Then you settle up. As Kennedy and Oz put it: “Federal law requires every recipient to file a tax return at the end of the year and reconcile what he received against what he was actually owed.” To reconcile — match what you got against what you actually earned — you have to file. The IRS wrote the rule and it has been enforced since 2012.
What changed is the grace period for people who do not file. The original rule cut off non-filers after one year. In 2023 the Biden administration stretched that to two years. Kennedy and Oz say they have put the one-year standard back.
That is being fought over right now. By their own account, the group Democracy Forward “immediately ran to court,” and no ruling has come either way. So one year is the administration’s position, not settled law.
What to do
On the Medicare side: nothing. An idea on an opinion page is not a change to your coverage, and the same editorial admits nobody has the will to pursue it. If a real proposal ever moves, it will not arrive quietly.
On the marketplace side, there is a real to-do, and it wins no matter who wins the lawsuit. If you take advance premium tax credits, file your tax return and reconcile it. Every year. The cost of skipping is your subsidy.
If you are bridging the years before Medicare on a marketplace plan, bring that year’s return and your income estimate to your next review. That one habit is worth more than any headline about what Congress might someday do.