What Is the Medicare Catastrophic Coverage Act of 1988 (MCAA)?

The Medicare Catastrophic Coverage Act of 1988 (MCAA) was a government bill designed to improve acute care benefits for the elderly and disabled, which was to be phased in from 1989 to 1993. The Medicare Catastrophic Coverage Act of 1988 was meant to expand Medicare benefits to include outpatient drugs and limit enrollees' copayments for covered services.

Key Takeaways

  • A year after enacting the Medicare Catastrophic Coverage Act of 1988, Congress was forced to retract the legislation due to widespread criticism.
  • Some found the wording of the bill regarding payment structures to be confusing, and so they pushed against it.
  • Many people find it hard to support changes to Medicare taxation as they feel that since they are paying out-of-pocket for their premiums anyway, they shouldn't be taxed an additional percentage.
  • Medicare tax is similar to Social Security tax, which is deducted as a payroll tax.

Understanding the Medicare Catastrophic Coverage Act of 1988 (MCCA)

It was the first bill to significantly expand Medicare benefits since the program's inception. Although the bill passed quickly with initial support, the House and Senate repealed it a year later in response to widespread criticism of the bill.

The MCCA was a supplemental premium that individuals eligible for Medicare Part A paid to finance the expanded coverage because of high federal budget deficits at the time. This supplemental premium was progressive, meaning that payments were gradual.

For this reason, it was designed not to cause hardship for less wealthy enrollees. These two characteristics represented a departure from previous methods of financing social insurance programs in the U.S.

One reason the bill failed was the lack of comprehensive information and clear communication in promoting this iteration in U.S. healthcare reform. The widespread misunderstanding of payment plans led to distrust and pushback against the bill.

MCCA and Medicare Wages

Medicare is a complex and weighty federal program that taxpayers help pay for with Medicare wages. These are generally taken out of the paychecks of U.S. employees on a regular basis. Controllers and individuals withhold a percentage from annual income.

Medicare Tax Rates

For 2022, the Medicare tax rate is 1.45% for the employee and 1.45% for the employer, or a total of 2.9%. Employers are responsible for withholding the 0.9% Additional Medicare Tax on an employee's wages that exceed $200,000 in a calendar year, regardless of filing status. There's no employer match for Additional Medicare Tax.

Medicare tax is similar to Social Security tax, which is also taken out of employees' paychecks. For 2022, the Social Security tax is 6.2% on the first $147,000 of wages.

Employers also pay a 6.2% tax on behalf of employees. The Social Security tax rate is assessed on all types of income that an employee earns, including salaries, wages, and bonuses.

Medicare Premiums

Those who paid into the Medicare program via taxes during their working years typically don't pay a premium for Part A (hospital insurance). However, the standard premium for Medicare Part B (diagnostic tests and outpatient care) is $148.50 per month (for 2021), except for those with higher incomes who may be charged a higher monthly premium.

As of September 30, 2021, the Centers for Medicare & Medicaid Services announced that Medicare Part D coverage (prescriptions) will cost $33 per month on average in 2022 versus $31.47 per month on average in 2021. The average premium in 2022 for Medicare Advantage plans will be $19 per month versus $21.22 in 2021.