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Sort of.

It's certainly easier to have CMS pass new regs then get a bill through congress. But both insurers and doctors are the recipients of that money and they are powerful lobbyists to keep the Medicare gravy train rolling. They tried to reduce trend on Medicare Advantage a year ago and they started running ads that CMS was secretly cutting Medicare.

Per capita medicare spending is in the short term going to be dominated by baby boomers retiring. Most Medicare spend comes at end of life so having more 65 year olds will temporarily lower per capita spend, but it can always go back up as they age.

Also, Medicare is subsidized by commercial insurance so eventually Medicare pay rates will have to rise as there are more Medicare members and fewer commercial payers.

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