The Medicare Catastrophic Coverage Act of 1988 (MCCA)

The Medicare Catastrophic Coverage Act of 1988 (MCAA) is 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. It was the first bill to significantly expand Medicare benefits since the program's inception.

Although the bill passed easily with initial support, the House and Senate repealed it in response to elderly people’s widespread criticism of the bill.

A supplemental premium that individuals eligible for Medicare Part A paid was meant 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 to not cause hardship for less wealthy enrollees. These two characteristics represented a departure from previous methods of financing social insurance programs in the United States.

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.

Medicare is a complex and weighty federal program that taxpayers help pay 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. In 2018, the Medicare tax was 1.45% on the first $200,000 of wages ($250,000 for joint returns; or $125,000 for married taxpayers filing a separate return). According to Code Sec. 3101(b)(2), for wages that exceeded $200,000 (still $250,000 for joint returns; or $125,000 for married taxpayers filing a separate return), Medicare tax was 2.35%.

Medicare tax is similar to social security tax, which is also taken out of employees’ paychecks. As of 2018, the social security tax was 6.2% on the first $128,700 of wages (although the maximum tax is $7,960.80). Half of the tax is also paid by the employer. The Social Security tax rate is assessed on all types of income that an employee earns including salaries, wages, and bonuses.