Medicare Advantage seems to work for the 16 million who signed on to this form of managed Medicare. And it’s appealing to many more.
More than half of those who enroll in Medicare for the first time, choose a Medicare Advantage plan. Private insurers like United Healthcare or Humana set up and run the plans. But this year insurers made surprise changes and dropped doctors and healthcare providers in some areas. That prompted a public outcry.
The House Ways and Means Committee held a Capitol Hill hearing on the future of Medicare Advantage. With Republicans and Democrats at odds about practically everything, you can bet there was little agreement about what works and doesn’t in the world of Medicare Advantage.
Texas Republican Congressman Kevin Brady opened the hearing with the dire analysis that the Affordable Care Act has harmed Medicare Advantage and will continue to do so.
The Affordable Care Act called for lower payments to insurers and sharpened the rating system about performance and delivery of services. You’d think that would be a welcome idea. Instead, critics of the Obama administration suggest this will lead to higher payments for Medicare recipients.
At the hearing, Dr. Robert Book a health policy analyst with the right-leaning, think tank, American Action Forum said, “Every beneficiary will experience some combination of higher co-payments, higher deductibles, a higher premium in excess of the Part B premium, reduced plan benefits services, and or smaller network providers.
But the sky is falling theory was challenged by the testimony of Medicare Rights Center President Joe Baker. He said, “The ACA (Affordable Care Act) strengthened the program for future and current enrollees. In addition to improving Medicare’s overall financial outlook, the ACA enhanced MA (Medicare Advantage) through added benefits, fairer cost sharing, and improved plan quality.”
Baker pointed out that streamlining the system wouldn’t hurt. And in fact, callers to the Medicare Rights Center’s helpline, and those who’ve talked to ConsumerMojo complain about the complexity of choices that leads to confusion.
Baker suggested that Congress fund state health insurance assistance programs fully so that they can help confused consumers. In addition, he also called for the passage of the Medicare Advantage Participant Bill of Rights Act.
The bill was introduced in June of 2014 by Democratic Congresswoman Rosa De Lauro of Connecticut and Democratic Senator Sherrod Brown of Ohio.
The act aims to prevent insurers from dropping doctors and other healthcare providers from their plans mid-year and causing havoc for consumers who are locked into Medicare Advantage plans.
When they introduced the plan Senator Brown said, “This bill would protect patients by making sure Medicare Advantage plans do not remove providers without warning or during the middle of a plan year.”
And Representative De Lauro suggested money, not quality, affected decisions to drop doctors and providers. “Congress has to hold these companies accountable, and make sure they are putting the care of their enrollees ahead of their profits.”