Cuts to Medicare Advantage Payments Face Opposition
A proposal to reduce reimbursements to private Medicare Advantage plans by as much as $50 billion to cover the cost of the State Children's Health Insurance Program and other programs "is all but dead," according to some Democratic lawmakers and congressional aides, AP/Long Island Newsday reports.
Medicare reimbursements for MA plans -- which cover extra benefits, such as vision and hearing tests and treatments -- are 12% more than reimbursements for the fee-for-service program for equivalent benefits.
In recent weeks, the National Association for the Advancement of Colored People and the League of United Latin American Citizens have sent letters to congressional leaders in opposition to the proposal.
NAACP Director Hilary Shelton in a March 14 letter wrote that the proposal would have a negative effect on the large number of low-income and minority Medicare beneficiaries who enroll in MA plans. She wrote, "Access to coordinated care and disease management services are especially critical to minorities who are more likely to suffer from common chronic health conditions, such as diabetes, asthma, respiratory disease and certain forms of cancer."
In a separate letter, LULAC President Rosa Rosales wrote that the proposal would "threaten access to comprehensive benefits, result in higher out-of-pocket health care costs and create financial barriers to care that will be particularly harmful for Hispanic seniors."
Some senators also have raised concerns about the proposal.
Sen. Chuck Grassley (R-Iowa) said, "There are a lot of blue states ... that have a lot of HMOs."
Karen Ignagni, president of America's Health Insurance Plans, said, "More and more members of Congress are having the opportunity to see how cuts would impact their beneficiaries."
However, House Ways and Means Health Subcommittee Chair Pete Stark (D-Calif.) in a memo to House Democrats wrote that elimination of the proposal would complicate efforts to expand SCHIP or increase coverage under the Medicare prescription drug benefit. In addition, Stark wrote that the private health insurers are "more worried about profits than patients" and that Medicare could find "less costly and more efficient ways" to provide benefits than MA plans (Espo, AP/Long Island Newsday, 4/15).
- Long Island Newsday: Newsday on Saturday examined how the debate over the proposal to reduce reimbursements to MA plans "is really a struggle over the future of Medicare itself and whether there will be a future for publicly supported universal health coverage." According to Newsday, the proposal could prompt private health insurers to end participation in Medicare, a move that would "be an inconvenience for the 19% who have such insurance" but would "strengthen traditional Medicare" (Friedman, Long Island Newsday, 4/14).
- Orlando Sentinel: The Sentinel on Sunday examined the cost of MA plans. According to Rich Morrison, vice president for government and regulatory affairs at Florida Hospital in Orlando, MA plans are "increasing the spend rate (of government dollars on Medicare), and we can't afford it." However, Michael Tuffin, senior vice president for AHIP, said that MA plans "are providing a better, comprehensive package (than conventional Medicare) and saving seniors out-of-pocket costs" (Wessel, Orlando Sentinel, 4/15).
- McClatchy/Wichita Eagle: McClatchy/Eagle on Monday examined how 3.3 million of the 4.4 million Medicare beneficiaries who lack prescription drug coverage likely qualify for a low-income subsidy for the Medicare prescription drug benefit. Volunteers and counselors "are having a tough time locating the remaining eligible people," McClatchy/Eagle reports (Pugh, McClatchy/Wichita Eagle, 4/16).