Insurers Push Back After CMS Cracks Down on Reform Communications
On Tuesday, health insurance company representatives and some Republican lawmakers criticized the Obama administration for what they consider to be a "gag order" on insurers on communication with their members regarding health reform legislation, CQ HealthBeat reports (Norman, CQ HealthBeat, 9/22).
The criticism comes in response to a request from HHS officials on Monday that health insurance companies stop sending their members mailings that provide "misleading and confusing" information about proposed health reform legislation and its effect on Medicare benefits and services.
In a memo to insurers, a senior HHS official also warned the companies that have disseminated the information about possible enforcement action. The memo stated that "such communications are potentially contrary to ... federal law."
The federal government has regulatory authority over communication between health insurers and their members.
Last week, Senate Finance Committee Chair Max Baucus (D-Mont.) requested that HHS look into a letter from insurer Humana to its Medicare enrollees. The Humana mailings stated that reform proposals could compromise care for "millions of seniors and disabled individuals" who "could lose many of the important benefits and services that make Medicare Advantage plans so valuable."
The Finance Committee's draft reform bill would impose direct payment cuts to MA plans.
CMS sent a letter to Humana last week and ordered the company to cease the mailings (Hilzenrath, Washington Post, 9/23).
Pushback From Republican Lawmakers
However, in a letter sent Monday to acting CMS Administrator Charlene Frizzera, House Ways and Means Committee ranking member Dave Camp (R-Mich.) expressed his "deep suspicion" that the agency might be using its authority to "intimidate and silence" groups that are trying to provide "legitimate facts" about the proposed Medicare cuts.
Senate Minority Leader Mitch McConnell (R-Ky.) and House Minority Leader John Boehner (R-Ohio) also criticized HHS' action (CQ HealthBeat, 9/22).
McConnell said, "We cannot allow government officials to target individuals or companies because they do not like what they have to say," adding, "Is this what we believe as a Senate -- that this body should debate a trillion-dollar health care bill that affects every American while using the powerful arm of government to shut down speech?"
Robert Zirkelbach, a spokesperson for America's Health Insurance Plans, said, "Seniors have a right to know how the current reform proposals will affect the coverage they currently like and rely on," adding that if the proposed benefits cuts are enacted, "seniors will face premium increases, reduced benefits, and, in some parts of the country, will lose access to their Medicare Advantage plan altogether" (Washington Post, 9/23).
CBO Director Casts Doubt
In related news, Congressional Budget Office Director Douglas Elmendorf on Tuesday said that benefits for seniors under Medicare's managed care plans could face reductions under the Finance Committee's draft bill, contradicting President Obama's promise that there would not be such cuts, the AP/Miami Herald reports (Werner, AP/Miami Herald, 9/22).
The proposed legislation would directly reduce payments to MA plans by about $123 billion over 10 years and indirectly reduce funding for those plans by an additional $15.6 billion, according to CBO (Washington Post, 9/23).
Elmendorf said the proposed payment cuts to Medicare in the bill "would reduce the extra benefits that would be made available to beneficiaries through Medicare Advantage plans." He added that MA plans could lose as many as 2.7 million beneficiaries over the next 10 years, noting that many of those would be potential enrollees who opted not to sign up for the plans because of the changes.On Tuesday, White House spokesperson Reid Cherlin issued a statement defending the administration's approach (AP/Miami Herald, 9/22). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.