Study: MA Enrollment Has Increased by 30% Since ACA Enactment
Enrollment in Medicare Advantage plans has increased by 30% since the Affordable Care Act was enacted in 2010 to a record 14.4 million beneficiaries, according to a report by the Kaiser Family Foundation and Mathematica Policy Research, The Hill's "Healthwatch" reports (Viebeck, "Healthwatch," The Hill, 6/10). The findings run counter to predictions that payment cuts to MA plans included in the ACA would reduce enrollment in the private Medicare plans.
The report found "little evidence" that the ACA has had an adverse effect on MA enrollment (Block, Modern Healthcare, 6/10). Mark Miller -- executive director of the Medicare Payment Advisory Commission -- said changes under the ACA "have put the plans under pressure to find efficiencies that in theory they ought to have been pursuing all along" (Adams, CQ HealthBeat, 6/10).
Enrollment in the private plans still lagged behind traditional Medicare, with just 28% of beneficiaries signed up for MA plans, a one-percentage-point increase since 2012. Minnesota had the highest enrollment in MA plans at 49%, while Alaska and Wyoming had the lowest, at 3% each.
In addition, the report indicated that relatively few insurers dominate the MA plan market. Five insurers offer plans that cover two-thirds of beneficiaries enrolled in MA plans, Modern Healthcare reports (Modern Healthcare, 6/10).
The report also found that the ACA cuts have helped close the gap between payments to MA plans and traditional fee-for-service Medicare: average payments to MA plans are now just 4% more than the traditional fee-for-service program, compared with 15% higher payments in the past.
Concerns Over Future Cuts
Researchers and other observers noted that future ACA cuts and other MA plan payment reductions could have a significant effect on MA plans, CQ HealthBeat reports.
The ACA calls for about $154 billion in cuts to MA plans through 2022, in addition to a tax on insurance premiums. In addition, lawmakers included $2 billion in payment reductions to MA plans as part of a deal to avoid the fiscal cliff earlier this year, and MA plans are subject to a 2% across-the-board cut under sequestration (CQ HealthBeat, 6/10).
"Over the next few years, it is possible there will be some shakeout in the market as payment reductions are implemented and benchmarks move closer to spending for traditional Medicare," the report stated, adding, "Ultimately, to remain viable, some plans either will have to become more efficient or modify the extra benefits they provide to their enrollees" ("Healthwatch," The Hill, 6/10).
Alissa Fox -- senior vice president with the Blue Cross and Blue Shield Association -- said the future payment changes are "a big concern" because "it's hard to see how you can keep the level of service, the level of cost sharing, the level of benefits stable because there are such huge cuts ahead" (CQ HealthBeat, 6/10).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.