Debate Over Medicare’s Private Plans Heats Up
While the Senate Finance Committee is still working on opening statements, the storm surrounding the Medicare Advantage program -- in which the government buys
Jul 31, 202026.8K Shares866.7K Views
While the Senate Finance Committee is still working on opening statements, the storm surrounding the Medicare Advantage program— in which the government buys insurance for Medicare patients from private insurance companies — is blowing up.
That’s because the agency that runs Medicare announced yesterdaythat it intends to investigate Humana for letters the insurance giant sent to MA-enrolled seniors urging them, according to the Centers for Medicare and Medicaid Services, to resist the Democrats’ plans to cut billions of dollars in overpayments to the program.
MA has been controversial because the cost to treat the average patient in the program is 14 percent higher than that to treat the average patient under traditional Medicare. Supporters of the subsidies — mostly Republicans and insurance companies — say the extra payments go to cover services not covered under the traditional program, like dental and eye care. But critics say those payments simply pad industry profit margins at the expense of taxpayers.
CMS says Humana may have violated an agency rule that MA information provided to seniors must first be screened by CMS officials.
“We are concerned that, among other things, the information in the letter is misleading and confusing to beneficiaries, who may believe that it represents official communication about the Medicare Advantage program,” Jonathan Blum, acting director of CMS’ Center for Drug and Health Plan Choices, said in a statement.
Republicans, however, are claiming a political witchhunt intended to influence the debate over health care reform. Rep. Tom Price (R-Ga.) head of the Republicans Study Committee, just issued a statement saying the administration “would clearly prefer America’s seniors be left in the dark” about the fate of their MA plans under the Democrats’ bills.
“„The President has admitted that the proposals being advanced in Congress would all make huge cuts to Medicare Advantage, so it is only reasonable that seniors on those plans know that their coverage is at risk. This gag order is nothing more than political bullying.
Senate Minority Leader Mitch McConnell (R-Ky.) echoed that sentiment from the floor of the upper chamber today.
“This is America,” McConnell said. “Citizens, either as individuals or grouped together in companies, have a fundamental right to talk about legislation they favor or oppose.”
Of course, for Republicans to decry the politicization of the federal Medicare agency is more than a little hypocritical. In 2003, as the GOP-led Congress was trying to push throughthe controversial creation of Medicare’s prescription drug benefit, it was the Bush administration that preventeda top Medicare actuary from revealing his cost estimates for creating the new program — estimates that exceeded others by hundreds of billions of dollars.
Paula M. Graham
Reviewer
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