To: Ms. Marilyn Tavenner, Administrator, CMS
From: 40 Senators – 21 Republicans and 19 Democrats
United States Senate, February 14, 2014
Excerpts
We write to raise serious concerns about the Medicare Advantage (MA) 2015 rate notice and the impact further cuts may have on the millions of individuals enrolled in the program. We are strongly committed to preserving the high quality health plan choices and benefits that our constituents receive through the MA program. Given the impact that payment policies could have on our constituents, we ask that you prioritize beneficiaries’ experience and minimize disruption in maintaining payment levels for 2015.
MA has been a great success and should remain a competitive choice for our constituents. Unfortunately, continued regulatory changes that affect the program’s funding, year after year, create disruption and confusion among beneficiaries who are looking for consistency and predictability.
While we are very supportive of your decision to assume a “doc fix” in the 2014 MA rate calculation and urge you to continue it this year, the MA program still experienced a real payment cut in 2014, not simply reductions in rates of projected growth.
We urge you to maintain payment levels that will allow MA beneficiaries to be protected from disruptive changes in 2015.
(Signatures of 40 Senators – click link to see names)
http://www.ahipcoverage.com/wp-content/uploads/2014/02/Bipartisan-Senate-MA-Letter-to-CMS-2015.pdf
Comment:
By Don McCanne, M.D.
AHIP, the health insurance lobby organization, has been conducting an intensive campaign to prevent the reductions in overpayments to the private Medicare Advantage plans – reductions required by the Affordable Care Act. A hint at how successful their campaign has been can be inferred from the fact that this letter from 40 senators, calling for perpetuation of the overpayments, but using AHIP rhetoric, was downloaded from the AHIP website.
If you read the entire letter you will see that it is filled with AHIP marketing phraseology touting the Medicare Advantage plans – distorting the benefits of these private plans. Democrats can’t blame Republicans for this one. Democratic politicians are very much a part of this conspiracy.
Last year the scheduled reductions were countered by increasing quality rewards to MA plans that had not earned them. This year, the reductions were partially countered by an accounting gimmick assuming a “doc fix” to scheduled reductions in Medicare payments, even though no such fix has been enacted. AHIP wants these “doc fix” increases to continue.
In a press release, AHIP President and CEO Karen Ignagni said, “CMS should protect seniors in the program by maintaining current payment levels next year,” even though there is no basis for them. Private insurers have promised lower costs, they have claimed lower costs, yet their costs are higher than for comparable patients in the traditional program.
Why should we care? The most obvious reason is that it is our tax funds that are being given to these private health plans, paying them more than it costs us to provide care in the traditional Medicare program. A much more important reason is that enrollment in these plans continues to expand, opening the door to converting Medicare into a “premium support” program (vouchers) for a market of private plans. Traditional Medicare will then be allowed to wither as an underfunded welfare program, and perhaps eventually be abolished. Then the value of the premium support vouchers will be allowed to diminish, shifting more health care costs to the beneficiaries.
If these 40 senators really cared about their Medicare beneficiaries, instead of asking CMS to overpay the private insurers, they would pass legislation to increase coverage for those in the traditional Medicare program in order to protect them from excessive out-of-pocket costs that currently require medigap or employee retiree health benefit coverage. Why should those in the private plans receive greater benefits when we’re all paying for them?
For single payer supporters who like to use the “Improved Medicare for All” designation, it is imperative that the traditional Medicare program be protected so that the public can understand that it is nominally a framework on which single payer improvements can be built.
For the time being, instead of Congress insisting on paying more to the private MA plans, we should demand that they move those overpayments to the traditional Medicare program where they’ll be put to better use in reducing financial hardship, rather than giving them to the private insurers to squander on gym memberships or whatever else might be used to market their plans.
