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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsMedicare Advantage plans may face cuts
http://hosted.ap.org/dynamic/stories/U/US_MEDICARE_ADVANTAGE_PLANS?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2014-02-22-03-52-55Feb 22, 3:52 AM EST
Medicare Advantage plans may face cuts
By RICARDO ALONSO-ZALDIVAR
WASHINGTON (AP) -- Cuts are on the table next year for Medicare Advantage plans, the Obama administration says. The politically dicey move affecting a private insurance alternative highly popular with seniors immediately touched off an election-year fight.
The announcement gave new ammunition to Republican critics of President Barack Obama's health care law, while disappointing some Democratic senators who had called on the administration to hold rates steady. Insurers are still hoping to whittle back the cuts or dodge them altogether.
Late Friday after financial markets closed, Medicare issued a 148-page assessment of cost factors for the private plans next year. It included multiple variables, some moving in different directions, but analyst Matthew Eyles of Avalere Health estimated it would translate to a cut of 1.9 percent for 2015, a figure also cited by congressional staffers briefed on the proposal.
"There's nothing to like here if you're one of the plans," said Eyles.
djean111
(14,255 posts)truebluegreen
(9,033 posts)because private enterprise is SO much more efficient. That is not how it worked out.
Private health plans, now called Medicare Advantage plans, were first allowed to participate in Medicare because some policymakers believed they could provide better services at a lower cost than traditional Medicare. In fact, because it was anticipated private plans would be so efficient, the government initially paid them five percent less for each beneficiary they enrolled than it would have cost to cover that same beneficiary in traditional Medicare.
In 25 years time, the powerful health insurance industry lobby has been extremely successful in turning this rationalization on its head. Instead of paying private plans less to reflect the efficiencies they argued would save the government money, Medicare now pays them significantly more than it would cost to cover the same beneficiaries through traditional fee-for-service Medicare. In fact, today the government pays an average of 14 percent more to cover a beneficiary in a private Medicare Advantage plan than it would cost to cover that same beneficiary in traditional Medicare.
The ACA cut costs by eliminating subsidies for Medicare Advantage. But of course, Republicans don't care about saving money, they only care about making Obamacare look bad.
El_Johns
(1,805 posts)pharmacorps.
Bluenorthwest
(45,319 posts)Act of 1997. Bush was elected in 2000. Bush got Part D passed, the drug benefit boondoggle, which is a different thing entirely.
El_Johns
(1,805 posts)Hoyt
(54,770 posts)freshwest
(53,661 posts)Hoyt
(54,770 posts)They get a monthly payment from the government per beneficiary, and some extra if really sick folks sign up. One advantage to these plans is they have to have a cap on out of pocket costs, which traditional Medicare does not unless you buy a supplement.
freshwest
(53,661 posts)TheKentuckian
(25,035 posts)pnwmom
(109,021 posts)Still, if they're popular maybe Obama should back off.
spin
(17,493 posts)Medicare Advantage plans are VERY popular with many who are on Medicare and the elderly VOTE!
Not surprisingly many Senate Democrats oppose the suggested changes.
February 20, 2014, 05:13 pm
Dems warm up to Medicare Advantage
By Jonathan Easley and Mike Lillis
Senate Democrats are mounting a surprisingly strong defense of Medicare Advantage, a private insurance option that their party used to deride as a wasteful giveaway to insurance companies.
Nineteen Senate Democrats this week signed a letter to the Centers for Medicare and Medicaid Services (CMS) warning of dire consequences for seniors if cuts to Medicare Advantage (MA) go through as expected later this month.
The rising tide of Democratic support is led by heavyweights including Sens. Charles Schumer (D-N.Y.) and Michael Bennett (D-Co.), as well as vulnerable Democrats facing reelection such as Sens. Mark Pryor (D-Ark.) and Mary Landrieu (D-La.).
Liberals have historically lampooned the alternative to government health insurance as receiving outsized federal support in comparison to Medicare. In keeping with this, the Democratic-led Congress that passed the healthcare reform law partially paid for it by enacting $200 billion in cuts to Medicare Advantage over 10 years.
Read more: http://thehill.com/blogs/healthwatch/medicare/198851-dems-warm-up-to-medicare-advantage#ixzz2u86GGivu
Recursion
(56,582 posts)This is one Medicare cut we should make without hesitation.
Bluenorthwest
(45,319 posts)Can you offer a compare and contrast of Advantage Plans in Texas and in Oregon? Or are you just riffing?
spin
(17,493 posts)I retired and am now on Medicare coupled with a Medicare Advantage plan. I am far happier with this than I was with my previous plan.
I had an operation last year that involved numerous visits to doctor's offices and a lot of expensive tests. After the operation, I had to stay overnight in cardiac intensive care. My total cost for all the doctor's office visits, the tests and the operation totaled $0.00.
In my opinion we should have Medicare for all or universal healthcare. That's what I was hoping for when I voted for both Clinton and Obama. It appears that instead of a world class healthcare system, the ACA could currently be described as a boondoggle. Some say that the cuts to the Medicare Advantage programs are to help finance the ACA. If so, I'm sure money to support the ACA can be obtained in many different ways and it seems somewhat unfair to place a burden on the elderly like me who live on a fixed income and most need reasonably priced health care to support a poorly designed and implemented program that many Americans seem to dislike.
I'm sure an extremely high percentage of those who have Medicare Advantage programs agree with me.
Recursion
(56,582 posts)The whole program is one big scam.
ProSense
(116,464 posts)From the OP:
Medicare Advantage cuts are to overpayments to insurance companies.
by Liberty Equality Fraternity and Trees
As you may remember, on Friday, Bernie Sanders (I-VT) and fifteen Democratic senators sent a letter to the White House urging the president not to include any cuts to Social Security, Medicare, or Medicaid in his budget. Many of us were disappointed or troubled by the fact that only 16 senators had signed onto the letter, especially as it had been circulating for a month.
Well, that same day, 19 Democrats joined a group of 21 Republicans to protest cuts in Medicare advantage in a letter to Marilynn Tavenner, Administrator of the Centers for Medicare and Medicaid Services.
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.
That's right: More Democrats care about cuts to Medicare Advantage than about cuts to Medicare itself.
Medicare Advantage plans are private plans run by insurance companies but paid for by Medicare. They began as Medicare+Choice plans in 1997 but were renamed Medicare Advantage in 2003. MA plans are notoriously inefficient because they generate corporate profits rather than more efficient care. Payments to MA plans average about 14 percent more than the cost of providing the same care to beneficiaries in traditional Medicare. Overpayments in 2009 alone totaled $11.4 billion. The Affordable Care Act sought to address this problem by reducing the subsidies to these private plans, shoring up Medicare itself and saving money to fund other aspects of health care reform.
This reduction of overpayments, you may remember, was one of Republicans' favorite talking points in 2010 and 2012. Republicans, who themselves wanted to destroy the Medicare program by turning it all over to MA-style vouchers, lambasted Obama and the Democrats for "cutting Medicare" and were able to boost their numbers with seniors because of such deceptive messaging.
Now back to our 40 senators who are very concerned about the health of the health insurance companies.
Here are the 21 Republicans:
Lamar Alexander (R-TN)
Kelly Ayotte (R-NH)
Roy Blunt (R-MO)
John Boozman (R-AR)
Richard Burr (R-NC)
Dan Coats (R-IN)
Saxby Chambliss (R-GA)
Thad Cochran (R-MS)
John Cornyn (R-TX)
Mike Crapo (R-ID)
Mike Enzi (R-WY)
Lindsey Graham (R-SC)
Chuck Grassley (R-IA)
Dean Heller (R-NV)
Jim Inhofe (R-OK)
Johnny Isakson (R-GA)
Rob Portman (R-OH)
Pat Roberts (R-KS)
Marco Rubio (R-FL)
Tim Scott (R-SC)
John Thune (R-SD)
And here are the 19 Democrats:
Michael Bennet (D-CO)
Maria Cantwell (D-WA)
Bob Casey (D-PA)
Joe Donnelly (D-IN)
Kirsten Gillibrand (D-NY)
Kay Hagan (D-NC)
Heidi Heitkamp (D-ND)
Amy Klobuchar (D-MN)
Mary Landrieu (D-LA)
Joe Manchin (D-WV)
Ed Markey (D-MA)
Jeff Merkley (D-OR)
Bill Nelson (D-FL)
Mark Pryor (D-AR)
Chuck Schumer (D-NY)
Jeanne Shaheen (D-NH)
Mark Udall (D-CO)
Tom Udall (D-NM)
Mark Warner (D-VA)
Of these 19 Democrats, only two--Kirsten Gillibrand and Ed Markey--signed Sanders's letter as well.
http://www.dailykos.com/story/2014/02/19/1278733/-More-Democrats-Care-about-Protecting-Medicare-Advantage-Than-About-Protecting-Medicare
It's all kabuki.