As Congress turns its attention to a $3.5 trillion budget plan intended to bolster the safety net in America, lawmakers are apparently considering provisions that would undermine that very goal. According to reports, Medicare Advantage is being targeted to pay for other government spending, potentially severing the healthcare promises made to the 27 million seniors and people with disabilities who chose Medicare Advantage plans.
It seems history is repeating itself: Every time Congress moves to cut Medicare, seniors and people with disabilities revolt. Congress should not make the same mistake again.
Seniors and people with disabilities know that Medicare Advantage delivers better services, better access to care, and better value than traditional Medicare. That’s why the program remains overwhelmingly popular. A Coalition for Medicare Choices poll found that 92% of seniors with Medicare Advantage are satisfied with their integrated prescription drug coverage, and 93% are satisfied with their preventive services, such as screenings, vaccines, and testing. The same poll found that 95% of seniors with Medicare Advantage would recommend it to their family and friends — far more than those who would recommend traditional Medicare.
Seniors benefit from a wide array of services above and beyond traditional Medicare — including meal deliveries, transportation, and help navigating appointments, as well as support for better nutrition and safe, affordable housing. The COVID-19 crisis demonstrated just how important these services are to the health and well-being of millions of Americans.
Medicare Advantage saves money for seniors and those with disabilities by capping out-of-pocket costs. And the cost of Medicare Advantage continues to fall; premiums have dropped 34% from 2017 to their lowest point in 14 years. MedPAC data show that Medicare Advantage plans are more cost-effective than traditional Medicare in delivering the same services, and net improper payments in Medicare Advantage are less than one-tenth those of traditional Medicare.
Seniors also benefit from better health outcomes. One Health Affairs study found that Medicare Advantage patients require less follow-up care than those with traditional Medicare. Another study published in the National Institute of Health’s National Library of Medicine found that Medicare Advantage outperforms traditional Medicare on 16 out of 16 different clinical quality measures.
Despite these results, lawmakers are considering using Medicare Advantage to pay for adding new dental, vision, and hearing benefits in traditional Medicare. These are important benefits, but adding them to Medicare Part B is duplicative, and paying for them by cutting Medicare Advantage benefits is unfair to the tens of millions of seniors who actively choose to enroll in Medicare Advantage.
Why? Because today, 98% of all Medicare beneficiaries already have access to an integrated Medicare Advantage plan that covers dental, vision, and hearing. There are other options as well, such as individual dental policies; Medicare Supplement Insurance policies with dental, vision, and hearing coverage; employer-provided coverage for working seniors; and the Medicaid program in states where adult dental coverage is provided.
Further, Medicare Advantage is doing important work to advance health equity. Medicare Advantage covers more racially diverse populations than traditional Medicare, and 57% of enrollees are women. Approximately 40% of Medicare Advantage enrollees make less than $25,000 per year, and about 9 million have an income below 200% of the federal poverty level. For these individuals, the out-of-pocket costs of traditional Medicare might be unaffordable — but are capped in Medicare Advantage.
Moreover, a new analysis from Wakely Consulting Group shows that if Congress adds these benefits to traditional Medicare without adjusting the Medicare Advantage benchmark, a Medicare Advantage plan would, on average, have between 48% and 73% fewer dollars available to fund innovative benefits such as transportation, nutrition, in-home services and supports, over-the-counter medicines, or other benefits to improve health and address social determinants of health. That amounts to between $696 to $1,056 a year that a senior or person with disabilities would lose in added benefits if these cuts went into effect.
Medicare Advantage enjoys bipartisan, bicameral support in Washington. Just last year, 403 members of Congress signed a letter urging the Centers for Medicare & Medicaid Services to protect seniors from cuts to their Medicare Advantage coverage. Congress members support Medicare Advantage because their constituents support Medicare Advantage.
The 27 million seniors and people with disabilities are once again counting on Congress to protect Medicare Advantage. Congress should not jeopardize an efficient, effective, and popular healthcare program that serves so many Americans for their coverage and care.
Matt Eyles is president and CEO of America’s Health Insurance Plans, the national association for health insurance providers.
