Posted on 03/27/2025 8:09:24 PM PDT by SeekAndFind
During the continuing resolution fight, the drum the Democrats kept beating was that Republicans wanted to gut Medicare - despite the fact that Joe Biden's administration oversaw years of cuts to Medicare Advantage, the plan increasingly chosen by the nation's seniors. Dems won't characterize cuts to Medicare Advantage as Medicare cuts, though, because what they're really trying to do is eliminate Medicare Advantage as a way to push "Medicare for All."
Now that we're headed into the reconciliation process, where finding ways to keep Medicare solvent will be a top issue, at least one lefty is on record admitting that cutting Medicare Advantage really does equal cutting Medicare - and we have to keep reminding them of that.
Medicare Advantage is an alternative to traditional "fee for service" (FFS) that offers additional benefits and more comprehensive medical care management, and is now used by more than half of Medicare enrollees, according to the Kaiser Family Foundation. Because it gives more choice and flexibility, the Bernie Sanders/Elizabeth Warren wing of the Democrat party don't like it one bit, and ensured that there were cuts to the program in both 2023 and 2024 - claiming that it is too costly.
As Biden staffers were on their way out the door they instituted a de facto third round of cuts, in the form of "underfunding and arcane rule-making," as Saul Anuzis writes at Washington Examiner. But, as Anuzis says, Team Biden also hosed Medicare Advantage enrollees in other ways:
Biden and congressional Democrats’ signature “Inflation Reduction Act” contained policies that resulted in a 39% hike in seniors’ Medicare Part D premiums. Biden and his coterie of advisers knew that was a huge liability heading into a close election where seniors are the most reliable voting bloc. So, his administration decided to take money out of Medicare Advantage to stabilize the stand-alone Medicare Part D market, resulting in less funding for Medicare Advantage in favor of original Medicare.
Now, Trump is left to govern in a situation where bad Biden policy has left those 54% of eligible enrollees who use Medicare Advantage facing a program even more drained of resources. In and of itself, that’s bad. But it’s even worse when you consider that Medicare Advantage is better for taxpayers and entitlement solvency than traditional Fee-for-Service Medicare.
During the budget continuing resolution fight, Democrats went full "Republicans are trying to cut Medicare and hurt poor people and push Grandma off a cliff," as usual. They left out the part where they and a few squishy Republicans (Sen. Bill Cassidy and Rep. Greg Murphy) are actively trying to cut Medicare by cutting Medicare Advantage - and they'd cut Medicare Advantage altogether if they could, relying on flawed studies from lefty think tanks and a politicized Medicare Payments Advisory Committee (MedPAC).
In reconciliation, Warren and crew will push for "changes" to Medicare Advantage, demonizing insurance companies and avoiding that other C word - cuts. (There's a lot to criticize there, to be sure, but there's a lot more fraud and waste in traditional Medicare.) Unfortunately, a "health policy expert" at Brookings Institute, one of those lefty think tanks creating anti-Medicare Advantage white papers, admits that they're pushing for cuts, but argues they're "good" cuts. From Axios:
- Republicans are already facing blowback over potential cuts to Medicaid, and adding Medicare would be even more politically dangerous, even if the changes in question are favored by many policy experts.
- "This is the Willie Sutton thing, right? This is where the money is," said Loren Adler, a health policy expert at Brookings, referring to MA.
- The political challenge, though, is that "the other party can say you cut Medicare without differentiating between, you know, good versus bad cuts," Adler added.
What about those criticisms of Medicare Advantage as costly? They're based on flawed studies that overemphasize some distinctions between MA and traditional Medicare, and ignore other distinctions. To describe it here would really get into the weeds, but when all of the variables are accounted for and properly weighted, numerous studies have shown that Medicare Advantage is both more cost-effective than traditional Medicare and leads to better outcomes for enrollees. A 2024 study from Elevance Health found:
In the last decade, growth in total Medicare program spending has been slower than predicted while Medicare Advantage (MA) enrollment has grown significantly.
This study found that higher MA penetration (i.e., percent enrolled in MA) is associated with lower total Medicare spending per capita, both across U.S. counties and year-over-year within a county.
In comparison to if MA penetration had stayed constant at 2011 levels, cumulative savings in total Medicare spending from 2012-2021 are estimated to be as high as $144 billion (in 2021 dollars).
If you're interested in those deeper dives, I recommend this piece from Health Affairs, this analysis from Avalere, and this analysis from FTI (published on industry advocacy group AHIP's website).
AHIP president Mike Tuffin told Axios:
"Thirty-four million Americans choose Medicare Advantage because it's far more affordable and delivers better outcomes than fee-for-service. We welcome the opportunity to build on the compelling success of Medicare Advantage and strengthen the program for the future."
Elizabeth Warren, Bill Cassidy, and Greg Murphy need to be clear with the American people that instead of proposing true accountability and the elimination of fraud and waste in Medicare/Medicaid, they're proposing cuts that would cause real harm to a majority of Medicare enrollees.
I am on Medicare advantage for 5 years and was very happy with it. But last 2 years they cut $1000 off from out of pocket expenses for vision, hearing and medical expenses.
Cutting when in fact it should go the other way, and companies should be able to offer a variety of options to seniors and Medicare rules would only apply to a basic policy.
Dems must have a hard time trying to steal from it.
I’m turning 65 this year and have been looking at medicare. At first, I thought of getting a MA plan, but I’m hearing they have high out of pocket costs nowadays. That the plans have really degraded and there are not that many plans offered where I live. That’s because of Joe Biden, not Donald Trump. So, I guess I’ll go with traditional medicare and a supplemental plan and a PDP.
Bookmark bump
I’m on standard Medicare plus a $0 premium Part D plan.
We’ve found Medicare Advantage a much better program than just plain medicare.
The solution is to get rid of fraud and waste, not require everyone over 65 to be on Medicare and then cut their benefits and force them onto a crap program that’s going to cost us more and the government less. Getting rid of the fraud and waste will accomplish what the democrats CLAIM to want without hurting those of us FORCED onto it.
“Under the Inflation Reduction Act, which was intended to cap out-of-pocket drug costs for Medicare beneficiaries, insurers are poised to significantly hike monthly premiums, with average bids for Part D plans expected to triple by 2025.
“In response to potential voter backlash, the CMS rolled out a three-year “demonstration project” to subsidize these premiums, aiming to keep them artificially low.”
Before you’re forced onto Medicare, if you have good insurance, refill any prescriptions you have, and get those last appointments and procedures done, and if you have optical and dental, get those taken care of while you can get decent reimbursements and the doctors don’t get cheated.
“She lived alone and was hospitalized five or six times within a year and a half. Basically, her Medicare Advantage insurance … refused to pay for her to go to a rehab facility after each hospitalization.”
“A survey of health systems by the Health Care Management Association revealed that 19% had stopped accepting one or more Medicare Advantage plans in 2023. And 61% reported that they were either considering or planning to stop accepting all Medicare Advantage patients within the next two years.
“The problem is nationwide, but more acute in some areas. In Minnesota, for example, nearly every major health system is refusing to do business with the three largest MA insurers, according to Kelli Jo Greiner, health care policy analyst and Medicare product manager with the Minnesota Department of Human Services.”
“By one estimate, taxpayers pay 22% more per Medicare Advantage enrollee than the cost of traditional Medicare.”
https://www.kiplinger.com/retirement/medicare/problems-with-medicare-advantage-plans-keep-mounting
Look into a part “G” plan
“Prior authorization protocols create real health risks for seniors. Diagnostic tests and medical procedures are often delayed and occasionally denied. These dangers were underscored in a report issued in April 2022 by the Inspector General of the Department of Health and Human Services. This report showed that one in 10 treatments that had been denied and one in five denied payments would have been covered by traditional Medicare. In short, insurers were simply not following Medicare guidelines for care. The report also showed that fully 75% of all medical services that were denied via prior authorization were overturned upon appeal, resulting in unnecessary and dangerous delays in patients getting care.
“For all of this, Medicare Advantage plans haven’t saved the federal government any money. Although some 48% of eligible seniors are enrolled in Medicare Advantage plans, the insurance companies offering them are gobbling up 55% of total Medicare spending.”
https://www.statnews.com/2022/11/15/replace-medicare-advantage-failure-with-medicare-part-f/
We have Aetna Medicare Advantage and there were not too many cuts to our coverage this year. The drug deductible went up from $350 to $590. Tier 3 drugs went up. My asthma inhaler went from $47 to $66. Dental and vision did not change. All in all its fantastic insurance. We have no complaints.
I stayed completely away from it because in severe, multiple hospital procedures, stays and visit eat away at the
‘advantange’. IMO, it’s good for healthy older Americans but when your multiple medical problems start it’s higher costs to you. That’s why I’m on my grandfathered Plan F plan. High monthly cost for me but no out of pocket expenses and I’ve yet to pay a penny on over a million dollars of hospitals stays.
Yes, Part G MediGap is preferable to those who may be more mobile or rural. MA is better for those with their roots firmly planted in one location or on a very tight budget.
This was all so confusing until I consulted a professional. It’s really not that confusing with the proper help.
EC
Yes, I consulted a professional also (who happens to be a family friend)..
She said, I can get you a suppliment plan and make a great commission off of it, but i’m not going to do that to you..
And I went with a part g plan.
I pay a little more in premiums, but I have yet to get more that a 247 bill (my deductible)...
I have not had a hospital or doctor bill in over 2 years
Excellent!
EC
I am a guy and I want to make sure I can get pregnant and be covered by medicare advantage. If not then it is racist or something....
#5 This is a thread from July 5, 2024
I used Boomer Benefits for help.
https://boomerbenefits.com
Many posting in the thread.
Supplement Medicare plan questions
https://www.early-retirement.org/threads/supplement-medicare-plan-questions.118457/
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