You need to distinguish between Medicare and Medicare Advantage. Medicare Advantage (MA) is the program where Medicare beneficiaries sign up with a private health plan and the govt pays the plan a per capita amount that is intended to cover the regular fee-for-service (FFS)Medicare benefits. The Medicare Advantage plan can then fill in some of the cost sharing, add additional benefits, and charge the member a premium.
Due to various changes in the law over time, the rates the govt pays MA plans have crept up over time relative to the FFS costs, so that now plans are being paid somewhere in the neighborhood of 114% of FFS costs. These additional payments get passed along to beneficiaries in the form of lower premiums and richer benefits. Of course, the govt paints it as the greedy health plans are lining their pockets.
There is definitely the political will to lower these payments and virtually everyone in the industry expects something to happen- at best payment rates won’t keep up with health cost trends. At worst, they will be cut significantly.
As a policy matter, you could argue that it is not fair that MA members are getting a greater subsidy than regular FFS members, and that payment rates should be cut. The reality though is that this will mean premium hikes and benefit cuts for MA members.
The Medicare and Medicare Advantage cuts will total almost $500 billion, and there has never been, is not now and never will be the political will to cut these benefits. Newt and the Repubs tried to slow the growth of Medicare in the 1990’s and were skewered by Clinton and the Dems. The Repubs were doing the right thing, but politically it was disastrous. History has a way of repeating itself.