A Recently Introduced House Bill Aims to Prevent Private Insurers From Further Exploiting Medicare
It's just one more item in the list of reasons to vote for Democrats this fall and keep the GOP as far away from the ability to do any more harm.
A few months ago, I was having some work done on my house.
The professional completing the work is someone I have known literally my whole life. He is well-spoken, honest, efficient, intelligent, and is as progressive as I am, which makes our occasional political conversations comfortable.
This particular day, though, our conversation about health insurance and Medicare started to get tense.
I could see my friend’s expression morphing from one of affable interest into genuine annoyance, so I quickly changed the subject.
What was it I said that made him so agitated?
I simply informed him the Medicare Advantage plan he was on is not Medicare.
“But Medicare is in the name,” he puzzled.
“Yes,” I said. “That’s the problem.”
Since its passage in 1965, Medicare has been on the list of items at which the republican party, and even some members of the Democratic party, have been steadily chipping away.
The George W. Bush administration landed a major blow to it in 2003 with the passage of the “Medicare Modernization Act” that created something called “Medicare Advantage” under Medicare’s Part-C provision.
The following year risk-adjusted large-batch payments offering Advantage plans started to make insurance companies even more insanely rich.
But the “Medicare” label is a ruse.
Medicare “Advantage” isn’t Medicare.
It’s private for-profit health insurance that fools recipients like my friend and millions like him into believing they are enrolled in Medicare.
More people are catching on to the scam, and two Democratic lawmakers just submitted a bill to strip the sacrosanct “Medicare” label from it.
California Rep. Ro Khanna and Wisconsin Rep. Mark Pocan this week introduced the “Save Medicare Act” designed to re-brand “Medicare Advantage” plans, prohibit private insurers from using the “Medicare” label in plan titles or advertisements, and fine insurers that do.
Rep. Khanna explained:
“‘Medicare Advantage’ is just private insurance that profits by denying coverage and the name is being used to trick seniors into enrolling. That’s not right.”
Rep. Pocan added:
“Only Medicare is Medicare. It is one of the most popular and important services the government provides. We should be working to expand this service to include coverage for dental, vision, and hearing care, as well as looking at ways to strengthen it rather than allowing these ‘Medicare Advantage’ programs to provide pale alternatives to what Medicare does. These non-Medicare plans run by private insurers undermine traditional Medicare. They often leave patients without the benefits they need while overcharging the federal government for corporate profit. This bill eliminates any confusion about what is — and what is not — Medicare, and ensures this essential program will continue to serve seniors and other Americans for years to come.”
According to The New York Times:
“8 of the 10 largest Medicare Advantage insurers — representing more than two-thirds of the market — have submitted inflated bills…and four of the five largest players — United Health, Humana, Elevance, and Kaiser — have faced federal lawsuits alleging that efforts to over-diagnose their customers crossed the line into fraud.”
Progressive talk show host and author of The Hidden History of American Healthcare: Why Sickness Bankrupts You and Makes Others Insanely Rich, Thom Hartmann, wrote:
“Medicare Advantage is a massive, trillion-dollar rip-off, of the federal government and of taxpayers, and of many of the people buying the so-called Advantage plans.
“It’s also one of the most effective ways that insurance companies could try to kill Medicare For All, since about a third of all people who think they’re on Medicare are actually on these privatized plans instead.”
As reported recently in Axios, according to Centers for Medicare & Medicaid Services (CMS), “Complaints about aggressive marketing tactics and other issues connected with private Medicare plans are surging.”
It adds:
“While enrollment in Medicare Advantage has risen every year since 2007, according to a KFF report, so, too, have questions about the quality of care and whether the program is becoming a haven for high-pressure sales tactics and scammers.”
Senate Finance Chair Ron Wyden (D-Ore.) has initiated an investigation in which he is requesting information from 15 state regulatory agencies about false or misleading marketing.
House Ways and Means Health Subcommittee Chair Lloyd Doggett (D-Texas) is on it as well. He and 30 additional other Democratic House members are recommending changes to private Medicare plans that include addressing aggressive and misleading marketing tactics.
Writing to CMS administrator Chiquita Brooks-LaSure, House members explained:
“Aggressive sales tactics have left vulnerable seniors and people with disabilities susceptible to being misled and unwillingly steered into Medicare Advantage plans.”
Sen. Wyden stated:
“I’ve been concerned about the growing number of complaints that have been reported. I’ve really come to the conclusion that not all MA [Medicare Advantage] is created equal. There’s some that is quite good and there are some ones that we have some questions about, and that’s what we’re doing.”
Americans are finally catching onto the scam.
The ultimate goal, besides the profit motive, is to migrate so many Americans away from traditional Medicare that republican lawmakers can then seem justified in putting a knife in Medicare permanently.
Fortunately, we have Democrats working to prevent that.
It’s just one more item in the list of reasons to vote for Democrats this fall and keep the GOP as far away from the ability to do any more harm.