These overpayments have allowed Medicare Advantage plans, which provide regular Medicare benefits and fill in the coverage gaps, to also offer seniors a bunch of extra benefits like dental care, chiropractors’ visits, and free gym memberships. It’s no wonder they’ve become popular, despite drawbacks like limited provider networks and large copayments that many seniors don’t discover until they get sick. (In fairness, these excess payments aren’t the only factor behind the planned cut, Politico’s Haberkorn reports.)
Wasik’s article makes clear that AHIP is the driving force behind the “grassroots” Coalition for Medicare Choices. When I first reported on the group in 2007—another time when politicians and policy wonks were attacking the overpayments to Medicare Advantage plans—the Coalition’s address was the same as that of a public relations counseling firm whose members included AHIP, Humana, and United Healthcare, big sellers of Medicare Advantage plan. Even today, the Coalition “doesn’t have a separate office from AHIP,” AHIP spokesman Robert Zirkelbach told the Medicare NewsGroup.
Besides revealing the Astroturf nature of the contacting-your-members-of-Congress campaign, there was more in the PR push for the press to examine. For example, AHIP hired North Star Opinion Research to survey seniors who have Medicare Advantage plans and those who have traditional Medicare. The headline of one press release notes, “Nine out of Ten Seniors Satisfied with their Medicare Advantage Coverage.” A close look at the release shows that those in traditional Medicare were equally satisfied.
Drill down to the survey data, and you’ll see that seniors’ satisfaction is pretty comparable in specific areas such as quality of care and scope of benefits, too. Medicare Advantage does have an edge in some cases, like drug and preventive care coverage—but traditional Medicare actually does better on managing chronic illness, one of AHIP’s big talking points for joining a Medicare Advantage plan.
The few press accounts there have been about the battle have not gotten into these details. For example, a Reuters piece about the TV ad campaign faulted the AHIP commercials for failing to mention that cuts will hit insurers, not beneficiaries. It’s good to see the press focus on the industry’s financial stake—but it’s likely that the payment reductions will get passed along to patients as higher premiums, just as the industry warns. The threat to insurers is then, as Wasik’s article notes, that as federal subsidies fall and prices rise, seniors will opt for traditional Medicare. Many plans are also likely to leave the market—which might not be a bad thing, as some markets have more choice than consumers can possibly handle.
Elsewhere, Fox News Business naturally took a business angle, examining the effects on insurers. Beltway newspaper The Hill has been on the story, covering it in bits and pieces.
But deeper issues have been missing, starting with this sad irony: even as a lobbying group with oodles of cash seeks to protect its bottom line while professing concern for one slice of beneficiaries, no one except a few advocacy groups without much money is expressing the same concern for the vast majority of the Medicare population, many of whom have traditional Medigap policies. These policies are under attack in Congress because they cover too much, and lawmakers want seniors to pay more of their own money before Medigap would be allowed to pay. Congress may outlaw Medigap policies altogether.
In the end, who will take the biggest hit? And what is the game plan here—to push everyone into privately-run Medicare Advantage plans? To prop up insurance company profits by overpaying them? It seems like these are fundamental questions for reporters to investigate—perhaps after they’ve explained to their audiences what, exactly, the Coalition for Medicare Choices is.
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