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March 25, 2007 at 04:00 PM
Democrats in Congress are not planning to eliminate the Medicare Advantage program offered by insurers–despite their claims to the contrary–the chairman of the Health Subcommittee of the House Ways and Means Committee said on March 21.
“America’s Health Insurance Plans, Blue Cross Blue Shield and others have been falsely claiming that payment reductions will reduce health care access for lower- and moderate-income seniors–and decrying a goal they ascribe to me of wanting to get rid of the Medicare Advantage Plan,” said Rep. Pete Stark, D-Calif.
But, said Stark, a long-time critic of the program, “… neither should we allow any Medicare provider sector to wall itself off from both scrutiny and from consideration for payment changes. Doing so would be irresponsible for this committee.”
Stark made these comments in his opening statement at a hearing on the program, which Democrats called based on an analysis by the Medicare Payment Advisory Commission that indicates Medicare is, on average, overpaying Medicare Advantage plans by 112%.
Stark’s comments were made against the background of a full court publicity press by AHIP and others, including a coordinated print advertising campaign and release of a survey indicating that both patients and physicians would be concerned if Congress makes cuts to the program.
AHIP and the Blue Cross and Blue Shield Association both released statements at the hearing recommending that Congress continue support. “This hearing offers an excellent opportunity to reinforce for the Congress and the public the critical, value-enhanced health coverage private health plans provide to 8.3 million Americas,” said Scott Serota, president of the association, Chicago.
And–throughout more than 90 minutes of testimony, cross-examination by Stark and other members of the Committee, and an extensive data presentation–officials of the Centers for Medicare & Medicaid Services also voiced support for the program.
For example, in response to a question by Stark regarding the overpayment issue, Leslie Norwalk, acting administrator of CMS, said: “I wouldn’t call it an overpayment. I would call it a payment for added benefits.”
Democrats on the committee are seeking to use the MedPac recommendations to cut appropriations for Medicare Advantage going forward and use those funds to provide for or expand other healthcare programs, such as the State Children’s Healthcare Insurance Program (SCHIPS). That program is running short of money, and Democrats want to open it to adults–in some cases, going forward by using some of the alleged overpayments to Medicare Advantage providers to pay for it.
In testimony about the program, MedPac officials contended that Medicare Advantage “has become a program in which there are few incentives for efficiency.”
“Although Medicare Advantage uses ‘bidding’ as the means for determining plan payments and beneficiary premiums, the bids are against benchmarks which are often legislatively set,” explained Mark Miller, executive director of MedPac.
