A Bush administration official spoke out Tuesday against letting states have more say over Medicare Advantage plans.

“State regulation of these plans is neither appropriate nor feasible,” said Abby Block, director of the Center for Beneficiary Choices at the Centers for Medicare and Medicaid Services.

Unlike the basic Medicare and Medicare supplement insurance programs, in which states play a large role, Medicare Advantage “is managed and almost entirely subsidized by the federal government,” Block said.

Block spoke here at a public hearing organized by the National Association of Insurance Commissioners’ new Medicare private plans subgroup.

Guenther Ruch, administrator for the division of regulation and enforcement at the Wisconsin Department of Insurance, chaired the meeting.

Speakers, including representatives for a California health care advocates’ group and the insurance commissioners of Louisiana and Ohio, testified about problems with Medicare Advantage marketing and operations.

Ruch asked witnesses whether regulation by “50 little monkeys rather than one large gorilla” would be more effective.

The commissioners and advocates said state regulation would be more effective.

Block argued that recent Medicare Advantage problems have been the result of unexpectedly rapid program growth.

“We have become far more sophisticated in evaluating plans and people,” Block said. “Let’s wait and look at 2008.”

Alethia Jackson, executive director of federal affairs at America’s Health Insurance Plans, Washington, spoke in favor of continued federal oversight.

Members of Congress have proposed giving state regulators more authority over Medicare Advantage plans.

“We oppose this approach because, based upon past experience, we believe that the practical consequences of these changes would be highly problematic, hindering rather than improving program administration and making the program less, rather than more, responsive to beneficiary interests,” Jackson said.