Federal officials attacked Medicare carriers in late 2009 for trying to get plan members to oppose the big health bills; now Republicans say the government is propagandizing in favor of the changes.

The Centers for Medicare and Medicaid Services, an arm of the U.S. Department of Health and Human Services, has produced a health system change brochure that discusses the recent changes in the Medicare program resulting from passage of the Affordable Care Act – the legislative package that includes the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act.

Senate Republicans have sent a letter to HHS Secretary Kathleen Sebelius contending that the brochure, “Medicare and the New Health Care Law–What It Means for You,” is “inaccurate and misleading brochure.

“We believe by selectively providing information, you are misleading seniors about the full impact of the new federal health care law,” the senators write.

The letter was signed by Senate Minority Leader Mitch McConnell, R-Ky., and also by Sens. Jon Kyl, R-Ariz.; Lamar Alexander, R-Tenn., John Thune, R-S.D.; Charles Grassley, R-Iowa; Michael Enzi, R-Wyo.; Dr. Thomas Coburn, R-Okla.; and Dr. John Barrasso, R-Wyo.

In the first paragraph, the senators write, the brochure says that ACA will increase the quality of health care.

The chief Medicare actuary says ACA changes probably will cause about 15% of the health care providers now in Medicare to drop out of the program, the Republican senators write.

“Changes that jeopardize access to health care services will not increase the quality of care,” the senators write. “It is not possible to simultaneously increase the quality of care and reduce access to services.”

The second paragraph of the brochure says ACA will “keep Medicare strong and solvent,” the senators write.

The chief Medicare actuary has noted that ACA calls for Medicare spending cuts to be used to pay for expanding other health programs, and that the government cannot simultaneously use the cuts to pay for other programs and extend the life of the Medicare trust fund, the senators write.

In late 2009, CMS officials engaged in a battle with health insurers over how the insurers could go about communicating with Medicare plan enrollees about the health bills then in Congress.

“Given your recent actions to prohibit private companies from communicating with their clients about the potential ramifications of health reform, you can understand our concern about this double standard,” the Republican senators write in their letter. “We are deeply concerned about the apparent inequities evident in this situation.”

Sebelius should explain how the brochure was developed and who developed it, and how it is being distributed, and she should indicate whether White House staffers were involved, the senators write.

“Please identify the name of each employee or contractor of HHS who was involved directly or indirectly in the creation, the development, drafting, review and clearance of the brochure,” the senators write. “Please provide a copy of each draft version of the brochure from the first draft through the final version.”

The senators are asking whether seniors are required to “opt-in” to receiving brochures of this type and, if so, when that opportunity is given and under what circumstances.

House Speaker Nancy Pelosi says the CMS brochure can help members of Congress clear up misconceptions about the ACA changes.

“Perhaps most significantly, it begins with what stays the same for Medicare,” Pelosi said, according to a written version of remarks she made at a news conference Wednesday. “No change in guaranteed benefits and no change in eligibility. During open enrollment this fall, seniors will continue to have a choice between original Medicare and Medicare Advantage. Medicare will continue to cover health cost the way it always has for seniors.”