Medicare Advantage Attracts a 63-Senator Coalition

Medicare Advantage supporters are showing that they can line up big, bipartisan coalitions of lawmakers in both the House and the Senate.

Sens. Catherine Cortez Masto, D-Nev., and Tim Scott, R-S.C., have persuaded 61 other senators to join with them in signing a letter asking Chiquita Brooks-LaSure, the Centers for Medicare & Medicaid Services administrator, to do what she can to support Medicare Advantage program continuity in 2023.

In addition to Masto and Scott, the list includes Democrats such as Amy Klobuchar of Minnesota as well as Kyrsten Sinema of Arizona and Joe Manchin of West Virginia.

The list also includes Republicans Marco Rubio of Florida, Rick Scott of Florida and Susan Collins of Maine.

The list does not include either Senate Majority Leader Chuck Schumer or Senate Minority Leader Mitch McConnell, and it does not include many of the most liberal senators, such as Bernie Sanders, a Vermont independent.

Earlier, Medicare Advantage program supporters persuaded 346 of the 435 members of the House to sign a similar letter.

What It Means

Members of Congress have struggled for decades to work on a bipartisan basis on issues such as health system change, and creating and passing a big social welfare program bill.

But life insurers and health insurers have repeatedly organized coalitions that have pushed Democrats and Republicans to work together to pass bills.

Both President Joe Biden and former President Donald Trump have developed legislative packages aimed mainly at lawmakers in their own parties and have generally struggled to pass anything other than big budget and emergency relief bills.

The success of insurers’ bipartisan legislative efforts could eventually increase policymakers’ interest in applying a bipartisan approach to other issues.

The Medicare Advantage Challenge

Medicare Advantage is a program that gives private insurers a chance to use a combination of federal money and enrollee premiums to offer comprehensive plans that serve as alternatives to traditional Medicare coverage.

Many Medicare Advantage plans now cover services such as basic dental care, hearing aid assistance and vision care that most public health specialists see as critical to good health, but that are not covered by the original Medicare program or most Medicare supplement insurance policies.

Medicare Advantage plans now cover 29.4 million of the 64 million people who are eligible for Medicare.

The plan issuers and their enrollees now face serious challenges, despite the popularity of the program, because of the enormous size of the U.S. budget deficit, and program critics’ assertions that covering Medicare Advantage enrollees costs the government more per enrollee than the traditional Medicare program does.

The Government Accountability Office recently reported that the federal government spent $7.3 trillion in the 12-month period that ended Sept. 30, 2021, and took in just $4.7 trillion in revenue, meaning that the government ended up with a $2.7 trillion operating deficit.

The Committee for a Responsible Federal Budget has argued that Medicare Advantage program changes could save the federal government $370 billion over 10 years.

Defenders say that the critics are failing to take the true health status of the enrollees into account and failing to acknowledge the value of the extra benefits, such as coverage of basic dental care.

Agents’ Perspective

In the past, many health insurance agents have preferred to sell Medicare supplement insurance policies over selling Medicare Advantage plans, partly because the marketing rules have been more flexible, and partly because of a belief that combining Medicare supplement insurance with traditional Medicare coverage leads to more flexible coverage for the client.

The National Association of Health Underwriters emphasized in a 2021 Medicare position paper that it wants policymakers to preserve access to private Medicare options, including Medicare Advantage plans.

“For many seniors Medicare Advantage coverage is an attractive and familiar coverage option that provides access to enhanced benefits with low and predicable out-of-pocket cost levels,” NAHU says in the position paper. “The popularity of this program continues to grow each year, so reimbursement cuts need to be avoided to prevent consumers from facing higher out-of pocket costs and reduced benefits.”

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