During the Medicare open enrollment period that ends today, the Trump administration once again asked beneficiaries to choose plans without the benefit of accurate, unbiased information. Throughout this period and the year preceding it, the Centers for Medicare and Medicaid Services (CMS) has unabashedly steered seniors toward private Medicare Advantage plans, while downplaying traditional Medicare.
Case-in-point: The New York Times reported that CMS has been sending emails to millions of beneficiaries encouraging enrollment in Medicare Advantage. The emails uncannily resemble advertising from big insurance companies. Effectively, that’s what they are.
“Get more benefits for your money,” says a message dated October 25. “See if you can save money with Medicare Advantage,” said another sent a week later. The messages – “paid for the by the U.S. Department of Health and Human Services” – urge beneficiaries to “check out Medicare Advantage” and point to an online tool to compare different options. – Robert Pear, New York Times, 12/1/18
CMS’ online plan-finder tool is similarly skewed toward private plans. The questions in the tool’s questionnaire seem to have been selected so that the inevitable answer to the beneficiaries’ needs is… drumroll, please… Medicare Advantage!
The enrollment information on Medicare.gov in general is also biased, largely by omission.
The website features a list of Medicare options, with Medicare Advantage plans at the top. “Original Medicare” is absent from the list. A new beneficiary could be forgiven for not even knowing that original Medicare exists. This is confusing – and misleading.
Unlike Advantage plans, original Medicare does not limit patients to a fixed network of providers, giving patients access to the best doctors and hospitals. Original Medicare covers beneficiaries when they are traveling. And, in combination with a supplemental Medigap policy, original Medicare insulates patients against high out of pocket costs. This bedrock health insurance program has served hundreds of millions of seniors for more than 50 years – with low overhead and no profit motive.
Yet, in its public outreach, CMS almost exclusively touts the benefits of private Medicare Advantage plans. These plans can have certain advantages for some beneficiaries, especially younger and healthier ones. Medicare Advantage plans often include prescription drug coverage, whereas subscribers to original Medicare must enroll under a separate plan (Part D) for that. Medicare Advantage can include extra goodies – including gym memberships and transportation to doctor visits – not covered in the traditional plan.
But the administration rarely mentions the downsides of private plans, which are considerable. Medicare Advantage patients are restricted to a limited network of providers, and may not be covered when traveling. They may encounter coverage limits and denied claims – and experience long delays in appealing claims.
The Trump administration hides the fact that your out-of-pocket costs for in-network care alone in a Medicare Advantage plan can top $6,700 a year. Or that you could wind up paying the entire cost for everything but emergency care if you need treatment while you’re away from home. Or, that the quality of care their providers offer can be poor. – Richard Eskow & Diane Archer, Common Dreams, 12/6/18
These issues may not matter as much to healthier patients, but everyone gets sick at some point. Beneficiaries with acute or chronic conditions often find it difficult to get quality care under Medicare Advantage. But if they try to switch midstream to original Medicare, they may not be able to obtain Medigap insurance to supplement it.
Our organization has partnered with the nonprofit Center for Medicare Advocacy to provide retirees (and near-retirees) with accurate, unbiased information about the two main Medicare options so that they can make a fully informed choice. Appropriately enough, the name of the initiative is the Medicare Fully Informed Project. One of the most compelling features of this project is a “Corrected Medicare & You Handbook,” including ‘red pencil’ notes correcting some of CMS’ misleading or incomplete language in its main consumer publication for Medicare.
There is little mystery as to why CMS is tipping the playing field toward Medicare Advantage. The Trump administration and its CMS chief, Seema Verma, have demonstrated a decidedly pro-corporate tilt in matters where the public interest should be the paramount concern.
Don’t let the insurance industry or the Trump administration deceive you. Don’t let them corporatize Medicare. Instead, let’s de-corporatize everyone else’s health care—and become a healthier, more humane nation. – Richard Eskow & Diane Archer, Common Dreams, 12/6/18
The National Committee does not oppose Medicare Advantage. For some beneficiaries, it may be the most practical choice – at least while they are relatively young and healthy. But we do believe that the playing field between private plans and original Medicare should be level. The Trump administration owes that to the tens of millions of Americans who rely on Medicare for health security in old age.
Instead of taking big, bold steps to lower prescription drug prices, the Trump administration has rolled out yet another incremental measure that merely nibbles at the edges of the problem – while at the same time putting additional burdens on beneficiaries. The Centers for Medicare and Medicaid Services (CMS) unveiled a new proposal this week that would limit coverage for drugs which treat several serious and chronic conditions:
“The Trump administration propose[s]… to cut costs for Medicare by reducing the number of prescription drugs that must be made available to people with cancer, AIDS, depression, schizophrenia and certain other conditions.” – New York Times, 11/27/18
As the New York Times explains, insurance plans providing prescription coverage to Medicare beneficiaries would no longer have to cover all of the drugs in six “protected classes.”
*Antipsychotic medicines (to treat schizophrenia and related disorders)
*Immunosuppressant drugs (to prevent rejection of organ transplants)
*Antiretrovirals (for treating H.I.V./AIDS)
*Various Cancer drugs
Some 45 million Medicare beneficiaries currently receive coverage for at least one of these classes of medications.
“Rather than talk about these incremental measures, it’s time for U.S. to do what every other industrialized country does and allow Medicare to negotiate the cost of drugs,” says Lisa Swirsky, Senior Policy Analyst at the National Committee.
In a 2018 Kaiser Family Foundation poll, 92% of respondents said they favored empowering the federal government to negotiate lower drug prices for people on Medicare. President Trump himself promised on the campaign trail to enact such a policy, but so far has not.
Democrats introduced legislation during the current Congress to allow Medicare to negotiate prescription prices, but GOP leadership refused to consider these measures. The 116th Congress taking office in January will have an opportunity to breathe new life into this effort, which would go much further in knocking down drug prices than anything the administration has proposed.
Meanwhile, proposals like the one just announced by CMS put the onus on Medicare beneficiaries – despite administrator Seema Verma’s claims to the contrary. Verma says that if seniors don’t like the restrictions in a drug plan, they can choose a different one. But Swirsky says it is unrealistic to expect seniors to pore through hundreds of pages of policy documents to divine a plan’s rules regarding protected class drugs. Far from putting seniors in the driver’s seat, as Verma insists, this proposal leaves them in the passenger’s seat – with Big Pharma at the wheel.
National Committee president Max Richtman stumped for Senate candidate Mike Espy in Tupelo, Mississippi yesterday. Democrat Espy faces GOP incumbent Cindy Hyde-Smith in a runoff election next Tuesday after neither captured a majority of the vote on November 6th. Speaking to a crowd of Espy supporters in front of Tupelo’s city hall, Richtman called this a “significant election” and proclaimed that a victory for the Democratic challenger would be “an earthquake.”
Richtman told the crowd that Espy is the candidate who will fight for Social Security, Medicare, and affordable health care. As a Congressman representing Mississippi’s 2nd district from 1987-1993, Espy consistently voted on behalf of senior citizens. His commitment to Mississippians’ earned benefits remains unflagging.
“We owe it to Mississippi seniors to honor and protect the commitment we made to care for them through Social Security and Medicare. It is vital that we safeguard the benefits Mississippians have worked their entire lives to earn.” – MS Senate candidate Mike Espy
Seniors make up 15.5% of Mississippi’s population. The state has some 660,000 Social Security beneficiaries and roughly 560,000 on Medicare.
Richtman joined several prominent national figures who have endorsed Espy for Senate, including former Vice President Joe Biden, Senators Cory Booker and Kamala Harris, and Congressman John Lewis, among others.
Biden declared that Mike Espy “promises to protect Social Security, Medicare and the federal requirement that health insurance companies cover people with pre-existing medical conditions.” Congressman Lewis affirmed that Espy will stand up for seniors’ earned benefits while “taking on the corporations to keep prescription drug prices affordable.”
Espy’s opponent, Cindy Hyde-Smith, is on the wrong side of issues affecting older Americans. Appointed last Spring to fill the seat of Republican Senator Thad Cochran, Sen. Hyde-Smith has voiced support for the Trump/GOP tax scam, voted for the bill designed to give Republican candidates a fig leaf on the issue of pre-existing conditions, and boasted that “no one will work harder” to pass a Balanced Budget Amendment, which would force cuts to Social Security and Medicare.
Her campaign became embroiled in controversy after she joked about attending a “public hanging” – prompting accusations of racism. For his part, the Democratic candidate continues to focus on kitchen table issues that affect working families and retirees.
“Mike believes that Mississippians need access to affordable health care and that fixing health care for the American people will require a bipartisan solution. He wants to lower the cost of prescription drugs and rein in out-of-control insurance premiums, high deductibles, and caps on individual health costs.” – Espy for Senate website
While Republicans will control the Senate regardless of the outcome of Mississippi’s special election, an Espy victory would give the GOP a thinner margin – and increase the chances for improving Social Security and Medicare in the next Congress.
“We feel like Mike Espy is the person we need to have in the Senate,” said Richtman.
Three weeks ago, we implored seniors to vote in their own interests on November 6th. In three of the past four midterm elections, older Americans lopsidedly voted for Republicans – despite the party’s proposals to cut and privatize Social Security and Medicare – and slash Medicaid. This time, seniors reversed that trend and voted in roughly equal numbers for Democrats and Republicans, helping the former flip the House of Representatives. (According to exit polling, the split among voters aged 65+ was 52% Republican/48% Democrat – within the margin of error.)
“Nationally, Democrats won in 2018 because when it came to ‘the deciders’ — [older] Americans —they fought Republicans to a draw. And how they did that is the story of this election.” – Politico, 11/13/18
The question is: why? Early indicators point to the issue of health care. In poll after poll, voters listed health care as a high priority in the midterm elections. Little wonder. Congressional Republicans voted for Obamacare repeal legislation that would have stripped coverage from tens of millions of Americans. When they failed to repeal, the Trump administration and Congressional GOP eliminated the Affordable Care Act insurance mandate penalty, and worked in other ways to sabotage the law.
Then there was the Trump/GOP tax scam. As we wrote three weeks ago:
Once the Republicans got control of the House, Senate, and White House, they enacted a tax cut that mostly benefitted the wealthy and big corporations, then claimed retirees’ earned benefits would have to be slashed to pay for it. Both the White House and Republicans in Congress proposed to eliminate or cut services for low income seniors and research into diseases affecting the elderly. – Entitled to Know, 10/23/18
In fact, budget proposals from the White House and the majority party in Congress called for billions of dollars in cuts to Social Security, Medicare, and Medicaid – along with a voucher system for Medicare. House candidates vowing to protect these programs prevailed in last week’s elections, including more than 70 endorsed by the National Committee.
A Democratic congressional challenger from Houston, Lizzie Fletcher, ran a campaign ad accusing her opponent of undermining health care protections — featuring a wrecking ball crashing into a cinderblock wall labeled, “People 50 and over.” The message resonated. She – and more than 30 other Democrats – helped the Democrats regain control of the House. In keeping with recent history, Americans aged 50+ made up 56% of the electorate in the midterms.
“[Democrats] won the popular vote for the House by a 6.7 percent margin… driven by a marked improvement among all segments of the electorate. But because older voters made up a larger share of the electorate in this year’s midterms, Democrats’ stronger performance with this cohort was critical to their success.” – Politico 11/13/18
We wrote on October 23rd that a significant shift in the senior vote would represent a historic turnaround. On election day, we saw a swing of 13% toward the Democrats compared to the 2014 midterms. Seniors are starting to vote in their own interests again – shocked into action, no doubt, by the existential threat the outgoing House majority posed to their health and financial security. This trend must continue if older Americans’ health care and earned benefits are to be protected – and hopefully, expanded – moving forward.
For more on the senior vote in the 2018 midterms, watch “Behind the Headlines” on Facebook Live.
Voters have put champions of Social Security and Medicare back in control of the U.S. House of Representatives for the first time in 8 years. Candidates who promised to protect and expand seniors’ earned benefits scored victories in races across the country, including many endorsed by the National Committee to Preserve Social Security and Medicare.
“This is a victory for seniors and their families who have seen their earned benefits threatened time and again under Republican control of the House. The election results mean that Congress can cast aside the tired trope of ‘entitlement reform’ (code for cutting benefits), and work vigorously to boost Social Security and Medicare for current and future retirees. The new majority will serve as a firewall against further attempts to slash Medicaid and repeal or sabotage the Affordable Care Act – and challenge President Trump to fulfill his campaign promises to protect Social Security and Medicare.” – Max Richtman, National Committee President and CEO
Legislation to protect and expand seniors’ earned benefits can now receive serious consideration in the 116th Congress after languishing under Republican control. This includes Rep. John Larson’s Social Security 2100 Act, which would increase benefits and keep the system solvent for the rest of the century – and several other bills supported by the National Committee to boost Social Security and Medicare.
When the new Congress convenes in January, Congressman Larson (D-CT) likely will assume the chairmanship of the House Social Security Subcommittee. Another champion of Social Security and Medicare, Rep. Richard Neal (D-MA), is expected to wield the gavel in the powerful House Ways and Means Committee, while Rep. Frank Pallone (D-NJ) probably will head the House Energy and Commerce Committee, which oversees Medicare.
“We will work with the new House leadership and members to give retirees a much-needed raise in their earned benefits – and defend seniors from demands that Social Security, Medicare, and Medicaid be slashed to pay for tax cuts for the wealthy and big corporations. This is a tremendous opportunity to restore American values of fairness and compassion – including caring for the sick and elderly – to the people’s house.” – Max Richtman, National Committee President and CEO