Trump administration tilts playing field toward Medicare Advantage

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 in general is also biased, largely by omission.

CMS Medicare website omits crucial information about original MedicareThe 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.

Center for Medicare Advocacy, partnered with National Committee to Preserve Social Security and Medicare, attempts to correct misinformation about Medicare Advantage plans

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.