Medicare Advantage plans are too often not a good option for people who need costly and complex care. But unions and corporations save money when they require their retirees to enroll in a Medicare Advantage plan; so, they too often tie retiree benefits to Medicare Advantage, making Traditional Medicare an unaffordable option. Robert Kuttner writes for The American Prospect on a group of union retirees in Connecticut who wanted traditional Medicare as an option, fought back, and won big time.
In brief, in 2017, Connecticut moved 65,000 public retirees into Medicare Advantage plans as a way for the state to save money. Yes, states save money, much like corporations, when they move retirees into Medicare Advantage. Insurers give retirees “extra” benefits to get books of business. But, insurers can and do deny enrollees their hospital and medical benefits inappropriately, when they need care, forcing them to gamble with their health and their lives.
Insurers profit from denying and delaying care to their enrollees. Whatever they don’t spend on care is money in their coffers. They also profit from having limited networks of specialists and hospitals, often imposing challenges on enrollees to get the specialty care they need. Specialists may be hard to see or have offices in places that are hard to access.
Some Connecticut retirees in grave health faced these obstacles to care in Medicare Advantage and organized. One retiree couldn’t get the follow-up care he needed after major surgery. Another retiree couldn’t get the rehabilitation care he needed. Had they been in Traditional Medicare, they would have had easy access to the care they needed.
The union leaders in Connecticut negotiated a deal with the state, which will still save the state some money but will also enable any public retiree to enroll in Traditional Medicare with supplemental coverage.
Because Medicare Advantage insurers also game the Medicare payment system, Medicare spending falls when people enroll in Traditional Medicare. The Committee for a Responsible Federal Budget projects $1.3 trillion in government overpayments to insurers offering Medicare Advantage plans over the next decade. That not only eats into the Medicare Trust Fund, it drives up Medicare Part B premiums for everyone with Medicare by $212 a person in 2025 alone, according to the Joint Economic Committee.
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