Merrill Goozner writes for his Gooznews Substack “if only the GOP was more like Willie Sutton.” Republicans in Congress are working to cut $880 billion from the budget to pay for tax cuts for the wealthy. If they followed the health care money, they would be looking no further than Medicare Advantage.
The government is currently overpaying insurers in Medicare Advantage about $1 trillion over the next ten years., according to the Congressional Budget Office. This past year alone, overpayments totaled $83 billion according to the Medicare Payment Advisory Commission. Medicare Advantage is the program to target; eliminating overpayments to insurers in Medicare Advantage would help eliminate fraud and waste, strengthen the Medicare Trust Fund and bring down Medicare Part B premiums.
Republicans want to resurrect Trump’s tax cuts from 2017, which would increase the federal deficit by more than $2 trillion in the next 10 years. Cutting Medicaid, which they are looking to do, would mean major cuts to hospitals, nursing homes, and other health care providers as well as loss of insurance coverage for millions of low-income Americans.
Some Republicans are pushing back against House Speaker Mike Johnson because many of their constituents depend upon Medicaid and the federal dollars it brings to their states.
The House voted on a budget resolution that would cut health care by $880 billion over ten years. Most of that money is likely to come out of Medicaid, although the resolution does not say that. So, there’s still some opportunity to guide Republicans to Medicare Advantage as a source of money.
Goozner notes that our national debt tends to rise more during Republican administrations than during Democratic administrations.
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Source: Statista; data through 2023
People in Medicare Advantage are no sicker than people in traditional Medicare–the government-administered Medicare program–even though the insurers would like you to believe otherwise. A new study out of Beth Israel Deaconness Medical Center, published in the Annals of Internal Medicine, found no difference in health status between enrollees in Medicare Advantage and traditional Medicare on four key metrics–obesity, high blood pressure, high cholesterol, and chronic kidney disease. Medicare Advantage enrollees are slightly more likely to have diabetes than traditional Medicare enrollees.
To address overpayments in Medicare Advantage, the Centers for Medicare and Medicaid Services could simply adjust the amount they pay insurers down by 20 percent or so. Medicare would save about $1 trillion.
In an editorial accompanying the research paper, Amal Trivedi and Richard Kronick wrote “Policymakers seeking to reduce health spending would better serve taxpayers by curbing MA overpayments rather than targeting Medicaid for savings.” Indeed they would!
Here’s more from Just Care:
- 33 experts call on CMS to continue reining in Medicare Advantage overpayments
- Congress could end overpayments to big insurers in Medicare Advantage and save $1 trillion, without gutting Medicaid
- 2025: What will become of Medicaid?
- Medicare Advantage insurers increasingly use step therapy for cancer drugs, delaying care