Will health insurers stop Congress from reducing their Medicare Advantage profits?

When health insurers lobbied to be able to offer Medicare benefits, they claimed that they could deliver more at a lower cost. But, years later they continue to cost significantly more per enrollee than traditional Medicare. Can they block Congress from reducing their Medicare Advantage profits?

Right now, health insurers are making money hand over fist offering Medicare benefits. They control about $140 a month per enrollee in rebate dollars and another $40 minimum a month per enrollee in overpayments. They use all the tools in their tool box to receive tens of billions of dollars a year more than they should according to one conservative estimate. Consequently, the Medicare Trust Fund is being drained prematurely of its assets, and Medicare Part B premiums are rising quicker than they otherwise would. Moreover, people in traditional Medicare are paying 14 percent higher premiums to subsidize Medicare Advantage.

For good reason, Democrats in Congress are looking at ways to reduce payments to Medicare Advantage plans to a level more on a par with traditional Medicare, reports Politico. So, the insurers are now using their enormous muscle to keep Congress from reducing their profits.

The Democrats need the savings to pay for the package of policies they hope to enact, including lower drug costs for people with Medicare. Given Senator Manchin and Sinema’s allegiance to their corporate benefactors, the Democrats in Congress are not likely to get that money from lowering drug prices or raising taxes on the wealthy. If they succeed at limiting overpayments to Medicare Advantage plans, it will be despite an investment of millions of dollars in an onslaught of insurance industry ads misleading the public about the implications of reducing their payments.

The insurers are making cuts “as toxic as possible,” according to an industry insider. To be clear, the cuts would not affect people’s premiums or access to care. Rather, they would eat into insurer profits.

And, contrary to the insurers’ claims, Krysten Sinema and Joe Manchin will be responsible, if indirectly, for the deaths of thousands of people with Medicare because they are refusing to allow Medicare to regulate drug prices. Right now, thousands of people are dying needlessly because they cannot afford their medications. But, misleading the public is  the health insurers’ standard modus operandi. And, it works almost always.

Here’s more from Just Care:

• MedPAC: Traditional Medicare consistently costs less than Medicare Advantage
• The deadly consequences of out-of-pocket drug costs
• Don’t judge a Medicare Advantage plan by its stars
• Medicare Advantage: What are we paying extra for?
• OIG finds Medicare Advantage continues to overcharge government