AMAC Action On Capitol Hill

AMAC Attends Medicare Advantage Hearing on Capitol Hill

Capitol-Hill-Domeby Andrew Mangione –

AMAC Vice President for Government Relations Andy Mangione attended the Energy and Commerce Committee’s Health Subcommittee hearing regarding Medicare Advantage this week on Capitol Hill.  The hearing focused on the effect ObamaCare will have on beneficiaries who receive their Medicare benefits through Part C, more commonly known as Medicare Advantage (MA).

The Republicans currently have a majority in the House of Representatives and can therefore call more witnesses to testify.  Democrats, who are in the minority in House, are also allowed to call witnesses.  For this hearing, a total of five witnesses were asked to testify; three by Republicans and two invited by Democrats.

Twenty-nine percent, or 15 million, of Medicare-eligible Americans currently receive their benefit via Medicare Advantage plans. This is a 30% increase in participation since 2010 and is a testament to the program’s growing popularity.  Witnesses cited data that shows that Medicare Advantage participants experienced fewer hospital admissions, readmissions and are generally healthier than those beneficiaries on Original Medicare due to the coordinated care methods and disease management programs that are the hallmark of MA.  Medicare Advantage members spend 20 % less time in hospitals versus Original Medicare beneficiaries.  A majority witness from the advisory firm Boston Consulting shared data that showed Medicare Advantage beneficiaries had lower mortality (death) rates than those utilizing Original Medicare.

However, ObamaCare cuts $308 billion directly from Medicare Advantage, and with many of them slated to start in 2014, tough questions regarding the reality of these reductions were asked by Subcommittee members. Witnesses cited Kaiser Family Foundation statistics forecasting that hundreds of thousands of Medicare Advantage beneficiaries will lose their plans next year.  Testimony also revealed that because of changes to provider networks as a result of ObamaCare, thousands of beneficiaries will not be able to maintain plans that they signed up for as recently as this year.  Testimony from witnesses for the majority dispelled minority testimony which stated that cuts to Medicare Advantage would drive down overall costs for the Medicare Program. Instead they argued that the money cut from MA would go to pay for the Medicaid expansion and health insurance subsidies which are both fundamental apparatuses of ObamaCare.

Minority witnesses tried to persuade Subcommittee members that ObamaCare actually “prolongs the life” of Medicare Advantage, but majority witnesses cited numerous facts that the reality of the law reduces choice, destroys provider networks, drives up costs for beneficiaries and dilutes the MA benefit as a whole.

The hearing was an eye opening experience as to the effect ObamaCare has on seniors and their health.  Our support of the Cassidy-Barrow initiative, (please see the details at which fights to keep MA fully funded, is one way AMAC fights to expose the consequences of this law and diminish its negative outcomes.

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7 years ago

Manuel Spinner: At this point in time no one can give you a definite answer but Obama has already said he does not like the Advantage plans. He has already taken $716 billion out of Medicare & given it to Medicaid. We are all in the same boat as you. They just had a hearing in DC last week about the MA plans. That’s why I suggested we all contact our congressmen/women & tell them our opinions. If we are silent we are at their mercy & may be anyway unless we can get some champions on our behalf.

Manuel Spinner
7 years ago

I have been told so falsely of the evils of “Obamacare.” Now I’m told of rhe fate of Medicare. Will someone of authority please ask President Obama directly and to the point if the Affordable Health Care provides for the demise of Medicare Advantage. No evading answers — just to the point. I can’t understand all of the statements today . jUST ASK PRESDENT OBAMA DIRECTLY “DOES YOUR AFFORDABLE HEALTHCARE ACT PROVIDE FOR DISCONTINUING MEDICARE ADVANTAGE NEXT YEAR,OR 2015, 2016, OR ANY FUTURE YEAR?”

I am up to my eyeballs in divisive answers,jpolitical animosities. I have been enrolled in Medicare Advantige for many year and I would like to know how to decide my insurance fate in the fuure. Please no political disertations — I am full of them.

7 years ago

Everyone needs to contact their Congressmen/women & let them know how you feel. Of course it’s not going to matter unless the Republicans keep control of the House & regain control if the Senate in 2014. They need to be REMINDED we have paid for our Medicare coverage over our working lifetimes and that we do still vote.

I read an article about the congressional meetings on Advantage plans and one of the people testified that seniors who have Advantage plans are healthier than seniors with Original Medicare. They said this is because our health is monitored more closely by our doctors. The only thing I can figure out is maybe because the doctors have been paid better through the Advantage plan. That is going to change as a previous post stated until the plans are phased out.

Did anyone notice United Healthcare didn’t advertise Advantage plans this year. The only ones I saw were trying to get you to purchase a supplement which if course costs more out if our pocket. UNH is in tight with AARP. That Liberal organization is up Obama’s a–. This appears to be where we may headed because it’s more money in AARP’s & the insurance companies pockets. You can bet AARP worked closely with Obama in forming the changes coming under Medicare.

Araminta Adkins
7 years ago

What is the difference between Medicare Advantage and Medicare?

7 years ago

The communist party in the USA rules and Obama care is the instrument of destruction

7 years ago

I find the various comments posted on this topic most interesting and very enlightening. Not so much for the fact that Medicare Advantage, along with traditional Medicare is being targeted for deep cuts, but that this seems to come as a utter surprise of so many people. This was, after all, to be fully expected given how Obamacare was written and then passed by Democrats in 2009. Cutting Medicare over $700 billion was one of the gimmicks the Democrats used to “finance” the law. That was four years ago and the nature of all those cuts and new taxes associated with Obamacare were well published in a number of newspapers and magazines. Yet this planned impact on both Medicare and Medicare Advantage seems to come as new news to so many people.

Dan Whipple, MD
7 years ago

I am a physician (ophthalmologist) is Avon, Indiana – a suburb 15 miles wet of Indianapolis. I have been in practice for 21 years and have always been a participating provider in Medicare. As such I am obligated to charge my medicare patients the federally mandated fees negotiated by congress in Washington, DC. I cannot charge more or less than this fee schedule and cannot balance bill my patients. In spite of having no control over my fees, I have been dropped by United Health Care advantage from their network. There is nothing my patients nor I can do about this. Most of these patients are quite elderly and have entrusted their care to me for 10 years or more. There are no other ophthalmologists in my county to see these patients (over 225 in number). I also was notified by Anthem that they were considering dropping me from their network, which effects over 945 patients. The only basis for these decisions is to boost the profits of the insurance companies.The reasoning behind this is to make it more difficult to seek out medical care. These companies also require their insureds to pay a copay every time they go to the doctor – which is not part of traditional medicare – in an effort to discourage them from going to the doctor. I cannot even believe these Advantage plans are legal. They are all for-profit companies that are traded on Wall Street and attempt to create ever increasing quarterly profits for their share holders. These Advantage plans are paid a lump some yearly by the federal government (our tax dollars) to cover each of their insureds. These companies then spend the rest of the year trying to withhold as much healthcare as possible to each of these insureds in order to keep as much of the prepaid money as possible as profit. So far, it has worked wonderfully for the insurance companies and has provided them with hundreds of millions of dollars in profits, which represent wasted tax dollars not going toward medical care. Hence, Obama’s plan to find a source of money to help fund his disaster Obamacare. It is terrible for the patients and for the tax payers.
This was all created by president Bush when he wanted Medicare to cover pharmaceuticals. The plan was to negotiate a discounted price for medicines as of a specified date. The current discounted price is in the neighborhood of 50%. The problem is that all the pharmaceutical companies tripled their prices so that the current discounted rate is still much higher than they were getting before Bush got Medicare involved. I have hundreds of patients that use eyedrops every day for glaucoma. These drops cost $35 a bottle (one month supply) for years before Medicare got involved. The cost of these drops have been raised to $125 per bottle (and more) that has now made them unaffordable. The Advantage plans were created to help cover these inflated pharmaceutical costs. It is the typical result of unintended consequences when the government gets involved in anything.
By far the biggest problem with the medical costs in our country today is the involvement and subsequent waste of the federal government in the system and the for-profit nature of the insurance and pharmaceutical companies. So what is Obama’s solution – more government and insurance involvement. That is because Obamacare is NOT about medical care. It is solely about the government taking control over a large sector of our economy. It is all designed to fail and ultimately create a single payer system with the government gaining full control.

7 years ago

“This was all created by president Bush when he wanted Medicare to cover pharmaceuticals.”

I dispute this assertion. The Par-D program is expensive for the Gov’t but is less costly than the initial estimate (a 1st for a government program) and less restrictive too. Multiple suppliers vie for customer sales based on cost/benefit to each customer. While there is a general pharmacy list, alternatives may be negotiated by individual. I have done so by enlisting my physician’s advocacy. HOWEVER, the ACA is way too restrictive and overreaching – forcing 1) cancellation of working, viable plans, and 2) membership of every adult. The “free” and unnecessary stuff in the new, approved plans give the Insurers the basis (cover to charge) for the higher rates of the new policies. FURTHERMORE, it never addressed the most fundamental cause of rising medical care – the actual cost of providing services – risk to providers (physicians, nurses, hospitals) of ruinous lawsuits which they address thru extra, unneded CYA testing. It also neglected to address the restricted access to insurances (over State Lines) and medical savings accounts that are untaxed. It’s just a power grab into Socialism!

Ronald White
7 years ago

We must continue the battle to save MA!! I watched the entire Hearings on Cspan with great interest but came away
Concerned about the future of MA….not 2014 but beyond. The same deceitful tactics are being used….relax everything
Will remain the same or is being improved say the Obama allies. This entire law should be repealed in favor of fixing
Specific problems only…not to replace our medical system with this monster!

James Pait
7 years ago

I have had a AARP MA plan by Unitedhealthcare for two years and have been somewhat satisfied although most of my providers hate it. I was notified recently that my cardiology group was removed from UHC’s providers’s list. They appealed and were denied. I have had two heart attacks and the relationship I have with my Cardiologist is vital. I think the Latin derivative of vital is life. UHC said they would find me another Cardiologist. Thanks but no thanks. I just got a provider list for 2014. It appears that the list has been cut by over 50 %. I know most of the good doctors in my area and almost none of them are on this list. I will therfore have to go back to Original Medicare in order to get access to the better doctors. If I get a supplementary plan it will cost an additional $3,000 ($6,000 including my wife) and I will have to also pay for A Rx plan. I have paid into Medicare since it’s inception. Please Senior Citizens, lets fight for what we invested in.

bob arnold
7 years ago
Reply to  James Pait

i have had my wife on a medicare advantage plan and both times s he went to hospital it cost 800 dollars deductible and then they changed it to 250 dollars a day and next time it cost 1250 for 5 days and then thetn primary doctor got out of the plan with was Humana, i then put her back in medicare with a supplement like i have and now no more charges
i spent 3 weeks in hospital having my kidneys removed and then 4 weeks in rehab cause i could not stand up and walk,the only cost i had was 12.00 for a haircut.
i will take medicare and a blue cross supplement any day of the week

bob arnold
7 years ago
Reply to  James Pait

united care is the worse for doctors dropping out and what could you except from something that is endorsed by the liberal group AARP.
make sure if ou sign up for one that they have a contract with all the hospitals in your are,i made that mistake with Humania at the time and it cost me more than the deductible as they did not have contract with the hospital that the doctor worked with,it cost the deductible plus another 40% of the bill.

beat advice stay away from them all and stick with medicare and a supplement and you will not have a problem or co-pay

7 years ago

I have paid into social security each time I have worked in a private company job, and my husband paid in social
security while in the army thinking I could draw his if something happened to him. When I retired from the government
job and tried to apply for his social security I was told if I applied I would have to pay them instead of them paying me.
I was to receive a raise on my social security the first of this year, when I got the raise it was all added to pay my
medicare and I received the same amount of money each month I received the year before.

Jim Lowden Jr
7 years ago

I am puzzled like Chuck and Cora are about the companies like BCBS Advantage, AARP Medicare Complete, Humana and other companies with Medicare Advantage Plans not saying a word about the forecasted future of Medicare Advantage. Perhaps AMAC’s Legislative Director could enlighten us about this phenomena in the next issue of the AMAC Advantage?? It would sure be helpful to know in advance which way the wind is going to blow. I don’t want to be like the frog who doesn’t realize the fire roaring beneath the pan of water he is sitting in is going to boil him until it is too late.

I have compared the three plans mentioned above, plus a local plan called Viva (University of Alabama-Birmingham), category by category on a spread sheet and find each one tweaks their plan from a marketing point of view. I found this to be the only rational way I could divine which plan was best for my wife and me. Not being God, I have no way to divine what health issues my wife and I will face in 2014. We discussed known pending health issues such as hearing aids and possible Cataract surgery in 2014 and balanced that against increases/decreases in the various plan’s doctor co-pays. One big factor that helped us decide which plan to go with was the yearly Out-of-Pocket amount which varied by more than $2000.00 between the various plans. Surprisingly, one of our basic concerns was our Prescription drugs. We found that not all insurance company’s Formularies are the same for the same identical drug. For example, a drug I have to take is listed as a Tier 1 by one Advantage Plan, but it is listed as a Tier 3 by another Advantage Plan. The difference in monthly cost is $3 co-pay versus $45 co-pay. How can that be???

7 years ago

I have been with an MA plan for about 8years and very satisfied with it. Have not heard that it might be changed. Now we find out that they are debating about it. What will 2014 bring?

bob arnold
7 years ago
Reply to  Judy

more cost ,more copays and deductile and more doctors getting out of medicare advantage plans,that is what you can except

Arlene P
7 years ago

I am impressed with the intelligent commentary posted above. I work as a community hospice RN. I see directly some of the impacts of new health care regulations on my clients. I hope those who have commented here have already contacted their US Congressional representatives. The ACA must be repealed.

Joe McHugh
7 years ago

I’m not sure why there is so much controversy about obama stealing the funding for the Advantage Care program and applying it to his Obama Care program. This fact was known in 2010 and the only reason that I can see for the current uproar is that people weren’t affected by it until now.

All of the Advantage Program funding is slated to be withdrawn over a period of years. It’s obvious that obama’s consultants decided that the people presently on the Advantage Program would be eventually forced to buy the Medi-Gap insurance with their own money. Medi-Gap insurance policies cover the 20% that the Medicare Program does not pay for.

All of this was slated to happen when obama first entered the Oval Office in 2009. Anyone that voted for this foreigner in 2008 or 2012 better not complain about Obama Care. There are a few people who didn’t vote for the Liar-In-Chief and those people are not very sympathetic about the complaints of the obama voters.

7 years ago

This whole thing is frightening. I believe the Independent Payment Advisory Board is just a way to get rid of us old folks. We will be denied treatment once we are past a certain age, given a bottle of pain killer & sent home to die. What this POTUS is doing to this country is just evil. My husband & I are on an Advantage Plan and we love it. We are changing to another one this year because the first one raised their rates too high. If these things go out of business, I don’t know what we will do. As it is, I am afraid that when my husband’s pacemaker needs replaced, the Board will say “no, he’s too old, Medicare will not pay for it”. Then what?

Bobby W.
7 years ago

More of the non-sense from the” LEFT ” it is hard for me to comprehend the greed and so called good that they want us to believe they are doing for the country.The Democrats have convinced so many people that they are entitled to something for nothing and of course millions believe it.This would be a dream come true for anyone. Stop and think of what it will really do to the future.I too have paid into Medicare since it started. All of the elected officials in Washington need to play by the same rules that are required of the American people.

7 years ago

I have been on a Medicare Advantage program for the last 10 years. It meets all of my needs and ensures my good health. I love managed care because it keeps me healthy. Why does this administration want to get rid of Medicare Advantage?

David Fulbright
7 years ago
Reply to  Pat

The part that makes me furious about what is happening to our MA plans is simple. We paid into the system. We paid in for years and years, if most people are like me. Now, a significant part of what we paid in is being taken for something that is going to a lot of people other than those of us who paid in. Medicare is not nearly what it was three or four years ago. Not long ago, I mentioned the changes which had cheapened down what we were receiving with MA plans. In one case a medical billing office said, “You are right. None of us likes the changes.”

In the second office, the lady looked at me and said, “If you think this is bad wait until you see the 2014 changes.” Then she added, “You didn’t hear that here. We aren’t supposed to mention that.” I pointed out that hearing is one of my health problems.

In the present system under our current President, seniors who paid in have been in a number of ways thrown under the bus. For my money, any legislature who voted for the current set up should be targeted by seniors in the next election., and we should encourage our adult children to vote against them to. We have votes. Use them to let legislators know that we are older now, not dead!

7 years ago

We have all received the solicitations from MA providers over the past couple of months with no mention of any effect from obamacare – just switch plans and sign up now. What is behind that? I would think these providers would be informing their clients what to expect in the near future as well as long term regarding the trashing of the USA’s health care system, and in particular Medicare/MA by the democrat party and their commissars in DC.

7 years ago

We have paid into Medicare from every paycheck since its inception. If you are still working take a look at your latest pay stub and you will see just how much you are contributing, This money was to be earmarked to help pay for our health care after we stopped working and no longer had our company health insurance. It seems the government can ignore its own laws and take (steal?) money from one program to fund their latest pet project. They did the same thing with Social Security to add disability benefits and funds for children whose parents died before they reached 18. They are always well meaning efforts, but funds should be added to support those programs if the American people think they are worthwhile.

They appear to be trying to offset this current money grab by paying the providers less for their services, pretending to be cutting waste from the program. This is absolute nonsense, now doctors will not make enough to stay in business or they can no longer take care of medicare patients or they have to run them through faster to keep enough money coming in to stay in business. Of course all this is occurring just when the huge number of baby boomers are starting to retire and when medicare needs every dime that has been given to it by workers during the course of their careers. This is absolutely shameful and dishonest and threatens to destroy the whole system.

7 years ago
Reply to  Jerry

Well said Jerry.

Adora Sala
7 years ago

I belong to Kaiser. I am 82 years old. I have been so worried about this that I am afraid to spend money on anything other than food, etc. I wish I knew what was going to happen to all of us. Have not received any notices or any e-mails. Need to know. How can I find out?

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