Earlier this January, the Medicare Payment Advisory Commission (MedPAC) convened and one topic of discussion was a report on Medicare Advantage (MA). While MedPAC has a long history of being a trusted congressional agency advising on Medicare and delivering recommendations to Congress, the controversy around this month’s report should raise eyebrows.
Since the early 2000’s, MA has been a uniquely successful public-private partnership that offers a strong alternative to totally government-run healthcare. MA plans receive a capped subsidy per enrollee which incentivizes appropriate levels of care and cost containment mechanisms. The benefits of this program are required to be equivalent on a dollar-for-dollar basis to traditional Medicare Fee-For-Service (FFS) benefits. This popularity has continued to increase - in 2023, it was estimated that over half of Medicare-eligible beneficiaries were enrolled in an MA plan. As NTU noted before, the success of this program can be attributed to the free market competition aspects wherein MA plans compete for enrollees based on their quality and satisfaction.
However, as MedPAC member Dr. Brian Miller rightly pointed out during the recent meeting, the panel should not be issuing biased analysis or reports that could lead to damage to a successful program or harm MedPAC’s reputation as a neutral independent agency. Dr. Miller’s critiques were astute: the report only highlights perceived negatives in MA plans, fails to highlight the positives, and his suggestions for improving the data analysis were ignored. MA plan positives include consistently low premiums (many enrollees need to pay $0 besides Part B) that have largely trended downwards since 2015. According to Kaiser Family Foundation, these average premiums have slid from $36 per month in 2015 to $15 per month in 2023.
While the report’s findings of potentially high disparity in payments between FFS and MA plans should be examined further, questions from its own leadership about bias and methodology must be answered first, before MedPAC becomes a partisan instrument like other previously independent agencies.