19 November 2023

About F%$#ing Time

Following years of higher costs for the government, deceptive marketing to seniors, and general health insurer rat-f%$#ery, the White House is looking to rein in the excesses of the Medicare Advantage industry.

When you bring private companies in, you get increased costs, and arbitrary denials of essential health services.

Nice that someone inside the Beltway is beginning to recognize this:

The Biden administration is proposing a fresh crackdown on private health plans that have grown to cover half of the people on Medicare, restricting marketing practices as part of an effort to help consumers in the federal insurance system for older and disabled Americans get the health services they need.

Under a draft rule issued Monday by the federal Centers for Medicare and Medicaid Services, Medicare Advantage plans would be required to work harder to encourage customers to make use of extra benefits available to them, rather than the companies merely invoking them as a selling point.


Older Americans choosing Medicare coverage “should not be subject to practices playing fast and loose with marketing rules,” Health and Human Services Secretary Xavier Becerra said during a Monday press briefing to outline the proposal.

The proposed rule marks the second time in a year that the administration has sought to stiffen regulation of Medicare Advantage, the private-sector version of Medicare that has soared in popularity in recent years. Late last year, HHS proposed a different set of changes that mainly focused on restricting predatory marketing practices, including deceptive advertising, by insurance brokers and agents trying to sell the private health plans to people on Medicare. That rule became final in April.


Medicare Advantage was created in 2003 as part of the same federal law that added prescription drug benefits to Medicare for the first time since the vast insurance program came into existence in the 1960s as part of President Lyndon B. Johnson’s “Great Society.” The traditional version of Medicare allows people 65 and older and those with disabilities to choose their own doctors and pay monthly premiums for outpatient care. The managed-care plans in the privatized version often offer extra benefits popular with older patients, such as vision and hearing services, but those plans usually restrict patients to a narrower network of health-care practitioners who have signed up to accept patients in a given plan.

When Medicare Advantage was created, replacing a few earlier forms of managed-care Medicare, the Republicans who held a majority in both chambers of Congress insisted the government pay the private plans more than the reimbursement rates under original Medicare, as an incentive for more plans to take part.

The Republicans wanted, and got, a subsidy for private insurers as a tactic to gradually unwind Medicare as a public insurance program.

Unfortunately, it's not politically tenable to shut down this bit of corrupt larceny of taxpayer funds, but aggressively enforcing existing regulations, along with frog marching a few insurance company executives out of their offices in handcuffs, could make them better, and eventually less of a drag on the taxpayer.


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