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Medicare Advantage

Labor Signs On To Save Medicare

In 1965, President Johnson signed Medicare into law, establishing the right to quality healthcare for millions of retired Americans. The labor movement was essential in passing this landmark legislation. It took decades of organizing—with labor working side by side with the Civil Rights and other social movements—to win one of the most robust public health programs in U.S. history. Now, Medicare is under attack: Profiteering corporations are promoting Medicare Advantage plans as an alternative to Medicare. But Medicare Advantage is not Medicare, it is a privatization scheme that funnels tax dollars through insurance companies to move enrollees into private insurance plans, undermining Medicare.

Beware Of Health Insurance Companies Bearing Gifts

Gainesville, FL - When it comes to Medicare Advantage, “beware of health insurance companies bearing gifts”, just like “beware of Greeks bearing gifts”, is a phrase that serves as a cautionary warning against trusting those who may have ulterior motives, particularly when they present seemingly generous health insurance policy offers. Everyone should be aware that not all offers of help or generosity are genuine and that one should critically and thoroughly assess the intentions and specifics behind such programs and policies. The idiom is particularly relevant in situations where aggressive sales agents of health insurance companies may present themselves as allies while harboring hidden marketing and sales agendas for Medicare Advantage.

Medicare Advantage Is Such A Threat To Workers, They Wrote A Paper On It

This past April, labor advocates for single payer health care published a white paper called, “Medicare Advantage: What Labor Leaders Need to Know.”In it, the authors remind labor leaders—including those in New York City who spent the last four years trying to push 250,000 municipal retirees into Medicare Advantage—that Medicare Advantage is “neither Medicare (the public, universal program without intermediaries between patients and the healthcare they need), nor is it an Advantage, except to profit-driven insurance companies.”

Medicare ‘Advantage’ By The Numbers

The quasi-privatized system called “Medicare Advantage,” otherwise known as Part C, was created in 2003 as a means of expanding the role of private sector corporations in the publicly-funded Medicare system. Proponents claimed it would lower costs and improve health care for seniors. It has achieved neither of those goals; instead, MA has become a wildly profitable scheme for private insurance giants, who have become adept at taking advantage of Medicare’s billing model to claim exorbitant profits. At this point, MA is more profitable for many companies than their conventional insurance businesses.

34 Million Seniors In Medicare Advantage Plans Face Rude Awakening

October 15 marks the first day of open enrollment in Medicare Advantage (MA) plans – a time that will deliver chaos and confusion for many of the 34 million seniors who depend on these plans to pay their healthcare bills. It’s yet another reminder that Medicare wastes billions of dollars funneling public money to private companies that are primarily driven by profit-seeking. Last year, more MA members than expected used their benefits to get necessary medical care. One might assume that companies would expect beneficiaries to use health care services. But after years of making outsized profits, the insurance companies that own these plans are reacting to this by downsizing plans, cutting benefits, increasing copays, and raising prescription drug deductibles. In other words, Medicare Advantage beneficiaries are being penalized for using the health care that they pay for.

New York City Teacher Retirees Save Their Medicare

The dissident Retiree Advocate caucus in the giant New York City teachers union won a decisive victory over the incumbents in the retiree chapter election June 14, winning 63 percent of the 27,000 votes cast. Turnout jumped compared to previous elections. In addition to running the 70,000-member Retired Teachers Chapter, they will send 300 delegates to the union’s delegate assembly. The leadership of the union got the message and abruptly dropped its support for Medicare Advantage, after three years of vigorously campaigning to impose a for-profit plan on 250,000 city retirees to save money for city officials.

Medicare Dis-Advantage: Overpayments And Inequity

Medicare Advantage—the privatized Medicare plans run by insurance firms but funded by the federal government—rips off taxpayers. On this there is little controversy. In March, MedPAC, Congress’s nonpartisan advisory board on Medicare policy, estimated that this year alone taxpayers will overpay Medicare Advantage plans by $83 billion—the savings to Medicare if all of those plans’ enrollees were instead covered by the traditional, fully public Medicare program. A 2022 New York Times exposé, “’The Cash Monster Was Insatiable’: How Insurers Exploited Medicare for Billions,” lays out the gory mechanisms—like fraudulent schemes (known as “upcoding”) to make patients look sicker on paper, which ups payouts from the government.

Healthcare Choices Narrow For Kentuckians In Medicare Advantage

Louisville - With open enrollment underway, older Americans are getting barraged with television ads, mailings and online notices hawking a variety of Medicare Advantage plans for health coverage. But many Kentuckians, including thousands of state retirees, are largely captive customers with such plans selected by their employer as part of health coverage promised for those 65 or older — an increasingly popular means to cover retirees. And members of such plans may have fewer choices for care because of ongoing contract disputes between Baptist Health and three national companies that offer Medicare Advantage plans in Kentucky including Louisville-based Humana, which covers most state retirees.

New Report: Insurers Are Gaming Medicare To The Tune Of $140 Billion

The federal government is losing as much as $140 billion per year by subsidizing private Medicare Advantage plans, according to a bombshell new report. In the groundbreaking investigation, health care researchers identified the four major ways that private insurers systematically exploit the taxpayer-funded national health insurance program while denying care to the nation’s most vulnerable patients. The researchers additionally found that seniors could save over $1,800 in annual fees taken from their Social Security checks if the government redirected what it spends subsidizing Medicare Advantage plans to instead reduce premium costs. Under the current arrangement, “traditional” Medicare pays about $12,000 a year to private Medicare Advantage insurers for every patient whose care they “manage.”

Two Large Medical Groups Shun Medicare Advantage Plans

Signaling what may be an emerging national trend, two influential medical groups with San Diego-based Scripps Health are cancelling their Medicare Advantage contracts for 2024 because of low reimbursement and prior authorization hassles, leaving 30,000 enrolled seniors to look for new doctors, or different coverage. "Negotiations with the payers for MA with our medical foundation groups and Scripps Health were unsuccessful and we have been forced to withdraw from those plans due to annual losses that exceeded $75 million," Scripps CEO Chris Van Gorder told MedPage Today in an early morning email.

Whipping Egg-Whips: Retirees Win Battles Against Medicare Advantage

An Egg-Whip sounds like a festive, holiday drink or a merengue dessert. It is anything but a delightful treat. Egg-Whip is the healthcare industry’s name for Employer Group Waiver Plans (EGWP), a provision for privatization of employer-based, retiree Medicare benefits that was written into the Medicare Modernization Act (MMA) of 2003. That law, which House Energy and Commerce Chair Billy Tauzin twisted arms to pass, added a drug plan to Medicare, not by including drugs as covered Medicare benefits, but by compelling seniors to purchase private drug plans. Big Pharma gained a massive influx of government money into its coffers and rewarded Tauzin with a $2-million-a-year job.

Care Denied: The Dirty Secret Behind Medicare Advantage

Jenn Coffey was so tired of having her care denied by her Medicare Advantage insurer that she signed a do-not-resuscitate order. “There was no more hope,” she said. “There was nothing left for me to hope for.” Coffey, a former EMT from Manchester, New Hampshire, went on Medicare, the government health insurance program for seniors and others with disabilities, after a breast cancer diagnosis left her unable to work. Like an increasing number of Medicare beneficiaries, she ended up on a for-profit Medicare Advantage plan; a marketer directed her to an option administered by UnitedHealth Group, a $450 billion insurer.

The $20 Billion Scam At The Heart Of Medicare Advantage

The health insurance behemoth Humana enjoyed a banner 2022. The Louisville, Ky.-based insurer made $2.8 billion in profits last year, while paying out $448 million in dividends to shareholders and more than $17 million in compensation to its CEO. The main driver of those earnings? The federal government spent $20.5 billion overpaying Humana and other private insurers for the Medicare Advantage plans they manage on behalf of seniors and people with disabilities. If not for those overpayments, Humana could have suffered a nearly $900 million loss in 2022, according to a Lever analysis.

Privatization Of Health Care By Unitedhealth Group

Privatization of public programs such as Medicare and Medicaid has been proceeding rapidly in recent years with little coverage by the media of its harms to patients, the public and taxpayers. This article has four goals: (1) to bring brief historical perspective to this trend in the U. S.; (2) to shed light on the experience over the last 12 years of profiteering by UnitedHealth Group, now the largest U. S. private health insurer; (3) to describe negative impacts on our health care system; and (4) to briefly consider lessons that can be learned from this concerted and stealthy exploitation of the public interest through the corporate greed of UnitedHealth.

Medicare Advantage Is Not An Advantage For Seniors With Cancer

When America’s seniors enroll in Medicare, they enter the most medically vulnerable stretch of their lives. And if they are unfortunate enough to be among the 1.9 million Americans each year who hear the terrifying words “you have cancer,” it is imperative they have access to the support and care they need to survive. About 60 percent of cancers occur in people ages 65 or older, accounting for approximately 70 percent of all deaths caused by the disease. But as recently diagnosed cancer patients embark on this unwanted, unexpected care journey, what many seniors do not realize is that their Medicare Advantage (MA) plan can often put them at a disadvantage by restricting access to the care they need and deserve.
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