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Medicare enrollments forms with Social Security card.
Chalk another victory up for the the health insurance industry. Their Medicare Advantage plans were scheduled to see a 2.3 percent cut go into effect this month. Instead, they convinced the Obama administration to give them a 3.3 percent increase, largely through a campaign of deceptive astroturfing.

Medicare Advantage plans are good business for the health insurance industry. Though only a little more than a quarter of Medicare beneficiaries buy these supplemental plans, they're big business. They're also relatively expensive for the federal government, which subsidizes them. In fact, the Government Accountability Office found that over the past three years, the federal government has overpaid insurers between $3.2 billion and $5.1 billion. That's something the Obama administration wanted to change, needing to find every cost-cutting measure possible to implement Obamacare. That's why the administration tasked the Centers for Medicare & Medicaid Services (CMS) with cutting those subsidies and why it proposed the 2.3 percent cut. The cut would have not been in benefits, but America's Health Insurance Programs (AHIP) didn't want MA enrollees to know that. So they did what every powerful industry group does: use some scare tactics and an Astroturf campaign.

Last week Katharine Raley, who heads the Ventura, CA, office of the state’s Health Insurance Advocacy and Counseling Program, got a warning call from a representative of Blue Cross. The insurance rep told Raley that an industry-backed advocacy group called the Coalition for Medicare Choices would be phoning beneficiaries in the county about a planned 2.3 percent reduction in federal payments to Medicare Advantage plans. “She was afraid beneficiaries would be nervous that the cuts would penalize them,” Raley said. [...]

The Coalition for Medicaid Choices’ campaign features ordinary seniors in slick, scary TV ads now playing around the nation, urging viewers to call their elected officials to stop the cuts. But the Coalition is not a true grassroots group. It’s a product of AHIP, which has pulled out all the stops in its effort to stop the rate adjustment, putting the Coalition’s 1.3 million members with Medicare Advantage plans to work ginning up letters, emails, and phone calls to legislators.

The result? More than 40,000 terrified seniors called their representatives. That's because AHIP was telling them that they would see their monthly premiums rise between $50 and $90. The part that AHIP left out was that they would not accept lower profits nor would they cut expenses, so customers would have to make up the difference. As a result of all those calls from terrified seniors, dozens and dozens of members of Congress called the CMS, and here we are.

AHIP isn't likely to try to out-and-out kill Obamacare; they've got too good a deal out of it overall, with all the new customers they're going to gain. But that doesn't mean they'll fight back on the margins. On less prominent fights like this one, and by chipping away at the various cost-cutting reforms, they'll both ensure their continued profits and the nation's overpriced health care. That is, until we have a president and Congress who will to stand up to them and create some real competition for them. Medicare for All, anyone?

Originally posted to Joan McCarter on Tue Apr 02, 2013 at 12:57 PM PDT.

Also republished by Daily Kos.

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Comment Preferences

  •  Republicans Will Use This As Proof Obamacare..... (7+ / 0-)

    is raising medical costs for seniors.  The details won't matter, the full story won't matter, the deviousness & the lies of the insurance companies won't matter.

    This will start appearing in Republican talking points.  Ted Cruz will have a field day w/ this one.  Sean Hannity & Bill O'Reilly will jump on the bandwagon.

    Coming to your local Republican Representative & Senator soon.....very, very soon.  

    •  Just as They Already Convinced Voters That the (3+ / 0-)
      Recommended by:
      MartyM, Mr Robert, Losty

      provider cost cuts had been benefit cuts.

      No way will Democrats interfere with the Republican message on these issue, we have a midterm election coming up and we don't want the base energized.

      We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

      by Gooserock on Tue Apr 02, 2013 at 01:17:26 PM PDT

      [ Parent ]

    •  10 years ago we got single payer voted on in (5+ / 0-)

      Oregon. It went down in flames, but we collected the signatures to get it on the ballot with Healthcare for All volunteers. And I have been thinking we might do better, even win, in the next few years with another try.

      But I'm worried that lots of volunteer hours in Oregon and other states are going to be lost to efforts to make ACA work. And I'm worried that this 20 year old heritage foundation plan will never be fixable and the insurance industry and hospital cartel will use it as a money spigot while real healthcare reform efforts will be slowed to a crawl.

  •  Medicare Advantage is another major (3+ / 0-)
    Recommended by:
    Mr Robert, Pluto, peptabysmal

    corporate subsidy bleeding money out of the treasury.  People are stupid, their represenatives apparently are the distilled essence of that stupidity combined with greed for those cash handouts from industry.

    Who cares that Medicare Advantage under the government share pays outs more than the cost of care and the private company gets the preumium from the patient as well.

  •  When insurers win, we ALL win. (3+ / 0-)
    Recommended by:
    Pluto, Losty, Mr Robert

    Why do you hate America, Joan?

    s/

    When you triangulate everything, you can't even roll downhill...

    by PhilJD on Tue Apr 02, 2013 at 01:51:26 PM PDT

  •  Here's another biggie (3+ / 0-)
    Recommended by:
    Losty, phonegery, Mr Robert

    The Medicare deductible is going from $147 to $1,331 per year.

    That's gotta hurt.

    To start with, beneficiaries would pay a single deductible each year, instead of separate ones for hospitals (presently $1,184) and physicians (presently $147).  The actual impact would depend on the kinds of services they use. Most (about 80%) are not hospitalized in any given year, so the new combined deductible would be higher than the amount they presently pay. But if they do need inpatient care, it would be much lower.
    http://www.philly.com/...

    It's on the table.



    Denial is a drug.

    by Pluto on Tue Apr 02, 2013 at 02:24:28 PM PDT

    •  That comes from combining the A & B deductibles (1+ / 0-)
      Recommended by:
      zaka1

      Yes, it's being discussed. Pushed, really, by some Repubs. To be honest I haven't given it a lot of thought, and it might even make sense if it helped bring down overall cost shares, as the 20% coinsurance is tough for less healthy seniors of limited means. A moderately higher deductible in exchange for lower coinsurance might be better for many seniors. Of course, they'd probably find a way to make it worse overall.

      "Liberty without virtue would be no blessing to us" - Benjamin Rush, 1777

      by kovie on Wed Apr 03, 2013 at 08:29:50 PM PDT

      [ Parent ]

    •  I hope this (0+ / 0-)

      is not true, but knowning how wonderful our politicians are it probably is.  It is hard enough to balance life on social security yet alone paid a higher deductable, trust me it isn't easy just paying out $147.00 deductable now, if it goes up to around $1,300.00 it will really hurt the disabled as well as the elderly.

      Does anyone in Washington have any idea of how the average person lives in their country?  No common sense ever gets in the way of any policy that comes out of Washington these days.

      And if we get into a conflict with Korea will we have to give up more to pay for more war?  

      "During times of universal deceit, telling the truth becomes a revolution­ary act. " George Orwell

      by zaka1 on Thu Apr 04, 2013 at 12:04:37 AM PDT

      [ Parent ]

  •  Another Good Reason for Single-Payer (2+ / 0-)
    Recommended by:
    conniptionfit, jasan

    Let's just bite the bullet and sign everybody up for Medicaid-for-All, single-payer and cut the Insurance Cartel out for good.

  •  This is the "we can fix it after passage" used... (2+ / 0-)
    Recommended by:
    phonegery, peptabysmal

    to keep us all quiet while Max Baucus created this law.

    "The Democratic Party is not our friend: it is the only party we can negotiate with."

    by 2020adam on Tue Apr 02, 2013 at 02:47:06 PM PDT

  •  I'm 53 and I hope that MA... (0+ / 0-)

    ...is just an entry in the historical record by the time I'm Medicare eligible.

    When you are right you cannot be too radical; when you are wrong, you cannot be too conservative. --Martin Luther King Jr.

    by Egalitare on Wed Apr 03, 2013 at 07:44:20 PM PDT

  •  and of course the administration has no way of (2+ / 0-)
    Recommended by:
    tb mare, divineorder

    countering the healthcare insurance mafia's propaganda b/c its hands are completely tied & it has no system in place to get its message out so it allows for even more bogus payments to the bloated insurance industry . . . (snark)

    wtf??? this is some seriously messed up shit.

  •  why, soitenly. (2+ / 0-)
    Recommended by:
    tb mare, divineorder

    Medicare for All, anyone?

    Medicare for all. Including DENTAL.

    and what all else we should provide ourselves.
    i'll give to you and you give to me and we all win.

    There is no Article II power which says the Executive can violate the Constitution.--@Hugh * Addington's Perpwalk: TRAILHEAD of Accountability for Bush-2 Crimes.

    by greenbird on Wed Apr 03, 2013 at 07:55:44 PM PDT

  •  Ri-i-i-ght.... (1+ / 0-)
    Recommended by:
    divineorder
    until we have a president and Congress who will to stand up to them and create some real competition for them.
    I don't think Jesus Christ himself could do what it would take to clean up our politics, i.e., take the money out of elections and stop the corruption.

    "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

    by SueDe on Wed Apr 03, 2013 at 08:06:28 PM PDT

  •  A little editorial quibble (3+ / 0-)
    Recommended by:
    dRefractor, Lying eyes, Womantrust

    In your second graf you describe the MA plans as "supplemental". A more accurate adjective for the type of plans that have scored this switch-up would be "alternative", as in an alternative to Traditional Medicare.

    Supplemental Medicare insurance plans, when attached to Medicare (the traditinal kind of plan) are separate policies paid for entirely by beneficiaries who want coverage for deductibles and the cost-sharing that comes with Medicare.

    Supplemental Medicare plans are heavily regulated by the rules applying for Medicare, but are not at all the same as MA plans.  The Medicare rules for supplemental policies are primarily focused on making sure that the insurancec is actually useful and not a scam on seniors.

    Medicare Parts A & B,  the (mandatory) Part D drug plans, Medicare Advantage plans and supplemental policies are confusing enough without blurring the descriptors that attach to them.

    When I hear younger people blythely calling for expansion of Medicare for all as a substitute the current status quo patchwork, I roll my eyes. Except for wraparound Medicare Advantage plans Medicare is not "easier" than what we have now.

    I am no proponent of MA plans (we deliberately chose traditional Medicare when my husband became eligible), but it is the more complex route.  Why that is the case for a universal benefit that effects every person who reaches age 65,  makes no sense to me. It would make more sense to me that the government option would be the least complex, easiest to navigate one, but sadly it just isn't.

    Araguato

    •  One advantage of MA plans (no pun intended) (2+ / 0-)
      Recommended by:
      dRefractor, divineorder

      is that other than ESRD there are no preexisting condition issues, exclusions or waiting periods, which do exist with medigap (i.e. supplemental) plans. You can't be kicked off a medigap plan if you get sick while on it, but you can get denied when applying for one if you have a preexisting condition. By law this isn't allowed with MA plans. Plus, many of them have zero premiums. Which makes sense since the government subsidizes them (even if it doesn't make sense fiscally for it to do this).

      "Liberty without virtue would be no blessing to us" - Benjamin Rush, 1777

      by kovie on Wed Apr 03, 2013 at 08:35:01 PM PDT

      [ Parent ]

      •  My understanding is that medigap policies (2+ / 0-)
        Recommended by:
        Lying eyes, divineorder

        can't deny you entrance on the grounds of pre-existing conditions as long as you can show proof of "creditable" (that's spelled correctly, meaning credit-able, not credible) Medigap, or other form of supplemental insurance from the beginning of your Medicare coverage.

        This is to prevent people from only acquiring Medigap insurance  after they need help with major medical claims due to illness.

        I know this was an issue for us since my husband does have an pre-existing condition.  I was really sweating this, but it worked out fine.

        The need for continuous coverage is the same one driving the need for the ACA individual mandate as many people would attempt to game the system by only signing up for insurance in the ambulance on the way to ER, and not before.  

        Medicare Advantage policies have one built-in  disadvantage compared to Traditional Medicare: they are usually closed sets of providers and hospitals, along the PPO/HMO models.

        There are half a dozen or so fixed arrays of benefits possible with Medigap plans.  You can choose which one best fits your needs. They are relatively easy to comparison shop. Not like the immensely complicated Part D plans which depend on the vagaries of your personal life like which meds you take (or expect to take over the course of a year) and which pharmacy you frequently use.  The permutations of selecting the most economical Part D choice takes a spread sheet to work out. It's crazy!

        Araguato

        •  My dad used to be on an MA plan (2+ / 0-)
          Recommended by:
          Womantrust, divineorder

          But his insurers, the only one in his area, stopped carrying MA plans, so he reverted to regular Medicare, later adding a Part D plan. But he eventually realized that while his health was still good, that would likely change someday, and the 20% coinsurance and no caps on out of pocket expenses would become unaffordable for his limited means.

          So he decided to get a medigap plan. Unfortunately, he did have a preexisting condition that he developed after his MA plan lapsed, and enough time had passed that he didn't fall into any of the guaranteed issue categories, so he didn't qualify for medigap, or at least a plan that would cover this condition.

          Luckily, he moved states in the interim to where MA plans were available, and was able to join one to his liking, without having to worry about preexisting conditions. I suppose you could criticize him for "gaming" the system, but he paid into Medicare his whole life, and except for a 1-2 year period where he only had Medicare, he always had either private insurance, medigap or MA, and it wasn't his fault that MA was dropped in his original area.

          The system's way to complex and needs to be simplified. Everyone needs to pay in a certain amount, if they can afford it, and everyone needs to be guaranteed access to decent health care no matter their medical or financial condition--no matter what age. Everyone but the poor and children need to pay in, and everyone including the poor and children must get decent health care. It's simply insane to not do this, not just from a moral pov, but a practical one as well. Our economy suffers due to people not getting health care.

          "Liberty without virtue would be no blessing to us" - Benjamin Rush, 1777

          by kovie on Thu Apr 04, 2013 at 07:30:34 AM PDT

          [ Parent ]

  •  Of course. Does anyone really not see Obamacare (1+ / 0-)
    Recommended by:
    TJ

    as the biggest gift ever to the health insurers?

    The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

    by accumbens on Wed Apr 03, 2013 at 08:08:20 PM PDT

  •  We need a person of high morals and iron will (0+ / 0-)

    to spear head Obamacare.  I nominate Joseph Stalin who should be more than a match for the health insurance crooks.

  •  They will emasculate it in the end (2+ / 0-)
    Recommended by:
    Womantrust, divineorder

    A few days ago Rachel showed how congress has been bought.  What do you expect? They are expected to deliver the goods after they get the campaign contributions.  And they do.  Only in America can people believe that paying twice as much as everyone else and getting much less to boot is the best system in the world.  It is all so sad.  And yet congresspeople get great coverage at low prices with few restrictions.  Hmmm. I wonder why.

  •  Good ol' Obama - out maneuvered again. (1+ / 0-)
    Recommended by:
    divineorder

    Why would anyone in their right mind think that an insurance company or anybody else  is going to absorb a loss they can pass on?  

    The more time passes, the bigger losers Obama voters become.

    What we need is a Democrat in the White House.

    by dkmich on Thu Apr 04, 2013 at 03:04:30 AM PDT

  •  I have a Medicare Advantage plan (1+ / 0-)
    Recommended by:
    divineorder

    For a lot of seniors who are living month to month, there is not much choice.

    You can take Medicare and get a supplemental policy. That will cost you about $200 a month when you include a prescription drug benefit.

    or..

    You can take a Medicare Advantage plan that has a zero premium.

    There is no doubt that you have more choices with straight Medicare and a supplemental policy and believe me it is the way to go, if you can afford the extra premium. For many seniors it's just not a cost they can afford.

    ...the GOP seems perfectly willing to hold their breath until the whole country turns Blue.

    by tommy2tone on Thu Apr 04, 2013 at 04:33:26 AM PDT

  •  One more reason to back single-payer (3+ / 0-)

    Yes, the insurance industry will bankrupt the Treasury. As will the pharma-hospital industry.

    Single payer! It's time!

    Somebody should work out a simple as possible transition chart, to take the nation from Not-Romney-Care to single payer. And use it to help lead the nation in that direction.

    A cat food nation? That's the fate of millions unless we soundly defeat the Entitled 1% in the 2014 and 2016 elections. Let's get to work!

    by catfoodnation on Thu Apr 04, 2013 at 05:45:54 AM PDT

    •  State by state single payer (2+ / 0-)
      Recommended by:
      divineorder, Grabber by the Heel

      I am greatly encouraged by the several recent news dispatches concerning a state-by-state move toward single payer.

      State medical care trusts, supported by taxation, greatly simplifying everything and at something like half the cost of profit-sickened medicine. Freedom to choose a doctor, etc. Maybe this is the best way and maybe it is the only way it can happen, with the paralysis in Washington, D.C.

      Then presumably all states will go along with this move, when their residents hear the exciting news from friends and kin in single-payer states.

      A cat food nation? That's the fate of millions unless we soundly defeat the Entitled 1% in the 2014 and 2016 elections. Let's get to work!

      by catfoodnation on Thu Apr 04, 2013 at 09:51:55 AM PDT

      [ Parent ]

  •  Not to be too snarky about this (1+ / 0-)
    Recommended by:
    divineorder

    but "... they would not accept lower profits nor would they cut expenses, so customers would have to make up the difference. " Is pretty much exactly what anyone would have predicted.

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