When Medicare Advantage was first signed into law, we were promised that commercial insurance companies would deliver high-quality medical benefits at a lower cost than Traditional Medicare. Almost immediately, it became clear that the opposite was true: these companies are delivering stingier benefits to seniors while costing taxpayers significantly more than the original, public program.
As Medicare Advantage has grown, it has attracted more scrutiny…which has made it even more apparent that the public is getting a bad deal.
Groundbreaking report on corporate overcharging
In the weeks before Medicare’s 2023 Open Enrollment period, Physicians for a National Health Program compiled a report detailing the many ways that Medicare Advantage corporations overcharge taxpayers. The total amount—up to $140 billion per year—could be used to totally eliminate Medicare Part B premiums; or to add dental, hearing, and vision benefits to Medicare and Medicaid.
Congressional hearing on Medicare Advantage
On June 28, 2022, the Subcommittee on Oversight and Investigations of the U.S. House Committee on Energy and Commerce held a hearing titled, “Protecting America’s Seniors: Oversight of Private Sector Medicare Advantage Plans.” Click HERE to read a live-tweet of the proceedings.
Federal investigations and industry watchdog reports
Medicare Advantage plans have kept federal investigators and industry watchdogs busy chronicling the many ways they harm patients and taxpayers. A collection of recent reports—which are in no way comprehensive—document everything from deceptive marketing tactics to narrow provider networks to inappropriate denial of care.
- American Economic Liberties Project: “Medicare Advantage and Vertical Consolidation in Health Care” (April 2024)
- Center for Economic and Policy Research: “Medicare Advantage and Deceptive Marketing” (Nov. 2023)
- Journal of Clinical Oncology: “Medicare Advantage: A Disadvantage for Complex Cancer Surgery Patients” (Feb. 2023)
- U.S. Senate Committee on Finance: “Deceptive Marketing Practices Flourish in Medicare Advantage” (Nov. 2022)
- Kaiser Health News: “Audits — Hidden Until Now — Reveal Millions in Medicare Advantage Overcharges” (Nov. 2022); Update: “Did Your Health Plan Rip Off Medicare?” (Jan. 2023)
- U.S. Government Accountability Office: “Medicare Advantage: Continued Monitoring and Implementing GAO Recommendations Could Improve Oversight” (June 2022)
- U.S. Department of Health and Human Services, Office of Inspector General: “Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care” (April 2022)
- U.S. Department of Health and Human Services, Office of Inspector General: “Some Medicare Advantage Companies Leveraged Chart Reviews and Health Risk Assessments To Disproportionately Drive Payments” (Sept. 2021)
- Kaiser Family Foundation: “Medicare Advantage: How Robust Are Plans’ Physician Networks?” (Oct. 2017)
Ready to take action? Write a letter to the editor or op-ed warning about the dangers of Medicare Advantage. You may also wish to call your member of Congress at (202) 224-3121 and urge them to both crack down on Medicare Advantage profiteering and make necessary improvements to the Traditional Medicare program. Questions? Email mandy@pnhp.org.