Biden Urged to 'Hold the Line' Against For-Profit Medicare Advantage Industry

Opponents of healthcare privatization gathered at the White House on Thursday to send President Joe Biden a message from tens of thousands of Americans: "Do not give in to corporate insurers."

With the Biden administration set to unveil its final payment rate for privatized Medicare Advantage (MA) plans on April 1, Alex Lawson of Social Security Works and Brittany Shannahan of Public Citizen delivered around 28,000 petition signatures to the White House imploring Biden to "reduce MA rates to a level commensurate with traditional Medicare and recoup all overpayments."

"Do not let them bully you," Lawson said during a livestream in front of the White House on Thursday. "Corporate insurers are holding the country's health hostage and demanding bags of cash."

Medicare Advantage is a privately run program funded by the federal government, and the major for-profit insurers that dominate the MA industry are notorious for denying patients necessary care and overbilling the government by making patients appear sicker than they are—a practice known as "upcoding."

One recent study estimated that Medicare Advantage plans overcharge U.S. taxpayers to the tune of $140 billion per year, which would be enough to zero out Medicare Part B premiums.

"Medicare is under threat from greedy corporations that are more focused on profit than providing patient care," said Shannahan, a Medicare for All organizer. "This is a threat to Medicare. This should be on campaign ads."

The Biden administration is expected to propose a 3.7% payment increase for Medicare Advantage in 2025. More than 30,000 people have submitted comments opposing that rate, according to Social Security Works.

Insurers, a powerful lobbying force in Washington, D.C., are also pushing back on the administration's plan—demanding that they receive more, not less, government money.

"Taking our money and denying our care: That's their business model," Lawson said Thursday.

Lawson and Shannahan welcomed the Biden administration's recent efforts to curb Medicare Advantage overbilling and other abuses.

Survey results released earlier this week by Data for Progress show that the Biden administration's efforts to curtail MA plans' wrongful care denials and overbilling are overwhelmingly popular across party lines.

In a blog post on Tuesday, Just Care USA president Diane Archer noted that "since its inception," MA has "cost the Medicare program more per enrollee than traditional Medicare" even as it imposes "obstacles to care that don't exist for people in traditional Medicare, including burdensome prior authorization requirements and restricted physician and hospital networks."

"Our government is spending more and enrollees are too often getting fewer Medicare benefits than they would in traditional Medicare," Archer wrote.

In their remarks in front of the White House on Thursday, Shannahan and Lawson urged the Biden administration to "hold the line" and take bolder action to rein in Medicare Advantage plans, which now cover half of all eligible Medicare beneficiaries.

"We need to see more," said Shannahan. "We know that Medicare Advantage insurers are throwing around cash trying to make sure that they can continue to exploit their patients undetected and unchecked."

Carmen Rhodes, senior adviser and programs director at Be A Hero—a group founded by the late Medicare for All champion Ady Barkan—wrote in an op-ed for Common Dreams on Thursday that the Biden administration must hold Medicare Advantage plans "accountable for their greed, not give them a raise."

"Hundreds of our grassroots supporters have shared their painful stories of being delayed or denied care by faceless, cruel insurance companies," Rhodes wrote. "Others reveal feeling tricked or even forced onto a Medicare Advantage plan and then being stuck in the 'Hotel California.' Their heartbreaking stories called Ady and now call all of us to take action."