SUBSCRIBE TO OUR FREE NEWSLETTER
Daily news & progressive opinion—funded by the people, not the corporations—delivered straight to your inbox.
5
#000000
#FFFFFF
5
#000000
#FFFFFF
medicare advantage
Project 2025's Plan to Kill Medicare Via Default Enrollments in For-Profit Alternative
"If implemented, Project 2025 would lead to a multibillion-dollar annual giveaway to corporations at the expense of Medicare enrollees and taxpayers," warns a new Center for American Progress report.
Aug 15, 2024
Project 2025—the far-right initiative to expand U.S. presidential power and purge the federal civil service—poses a dire threat to the government-run healthcare coverage enjoyed by tens of millions of senior citizens by making private, for-profit Medicare Advantage plans the default option for all Medicare enrollees, a report published Thursday warned.
The Center for American Progress (CAP) report said the goal of the Heritage Foundation and other right-wing groups behind Project 2025 involves "pushing the United States toward a future of fully privatized Medicare."
"If implemented, Project 2025 would lead to a multibillion-dollar annual giveaway to corporations at the expense of Medicare enrollees and taxpayers, and at the expense of Medicare's financial sustainability," CAP said, noting that "Medicare Advantage costs the Medicare program 22% more per enrollee than traditional Medicare."
"If Project 2025's plan to make MA the default option were to expand the proportion of Medicare beneficiaries in MA to 75%—up from its current enrollment level of 51%—CAP estimates that wasteful spending could approach an eye-popping $2 trillion over 10 years," the publication states.
Furthermore, the report says that "making Medicare Advantage the default option would restrict more Medicare enrollees' options over which doctors and hospitals they can receive care from."
Report co-author and CAP research associate for health policy Brian Keyser said in a statement that "Project 2025's plan to make Medicare Advantage the default option would give corporations even more power and strip doctors and patients of the freedom to make decisions about what care enrollees can or cannot receive."
"Project 2025's plan makes it clear—its priority is to help boost profit-driven corporations' bottom lines at the expense of Medicare enrollees' access to care and the future solvency of Medicare," Keyser added.
Often derided as "Medicare Disadvantage" by critics, MA was created by a GOP-controlled Congress and signed into law in 2003 by then-President George W. Bush "as a way of routing hundreds of billions of taxpayer dollars into the pockets of for-profit insurance companies," according to frequent Common Dreams opinion contributor Thom Hartmann.
A report published last year by Physicians for a National Health Program revealed that MA plans are overcharging U.S. taxpayers by up to $140 billion per year, enough to completely eliminate Medicare Part B premiums or fully fund Medicare's prescription drug program.
The MA report is part of a CAP series on Project 2025—which also includes ananalysis from last week showing how the initiative "would make it easier for big corporations to dump dangerous toxins that poison Americans."
According to the report, the initiative's plan to dismantle environmental regulations—as former President Donald Trump, the 2024 GOP nominee, did during his first term—threatens to reverse progress in protecting Americans from toxins like lead, soot, and other poisons including per- and polyfluoroalkyl substances (PFAS), also known as "forever chemicals" because they don't break down easily over time.
In an attempt to distance himself from the extremist agenda, Trump has claimed that he "knows nothing about" Project 2025 or who is behind it.
However, at least 140 people who worked in the first Trump administration have been involved with Project 2025, and last week The Washington Post published an article revealing that Trump took a private jet flight with Heritage Foundation president Kevin Roberts to a conference where the GOP nominee said that the conservative think tank is "going to lay the groundwork and detail plans for exactly what our movement will do."
Keep ReadingShow Less
As Medicare Turns 59, We Still Must Defend It
Even after nearly six decades of Medicare’s overall success, we must continually protect it from conservatives’ attempts to cut and privatize the program.
Jul 30, 2024
Before Medicare was
signed into law by President Lyndon Johnson 59 years ago today, nearly half of American seniors had no hospital insurance. Private insurance companies were reluctant to cover anyone over 65. Even fewer seniors had coverage for non-hospital services like doctor’s visits. Many of the elderly were forced to exhaust their retirement savings to pay for medical care; some fell into poverty because of it. All of that changed with Medicare.
In Medicare’s first year of coverage, poverty decreased by 66% among the senior population. From 1965, when Medicare was enacted, to 1994, life expectancy at age 65 increased nearly three full years. This was no coincidence. Access to Medicare coverage for those who were previously uninsured helped lift seniors out of poverty and extend their lives.
As with Social Security, workers would contribute with each paycheck toward their future Medicare benefits. Upon putting his signature on this new program, a keystone of the Great Society, President Johnson declared, “Every citizen will be able, in their productive years when they are earning, to insure themselves against the ravages of illness in old age.”
Project 2025, the right-wing blueprint for a second Trump presidency, would gut traditional Medicare by accelerating privatization and repealing drug price negotiation.
Medicare has been improved several times over the decades. In 1972, Americans with disabilities (under 65 years of age) became eligible for Medicare coverage—along with people suffering from chronic kidney disease needing dialysis or transplants. In 2003, prescription drug coverage was added to Medicare (though the program was prohibited from negotiating prices with drugmakers). The Inflation Reduction Act of 2022 finally empowered Medicare to negotiate prices with Big Pharma—and lowered seniors’ costs by capping their out-of-pocket expenses for prescription drugs and insulin.
Nearly 60 years after it was enacted, Medicare is one of the most popular and efficient federal programs. Ninety-four percent of beneficiaries say they are “satisfied” or “very satisfied” with their quality of care. Unlike many other federal programs, Medicare spends less than 2% of its budget on administrative costs.
Medicare isn’t perfect. It should be expanded to cover dental, hearing, and vision care. More urgently, though, the privatized version of the program, Medicare Advantage (MA), is gobbling up a larger share of the program despite myriad problems, including MA insurers overbilling the government and denying care that’s always offered by traditional Medicare. The Biden-Harris administration has been working to hold those private plans more accountable, but much remains to be done to protect traditional Medicare from efforts toward privatization.
Even after 59 years of Medicare’s overall success, we must continually defend Medicare against conservatives’ attempts to cut and privatize the program. Our founder, Rep. James Roosevelt, Sr. (D-Calif.), son of President Franklin D. Roosevelt, knew that Medicare (along with Social Security) would need continuous advocacy to withstand assaults from antagonistic political forces. That’s why the word “preserve” is in our organization’s name.
Many conservatives opposed Medicare from the start, labeling it “socialism” and “socialized medicine.” In 1962, Ronald Reagan warned that if Medicare were to be enacted, “One of these days you and I are going to spend our sunset years telling our children, and our children’s children, what it once was like in America when men were free.”
Today, the onslaught continues. The House Republican Study Committee’s (RSC) 2025 budget proposes to cut Medicare by an estimated $1 trillion over the next decade. The RSC would replace Medicare’s current system with vouchers, and push seniors into private plans that can and do deny coverage. Project 2025, the right-wing blueprint for a second Trump presidency, would gut traditional Medicare by accelerating privatization and repealing drug price negotiation.
Democrats by and large support protecting and even expanding Medicare. President Joe Biden tried to add dental, vision, and hearing coverage in his Build Back Better Act, but encountered resistance from Republicans and centrist Democrats. It’s still a laudable goal.
Republicans, for the most part, advocate cutting Medicare benefits and privatization. We endorsed Vice President Kamala Harris for president, because she knows the importance of Medicare to America’s seniors and people with disabilities—and has vowed to protect them. Former President Donald Trump, on the other hand, has been rhetorically all over the map on this topic, telling CNBC he is “open” to “cutting entitlements” but claiming to support Medicare. (His budgets as president called for billions of dollars in Medicare cuts.)
The 59th anniversary of Medicare is both an occasion for celebrating the program’s enormous successes over the past six decades—and a time to defend Medicare in the marbled halls of Washington, D.C., and at the ballot box this November.
Keep ReadingShow Less
To Win ‘Medicare for All,’ First Reclaim Medicare From Profiteers
If we want to build on the promise of Medicare, then we’re going to have to grapple directly with the power of corporate health insurance: That starts with taking on the so-called “Medicare Advantage” program.
Jul 30, 2024
Fifty-nine years ago today, President Lyndon Johnson signed Medicare into law—a high-water mark in the fight for universal healthcare that had started decades before and that continues to this day.
Ever since Medicare became law, it has been a shining example of what is possible in U.S. healthcare: a truly public, truly universal program that has saved countless lives and prevented untold financial ruin among America’s seniors. But alongside this success, corporate health interests have also grown immeasurably more powerful. Insurers like UnitedHealthcare and Blue Cross Blue Shield have erected cruel barriers to care and are laughing all the way to the bank.
If we want to build on the promise of Medicare—and win the best possible version of Medicare for All—then we’re going to have to grapple directly with the power of corporate health insurance. That starts with taking on the so-called “Medicare Advantage” program.
The Strategic Importance of Medicare Advantage
Single-payer advocates understand that there can’t be “Medicare for All” if there is no “Medicare.” And no, Medicare Advantage (MA) doesn’t count as Medicare. The health insurance corporations that run these plans have a business imperative to prioritize profits above all else; this is anathema to any public health program.
Physicians for a National Health Program (PNHP) has compiled overwhelming evidence that MA insurers are harming patients, physicians, and hospitals by delaying and denying care—harms that are virtually unseen in Traditional Medicare. Nor is this cruelty even a trade-off for lowering the cost of healthcare. In fact, these corporations are paid far more than what is spent for similar patients in Traditional Medicare—up to $140 billion per year, or as much as 35% above the funding levels of Traditional Medicare.
There is no road to Medicare for All that ignores this existential threat.
Where we see middlemen standing between patients and the care they need, we should remove them. Where we see limited provider networks, we should expand them. Where we see piles of pre-authorization paperwork, we should shred them.
Thankfully, support for eliminating overpayments to MA extends far beyond those who are already committed to single payer. This fight builds our movement by mobilizing a wide range of people who understand, or can be educated about, the damage insurance companies are doing to patients. When we find common ground, we should walk together.
For that reason, PNHP is exposing MA overpayments and demanding a more fiscally responsible approach from policymakers. We are working closely with several organizations to change the national conversation and provide a badly needed counterweight to the lobbying might of big insurance.
When MA was created, way back in 2003, corporate insurers promised to reduce the cost of healthcare by improving care coordination and health outcomes. A healthier population, they claimed, would be less expensive. We should demand that MA corporations live up to these lofty promises without billions of dollars in overpayments.
We’d like to see them try.
Improved Medicare… for ALL
Winning back $140 billion in annual overpayments begs a tantalizing question: How can we use those funds to improve Medicare for all seniors?
Instead of the paltry benefits that MA plans offer, those funds would help us add robust hearing, vision, and dental benefits; totally eliminate Medicare Part B premiums; and fold in the Medicare Part D prescription drug benefit. Imagine the relief a senior on Medicare Advantage would feel when enrolling in a plan that actually covers the full range of dental care, while also freeing themselves from the narrow provider networks and prior authorization requirements imposed by MA plans.
Most critically, we need to establish a low out-of-pocket maximum for Medicare. Insurance corporations lure seniors and people with disabilities into the MA trap by selling lower up-front costs while hiding substantial barriers to care. It’s a classic bait and switch. Eliminating the need to purchase Medigap would level the playing field and allow everybody to remain in Traditional Medicare.
Let’s work to build a movement of seniors, physicians, students, people with disabilities, and everybody else who cares about Medicare.
Well, not everybody—but that’s our ultimate goal. PNHP advocates for a national single-payer health insurance program, and what better way to get there than through an improved version of the already popular Medicare program?
Where we see middlemen standing between patients and the care they need, we should remove them. Where we see limited provider networks, we should expand them. Where we see piles of pre-authorization paperwork, we should shred them.
We should also expand benefits to include all medically necessary care, and ultimately eliminate out-of-pocket costs that deter people from seeing a doctor. Once these improvements are in place, we will have a program that’s truly worthy of the name Medicare for All.
The advocacy work for these priorities—ending MA overpayments, improving Traditional Medicare, and realizing our vision for single payer—overlap and build on one another.
Let’s work to build a movement of seniors, physicians, students, people with disabilities, and everybody else who cares about Medicare. Together, we can take on the corporate insurers that are wreaking so much havoc in our lives and lay the groundwork for winning a single-payer program that brings everybody in and leaves nobody out.
Keep ReadingShow Less
Most Popular