On October 18, the Senate Finance Committee held a hearing on Medicare Advantage (MA) marketing practices, with a focus on deceptive plan and broker behaviors that can derail beneficiary decision-making and access to care. Troublingly, such messaging is often, and increasingly, designed to confuse. According to the Centers for Medicare and Medicaid Services (CMS), beneficiary complaints about misleading marketing more than doubled from 2020 to 2021.
The Senate Finance Committee initially reviewed MA marketing challenges in a November 2022 report, documenting the alarming methods plans, brokers, and agents sometimes employ to boost enrollment and profits. The report also outlined steps CMS could take to curb these harmful practices. Since then, CMS finalized key marketing restrictions and heightened oversight of advertising activities. These policies are newly in effect for this year’s Fall Open Enrollment (FOE) period—which runs from October 15 to December 7 and is the time of year when people with Medicare can make unrestricted coverage changes—and should help limit beneficiary exposure to certain types of misinformation.
The Committee acknowledged these updates and considered next steps during last week’s hearing. In opening statements, Chairman Wyden (D-OR) and Ranking Member Crapo (R-ID) focused on the importance of better consumer safeguards and enrollment tools, respectively, while witnesses discussed the critical role of State Health Insurance Assistance Programs (SHIPs) in providing objective consumer counseling, as well as the need for more plan transparency, beneficiary protections, and broker payment reforms.
The hearing was timely; for many beneficiaries, FOE is marked by intense outreach from private Medicare plans. As recent reports from KFF and The Commonwealth Fund have reinforced, this annual onslaught of ads, phone calls, mail, and other solicitations can be overwhelming.
Plan comparisons are already complex; prolific and unreliable outreach further complicates the landscape. For 2023, the average beneficiary had access to 43 plans, over twice as many as in 2018. Plans can differ on everything from costs to coverage, making detailed analysis both critical and difficult. This can lead to poor or no decisions, which in turn can have serious consequences like higher costs and lack of access to care. Problematic marketing can make these coverage decisions harder and these negative outcomes more likely.
The Medicare Rights Center applauds the Committee’s ongoing attention to deceptive MA marketing practices. While the updated rules are an essential advancement, additional changes are needed. To more fully protect people with Medicare, we urge policymakers to strengthen marketing guardrails, modernize the plan choice architecture, and improve the MA enrollee experience. This includes setting and enforcing standards for the marketing of supplemental benefits, boosting plan oversight, filling gaps in marketing rules, and properly aligning payment incentives. To simplify enrollment, we support swift passage of BENES 2.0 and making plans easier to compare, including through enhanced tools, standardization, and adequate SHIP funding. Reducing barriers to care will require aligning benefits and cost protections across Medicare and easing Medigap restrictions, as well as greater attention to MA coverage denials, appeals, and disenrollments. We welcome the recently unveiled bipartisan legislation to ensure provider directories are accurate, and encourage further engagement on these and other MA functions, such mid-year network changes, that may prevent or delay care.
Need help with FOE? Contact your local State Health Insurance Assistance Program (SHIP) for unbiased, one-on-one counseling; contact Medicare online at https://www.medicare.gov or by calling 1-800-MEDICARE; or call the Medicare Rights Center’s national helpline at 800-333-4114.
Read the Medicare Rights Center’s consumer-friendly guide to FOE. It includes a list of upcoming changes, expert advice, and related issues of interest to people with Medicare.
View the archived Senate Finance Committee hearing, Medicare Advantage Annual Enrollment: Cracking Down on Deceptive Practices and Improving Senior Experiences.
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