Medicare Rights Urges CMS to Center Beneficiary Needs in MA and Part D

By Julie Carter
January 29, 2026
5 Comments

This week, Medicare Rights submitted comments in response to the annual Medicare Advantage (MA) and Part D proposed rule for 2027 from the Centers for Medicare & Medicaid Services (CMS). The proposed rule has a few positive ideas but reverses course in several important domains. If finalized, those changes would allow more aggressive and misleading marketing while eliminating requirements for plans, agents, and brokers to share important information with beneficiaries and the public.

The Positives

Better Public Access to Risk Adjustment Data

One of the bright spots in the proposed rule would help the public gain access to data on risk adjustment, one factor that affects the way plans are paid. We support this proposal, as it could improve research and oversight as well as help combat overpayment.

Help for MA Enrollees When Providers Leave Plans

Another potential policy would streamline beneficiary access to a Special Enrollment Period (SEP) when their providers are no longer in network for a plan. We support the outlined change, as it would help people switch plans to keep seeing their chosen providers, promoting care continuity and beneficiary choice.

We support the potential policy that would streamline beneficiary access to an SEP when their providers are no longer in network for a plan.

Allowing Enrollees in Integrated D-SNPs to Keep Their Coverage

The proposed rule would relax a forthcoming requirement that would have pushed Dual Eligible Special Needs Plans (D-SNP) enrollees in some states, including New York, away from plans that do more to integrate Medicare and Medicaid coverage. We support this proposal, though we continue to urge CMS to help states and plans truly integrate coverage for people who are dually eligible.

A separate proposal would change rules about when some D-SNP enrollees can be automatically enrolled in other plans. While enrollees would be able to undo such changes, these types of passive enrollments can often lead to people losing access to their chosen providers or being very confused about their coverage. We oppose this and other proposals that interfere with beneficiaries’ ability to affirmatively choose their own coverage. Beneficiaries should not be pushed into plans they did not choose freely.

The Negatives

Backsliding on Marketing Limitations

Unfortunately, much of the rule would undermine beneficiary safeguards by allowing marketers to blur distinctions between educational events and sales pitches, permitting call centers to collect private data from beneficiaries without telling them what plans they are selling, and eliminating buffers that currently let prospective enrollees seek feedback or other help from friends and family.

Another proposal we strongly oppose would allow marketers to stop pointing callers to SHIPs which provide objective, free, one-on-one assistance.

Another proposal we strongly oppose would allow marketers to stop pointing callers to State Health Insurance Assistance Programs (SHIPs) which provide objective, free, one-on-one assistance to Medicare beneficiaries, their families, and caregivers. This would increase reliance on biased information sources like agents and brokers and create unnecessary hardships for beneficiaries.

We urged CMS to withdraw these proposed changes. Instead, more should be done to ensure plan marketing is limited, straightforward, clear, and honest.

Denying Important Information to Enrollees

Other aspects of the rule would further limit the information plans must share with beneficiaries. One such proposal would withdraw a requirement for plans to notify enrollees about unused supplemental benefits and how to access them. We supported the creation of this notification because although many people choose MA for supplemental benefits, they often go unused, suggesting access or other barriers. Helping people keep track of their benefits could improve utilization and clarify needed reforms.

Other proposals would eliminate requirements for plans to assess and publicly post whether they treat all enrollees fairly in prior authorization policies and procedures.

Other proposals would eliminate requirements for plans to assess and publicly post whether they treat all enrollees fairly in prior authorization policies and procedures and excuse them from notifying enrollees that they can receive help and information in other languages.

We strongly oppose these efforts to limit not only information plans must provide enrollees or potential enrollees but also public accountability for bad plan behaviors.

Medicare Rights on the Record

In our comments, Medicare Rights spoke out against the negative proposals and in support of those that could help people with Medicare get the care they need. We will continue to urge CMS to withdraw or revise provisions that prioritize insurance companies over older adults and people with disabilities and that remove sources of accurate, unbiased assistance. In these days of affordability challenges and health system upheaval, Medicare must be a safe and stable bastion of high-quality care.

Read the proposed rule.

Read our comments on the proposed rule.

Policy Issues: Medicare Advantage

Show Comments

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5 Comments on “Medicare Rights Urges CMS to Center Beneficiary Needs in MA and Part D”

James Long

January 30, 2026 at 10:08 am

I appreciate the Medicare Rights Center’s dedication to beneficiary safeguards and agree with many of the stances taken on the issues; however, I believe your recent assessment of the role of independent agents and brokers—and the proposed changes to marketing limitations—overlooks the critical, boots-on-the-ground support that professionals provide to millions of Americans.

1. Professional Expertise vs. Volunteer Guidance
While we have deep respect for the State Health Insurance Assistance Programs (SHIP) and the volunteers who staff them, it is important to recognize the difference between general information and specialized expertise.

Training and Certification: Independent agents undergo rigorous annual AHIP and carrier-specific certifications, alongside state-level continuing education.

The Nuance of Choice: SHIP counselors are often trained to provide “objective information,” but as the Medicare landscape becomes increasingly complex, information alone is not enough. Beneficiaries need expert analysis. We frequently spend hours correcting misinformation or filling in technical gaps left by well-meaning but under-trained volunteers who may inadvertently allow personal biases to influence their guidance.

2. Service Beyond Compensation
The characterization of agents as “biased sources” driven solely by commission is increasingly detached from the current reality of the insurance market.

Zero-Commission Advocacy: In the current 2026 landscape, many carriers have significantly reduced or entirely eliminated commissions for certain plans. Despite this, we continue to recommend these plans when they are the best fit for a client’s specific doctor network and medication needs.

Fiduciary-Level Commitment: As independent agents, we represent as many carriers as possible specifically to ensure a “plan match” rather than a “sale.” We often work for free to assist clients with enrollment in non-commissionable plans because our reputation is built on trust, not a single transaction.

3. The Human Element in Safeguards
The Medicare Rights Center expresses concern that “eliminating buffers” will prevent enrollees from seeking help from friends and family. In reality, independent agents serve as that professional buffer.

We handle the “private data” with strict HIPAA compliance that call centers and volunteers may not always mirror.

We provide a local, consistent point of contact year-round—something neither a 1-800 number nor a rotating volunteer staff can offer.

4. Accountability Drives Better Outcomes
Unlike anonymous marketers or volunteers, licensed agents are held personally and financially accountable by State Departments of Insurance and CMS. We are not “blurring distinctions”; we are providing a comprehensive service that includes education, enrollment, and post-enrollment advocacy.

Conclusion: I urge the Medicare Rights Center to view independent agents not as “biased marketers,” but as the essential infrastructure that keeps the Medicare system navigable for the average citizen. Restricting our ability to communicate with beneficiaries (Including the clients I have helped for over 18 years) doesn’t protect them; it leaves them stranded in a complex system without the professional advocate they deserve.

Peter Beaudry

January 30, 2026 at 3:03 pm

I am not an insurance agent, however I do agree with Mr. Long’s comments. I have found that my local independent insurance agent annually has been able to guide me to the best option for my Part D. A few years ago we had an issue come up that our agent took hold of for us and resolved.

I expect from Mr. Long’s explanation that he likewise does his best for his clients, however, I expect that not all of them do. It would be nice if there is a listing of agents that meet Mr. Long’s criteria and maybe even evaluated by Medicare Rights Center and/or the State SHIP. I will be moving to another state this year and it would be helpful to know the availability of an independent agent that is knowledgeable about Medicare.

mike

February 18, 2026 at 11:12 pm

Spot on James. This is a ridiculous article in how they portray independent agents.

PETER ARTHUR ROUSSEAU

February 12, 2026 at 5:59 pm

CMS needs to increase the funding for MA plans and for Part D Medicare beneficiaries. I used to have 28 Part D options each year for my clients; now I have only 9 and most of these no longer pay commissions to brokers like myself for enrolling Medicare Beneficiaries into a Part D plan. This is an important part of my fiduciary responsibility to my customers, to help them select the best Part D plan each year. If I am no longer to be paid a commission I am conflicted on how I should respond moving forward. CMS needs to fix this or Medicare Part D runs the risk of imploding completely leaving seniors the definite losers. Also, the leveling of the funding for MA plans is causing the plan sponsors to reduce benefits, increase out of pocket limits and Copays for services, severely reduce network participation generally creating unnecessary anxiety in seniors who might be enrolled in these plans. Seniors should not be burdened with anxiety, confusion and frustration where their health care coverage is concerned. A senior citizen deserves better than this and I urge the Trump administration to acknowledge these problems and provide solutions that help seniors enrolling in Medicare and the brokers who are so important to them in making solid and proper selections of plans; otherwise the broker community will find themselves less interested in helping find the best plans to recommend to seniors entering into the Medicare Healthcare System. Seniors would be on their own and they have no knowledge of this field and would necessarily make poor decisions for themselves and their pocketbooks. CMS needs to solidify the broker community’s unique and necessary role in helping seniors get the best coverage possible for their sunset years by increasing the current level funding provided for the Medicare MA and Part D programs to a more sustainable level for all involved.

mike

February 18, 2026 at 11:08 pm

“This would increase reliance on biased information sources like agents and brokers and create unnecessary hardships for beneficiaries.”

This is an asinine statement, For most of our clients we are the saving grace navigating everything from ordering a new member cards, digging into unknown charges, ensuring and even finding out why a doctors office is incorrectly informing them before they cut a check? Lets talk about running the endless Rx reports [that….. wait for it] we didn’t get paid for this year….. As much as I personally would love to see the a shift toward agents taking on more of a fiduciary role when it comes to medicare especially but the insurance companies are calling the shots, i.e. the shareholders call the shots and it looks like at times they speak for CMS as well. Pay or no pay we haven’t kick anyone to the curb stating, “sorry Bub no money, no part D recommendation go to medicare[dot]gov, good luck” I find it offensive that a percentage of brokers and FMO’s are scumbags and then all of a sudden every independent agent in the country is taking advantage of seniors ‘steering’ them into plans that give the agents big fat bonuses. I would think there would be more incentive to ‘steer’ people away from plans that pay no commission I guess that actually makes sense and that’s why I haven’t see every online insurance blog and news sites reporting about that. LOL. It’s not the case for most agents. Quite the opposite my father built his base by word of mouth and the community trusts him and relies on him every year, instead of having umbrellas in a drink playing golf somewhere tropical he is in out hometown helping the people that need it most and teaching me to do the same. Every year I’ve been doing this it seems more like charity work from plans exiting the county and state to now no commissions. So with as much respect as I can possibly muster I would ask you and whatever organizations you associate with to rethink the stance and and especially the public messaging in regards to independent agents and brokers. You keep that up and chop us at the knees he will retire and instead of taking the reigns I will be forced to make my IT side gig a full time business. I guarantee this will be the case across the country. There is already going to be a huge need for more agents by the numbers as the boomers finally start to part time retire (10 year late).

“or being very confused about their coverage. We oppose this and other proposals that interfere with beneficiaries’ ability to affirmatively choose their own coverage. Beneficiaries should not be pushed into plans they did not choose freely.”

So do you expect these ‘confused’ people to call 3,5,7 plans plus pard D and compare everything. DO the SHIP counselors have access to the fomulary and comparisons? Do you think if a turning 65 calls United directly will the united employee run Humana and Anthem and let them know it looks like Anthem is the best fit and to go with Health spring for Part D and when costed it out it cheaper is the you just Good Rx the one med that is not on the formulary until you talk to the Doctor about alternatives? This is what an INDEPENDENT agent can do. I really am urging Medicare Rights and the author Julie Carter to retract this article and figure ways to align with people who are part of these communities and even medicare recipients themselves.

I think that SHIP counselors need to be licensed to be able offer accurate information and keep in inline with HIPAA. I didn’t use vulgar language I wanted to but it would of sounded like Gordan Ramsey.

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