Medicare Rights Center President Joe Baker Testifies on Medicare Advantage Plans
— Underscores Positive ACA Reforms, Remaining Challenges, and the Path Forward —

Washington, DC – As the Affordable Care Act (ACA) continues to rollout, today Joe Baker, President of the Medicare Rights Center, testified before the Subcommittee on Health of the U.S. House Committee on Energy and Commerce about the positive impact of the ACA on Medicare Advantage (MA) and how to further improve MA plans for people with Medicare.

Recent changes to MA advanced by the ACA have strengthened the program for current and future enrollees. In addition to improving Medicare’s overall financial outlook, the ACA enhanced MA through added benefits, fairer cost sharing, and improved plan quality. For instance, the ACA expands coverage for preventive services; prohibits MA plans from charging higher cost sharing for renal dialysis, chemotherapy and skilled nursing stays; and requires that plans spend 85% of beneficiary premiums and federal payments on patient care.

“While many predicted that ACA changes to the Medicare Advantage payment system would lead to widespread disruption of the plan landscape, we have not seen that among the clients we serve or generally. The premium costs, benefit levels, and availability of plans remain relatively stable,” said Baker.

Baker also addressed recent perceptions concerning slimming MA provider networks. To this, Baker said, “While there appears to be an increased incidence of slimming Medicare Advantage provider networks this year, we must stress that we see some version of this every year. Changing provider networks are an inherent risk of any managed care system. Our advice to beneficiaries remains the same: people can switch to another Medicare Advantage plan or to Original Medicare during the Fall Open Enrollment Period if a Medicare Advantage plan no longer meets their needs.”

According to Baker, “Each year, Medicare Rights counsels thousands of people with Medicare Advantage about topics ranging from enrolling in a plan to appealing a denied claim. We find that Medicare Advantage plans are a good option for some, but not for all. Many of our callers are satisfied with their plan, and their inquiries are easily resolved. Others find navigating a Medicare Advantage plan challenging.”

Baker concluded by urging Congress for MA changes to further strengthen the program and help people with Medicare by:

• Simplifying MA plan selection and coverage rules;
• Improving beneficiary notice regarding annual plan changes;
• Further streamlining and standardizing MA plans;
• Improving the appeals system;
• Adequately funding independent counseling resources; and
• Expanding Medigap supplemental coverage options

Read the testimony

Read the testimony summary

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