Unpacking the Problems with "Medicare Advantage for All"

The opinion below comes from the Center for Medicare Advocacy (CMA), a non-profit organization founded by Elder Law Attorney Judith Stein. Their mission is to advance access to comprehensive Medicare coverage, health equity, and quality health care for older adults and people with disabilities through exceptional legal analysis, education, and advocacy. You can learn more about them at medicareadvocacy.org.

For context, President-elect Trump is set to nominate Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services, the federal agency responsible for health care for millions of Americans. Currently, Medicare beneficiaries can choose traditional coverage (Parts A & B) with Part D for prescriptions, supplemented by private insurance to cover gaps, or opt for a Medicare Advantage plan at no additional cost. However, Medicare Advantage plans are often seen as less efficient, creating more barriers to care, and costing taxpayers more than traditional Medicare.

Dr. Oz's proposal suggests that all participants should lose their traditional Medicare and be automatically enrolled in a Medicare Advantage Plan. Here is the response from the Center for Medicare Advocacy:

"Dr. Oz’s goals for Medicare would push the program in exactly the wrong direction and harm millions of beneficiaries. Even more extreme than Project 2025, which would make Medicare Advantage (MA) the default coverage in Medicare (but ostensibly retain a diminished traditional Medicare), Dr. Oz has called for “Medicare Advantage for All,” meaning private insurance companies would run the entire program – and beyond.

"Dr. Oz’s “Medicare Advantage for All” proposal is aimed at providing coverage for everyone not on Medicaid by putting everyone into Medicare Advantage “using an affordable 20% payroll tax” divided between employers and individuals.

"Both Project 2025 and Medicare Advantage for All are based on the flawed premises that MA saves the program money and provides better quality outcomes – neither of which is true. In fact, according to MedPAC, MA costs the Medicare program at least 22% more than what Medicare would have paid if MA enrollees were in traditional Medicare.

"Despite these significant and wasteful overpayments, quality outcomes for patients are decidedly mixed. Medicare beneficiaries increasingly flee MA because it fails their need for high quality care from the health care providers they choose.

"Forcing everyone into MA plans would subject them to excessive prior authorization requirements, which often lead to delays and denials of needed care, and limited provider networks. Instead of MA for All, policymakers should rein in MA overpayments and use them to expand traditional Medicare, including adding dental, hearing, and vision coverage and adding an out-of-pocket cap, which would benefit all Medicare beneficiaries."

Read more at https://medicareadvocacy.org/report-real-impact-of-medicare-advantage/