Legislative Update: November 2014

Legislative Update: November 2014

Enrolled in Medicare Advantage? $3,700 in Benefit Cuts by 2017 Predicted

By Jessie Gibbons, Legislative Assistant

Open enrollment for Medicare Advantage (MA) plans is now in progress, and before selecting or renewing your current plan, The Senior Citizens League (TSCL) encourages all members and supporters to explore their options diligently. According to the Congressional Budget Office, more than $300 billion will be cut from the program by 2023 due to requirements under the Affordable Care Act (ACA), and many MA plans may be making modifications to benefit packages and provider networks that could affect enrollees significantly.

At a recent hearing from the House Ways and Means Health Subcommittee, experts in the MA field warned that their plans will not be able to absorb the looming cuts, and they will likely have to trim benefits or increase out-of-pocket costs as they are phased in over the next decade. One witness, Chris Wing – the CEO of SCAN Health Plans – said his MA plan that covers nearly 200,000 seniors in California and Arizona will have to begin limiting provider networks or withdraw from a few markets altogether.

Some MA plans, including UnitedHealth – the largest provider of MA coverage – have already begun modifying their offerings in order to accommodate the increasing financial pressure. Last year, UnitedHealth dropped thousands of physicians from its networks, which left many enrollees doctor-less. Without much notice, they had to either find new physicians, or pay more out-of-pocket to see their former, trusted and out-of-network doctors. Because the open enrollment period had already ended, seniors were unable to change plans in order to keep their physicians and their low costs.

MA enrollees could be impacted by the ACA’s cuts in other ways, as well. They could begin to see higher premiums, deductibles, or co-pays in the coming years. They could also see reduced supplemental benefits like vision or dental coverage. According to another expert witness at the House Ways and Means Health Subcommittee hearing – Robert Book of the Health Systems Innovation Network – by 2015, MA beneficiaries will see an average reduction of $1,530 in benefits due to the reduced funding from the federal government, and in 2017 that number will grow to an astounding $3,700.

To avoid significant cost increases and unexpected benefit cuts next year, TSCL encourages its members and supporters to examine all MA plan offerings closely before making a selection or allowing a plan to automatically renew. The open enrollment period ends on December 7th, and coverage begins on January 1st. In the meantime, TSCL will continue to monitor the status of the MA program and advocate for legislation like the Medicare Advantage Participant Bill of Rights Act, which would protect MA enrollees from unfair and abrupt changes to physician networks.