WASHINGTON – Congressman Vern Buchanan, Vice Chairman of the House Ways and Means Committee and Chairman of the Health Subcommittee, and Congressman Darren Soto (D-FL) announced today that they led a letter with 18 members calling on President Biden’s Centers for Medicare and Medicaid Services (CMS) to reconsider its proposed rate notice to the Medicare Advantage (MA) program that could impact seniors’ access to care and undermine the increasingly popular and successful program. The agency plans to finalize the rule by April 1.
According to the Berkeley Research Group (BRG), projected MA medical costs will jump by 4 to 6 percent in 2025, while at the same time, federal government payments to MA plans will decrease by 0.16 percent. Buchanan’s Congressional District, FL-16, has nearly 100,000 seniors enrolled in Medicare Advantage that would be negatively impacted by this proposal.
“I am deeply concerned about the administration’s proposed rate notice for Medicare Advantage health plans,” said Congressman Buchanan. “At a time when more than half of the Medicare beneficiary population is enrolled in an MA plan, coupled with still stubbornly high levels of inflation that is pinching the pocketbooks of everyday Americans, the last thing we should be doing is raising health care costs on our nation’s seniors, many of whom are living on fixed incomes.”
According to CMS, roughly 33 million seniors and those with disabilities have elected to enroll in MA, with enrollment projected to exceed 34 million by the end of 2024. The proposal could disincentivize benefits if CMS finalizes the rates as is. Seniors choosing MA now make up 52 percent of the Medicare beneficiary population.
"Medicare Advantage stands as a cornerstone, offering accessible healthcare to over 30 million seniors and individuals with disabilities across the nation, with a significant 2.7 million in Florida alone. It is imperative to uphold these vital components to preserve the quality and accessibility of healthcare for Medicare Advantage recipients,” said Congressman Darren Soto. “Sustaining stable payments is crucial to guaranteeing reasonable premiums, preserving supplemental benefits, and maintaining competitive provider reimbursements for the millions of seniors and individuals with disabilities who rely on Medicare Advantage."
“We recognize the MA program has undergone changes in recent years, including significant growth due to popularity of the program,” the lawmakers wrote in the letter. “However, as we work to improve the overall program, the data and cost assumptions used to project the program’s rates must be grounded in the most recent data available and take into account any increased costs that might occur before the rate notice is finalized, either through rulemaking or Congressional action.”
As noted by Grover Norquist, President of Americans for Tax Reform, “it is the free market aspects of MA that have made the program so successful. Efforts should seek to improve this vehicle and capitalize on its success – not push people towards less efficient, less popular alternatives.”
In addition to being the Vice Chairman and most senior Republican on the powerful U.S. House Ways and Means Committee, Buchanan is also the Chairman of the Health Subcommittee, which has broad jurisdiction over traditional Medicare, the Medicare prescription drug benefit program, and Medicare Advantage.
You can read the full letter HERE or below:
March 25, 2024
The Honorable Xavier Becerra The Honorable Chiquita Brooks-LaSure
Secretary Administrator
Department of Health and Human Services Centers for Medicare & Medicaid Services
200 Independence Avenue, SW 200 Independence Avenue, SW
Washington, DC 20201 Washington, DC 20201
Dear Secretary Becerra and Administrator Brooks-LaSure:
We write regarding the Calendar Year (CY) Advance Notice for the Medicare Advantage (MA) program to ensure the final rate announcement accurately reflects growth rates and health care cost increases. It is essential for the over 33 million seniors and individuals with disabilities currently enrolled in MA that the Centers for Medicare & Medicaid Services (CMS) keep payments to the program stable during a time of increased demand for care, as well as the implementation of significant changes stemming from recent rulemaking. Payment stability will ensure that premiums remain affordable, popular supplemental benefits remain intact, and provider reimbursements remain competitive.
We recognize the MA program has undergone changes in recent years, including significant growth due to popularity of the program. However, as we work to improve the overall program, the data and cost assumptions used to project the program’s rates must be grounded in the most recent data available and take into account any increased costs that might occur before the rate notice is finalized, either through rulemaking or Congressional action.
As you know, the Advance Notice proposes an effective growth rate of 2.44% when calculating the 2025 benchmark, which does not fully account for the increases in utilization over the past year, in part because it does not include utilization data from the fourth quarter of 2023. We are concerned that the proposed MA growth rate, combined with higher-than-expected utilization, could result in providers receiving lower reimbursement rates for their services, as well as increased premiums or reduced supplement benefits provided to beneficiaries. We urge CMS to closely consider all appropriate data and information, including data indicating higher trends in Q4 2023, to ensure that growth rates in the final Rate Notice reflect recent seniors’ expected health care needs in 2025.
Through considering Q4 2023 data, CMS would ensure that the MA program maintains its affordability, benefits, and choices for the program – which now serves more than half of those eligible for Medicare – while improving the quality and long-term stability of the program. We look forward to working with you to ensure that the MA program can continue to effectively serve its enrollees and remain an essential contributor to the health and wellness of America's seniors and those with disabilities.
