Voters Overwhelmingly Support Cracking Down on Medicare Advantage Profiteering
By Sabrina Jacobs
Medicare Advantage has recently become a popular alternative to traditional Medicare. The program provides beneficiaries with coverage for healthcare that Medicare may not cover, such as gym memberships, vision, and dental. For every person who is enrolled in Medicare Advantage, the government pays private insurance companies a fixed amount of money each month. In 2022, 28 million people were enrolled in Medicare Advantage, which is nearly half of the eligible Medicare population. Those enrolled in a Medicare Advantage plan accounted for $427 billion (or 55 percent) of total federal Medicare spending.
While Medicare Advantage may sound like a good plan in theory, federal investigators have discovered that private insurance companies have been overcharging the government. By exaggerating the health problems of their patients — for example, by asking doctors to look deep into their patients’ medical histories to create additional diagnoses — insurance companies have taken advantage of the program and received extra payments. As a result, the U.S. government has wrongfully overpaid roughly between $12 billion and $25 billion to insurance companies.
Data for Progress polling finds that 75 percent of voters are concerned about Medicare Advantage insurers profiteering from the program. This includes 75 percent of Democrats, 73 percent of Independents, and 76 percent of Republicans.
In order to crack down on profiteering insurers, the Biden Administration announced that it will more aggressively audit Medicare Advantage plans. Eighty percent of voters support a more accurate scoring model to avoid overpayments, including 80 percent of Democrats, Independents, and Republicans alike.
By cracking down on Medicare Advantage profiteering, the U.S. government could save up to $355 billion over the next 10 years, which would equate to $35.5 billion in savings per year, assuming savings start in two years. If savings start immediately, we could save up to $46.5 billion per year. Some members of Congress have proposed reinvesting these savings into traditional Medicare in order to lower premiums, reduce deductibles, and expand benefits to include dental, vision, and hearing. Eighty percent of voters support reinvesting annual savings into traditional Medicare improvements, including 82 percent of Democrats and 79 percent of both Independents and Republicans.
Currently, Medicare Advantage requires beneficiaries to see providers in a predetermined network, limiting the care options for patients who can’t afford to pay fully out of pocket for an out-of-network provider. Furthermore, 40 percent of Medicare Advantage beneficiaries aren’t aware that they have to stay in network, leading to unexpected medical bills after patients have already received care.
Data for Progress finds 77 percent of voters support requiring Medicare Advantage plans to cover services that accept Medicare’s approved rate. This includes 82 percent of Democrats, 73 percent of Independents, and 74 percent of Republicans.
Medicare Advantage providers have been exploiting the U.S. government by overcharging it for years. The money that went into Medicare Advantage could have been used to lower premiums and fund additional benefits. However, insurance companies have been actively lying about their patients' health and taking more money than necessary. Voters across party lines realize how crucial it is that the Biden Administration cracks down on these insurance providers and redistributes the savings into traditional Medicare.
Sabrina Jacobs (@bri_jacobs) is a staff writer at Data for Progress.