December 9, 2011

The New Hampshire Union Leader is believed by many people to be the most influential paper in the Granite State.  So when the Union Leader editorializes about the President’s government takeover of healthcare law, it’s worth more than a passing glance; the editorial appears below.  The paper describes how 7,600 beneficiaries of Medicare Advantage (MA) plans have already received notices that their coverage is being cancelled as a result, in part, of the President’s misguided law.  The editorial also notes that thousands of Medicare beneficiaries are being forced to change doctors. 

Medicare Advantage plans are private plans which receive capitated monthly payments (adjusted for demographics and health status) which generally offer expanded benefits and lower cost sharing compared to traditional fee for service (FFS) Medicare.  The popularity of MA plans as an alternative to FFS Medicare is evident in its enrollment more than doubling since 2005 from 5.3 million to 11.1 million beneficiaries. 

For the more than 11 million Medicare beneficiaries enrolled in Medicare Advantage (MA) plans nationally, the President’s government takeover of health care law may prove to be particularly onerous. 

A recent report from the Medical Industry Leadership Institute and Carlson School of Management, “What Changes will Health Reform Bring to Medicare Advantage Plus Benefits and Enrollment?”, explains with a state-by-state analysis how access for MA beneficiaries will change dramatically in coming years as a consequence of $206 billion in payment cuts to MA plans in the President’s law.

According to the report:  “MA plans will have to cut healthcare benefits, increase cost sharing, or increase premiums (or some combination thereof)…with lower payments and fewer enrollees, fewer MA plans will be able to stay solvent…Medicare beneficiaries will either lose their MA coverage altogether…or be faced with higher out of pocket costs and/or benefit reductions.

For those MA enrollees forced into FFS, they may no longer be able to see their MA doctors.  “Some physicians are members of particular MA plan provider networks established by insurers, but do not accept Medicare FFS patients.  These providers are available only through MA plans.” 

The report concludes “by 2017, when the changes are fully phased-in, enrollment [in MA plans] is projected to be 50 percent lower, the average would-be beneficiary will lose $3,700 in benefits…and the number of [MA plan] choices available in the average county will be reduced by about two thirds.”

Based on the report, even if only a quarter of the 7,600 MA beneficiaries mentioned in the editorial lose MA coverage altogether, New Hampshire will still be way “ahead” of schedule given lost coverage predictions for New Hampshire of 863 people in 2013; 1,825 people in 2014; 3,218 people in 2015; 4,682 people in 2016; and 8,008 people in 2017 – at that point representing a 46% reduction in total MA plan enrollees (CMS PB2010 baseline). 

So it’s no wonder folks in the Granite State are not too happy.

 

A small taste: NH samples Obamacare

EDITORIAL

Published Dec 1, 2011

“Remember when President Obama said that if his health care ‘reform’ law passed, you’d still get to keep your doctor?  Medicare Advantage participants in the Granite State are finding out what a lie that was.

“Medicare Advantage is a subset of Medicare in which the federal government pays private insurers a set monthly rate to provide coverage that is approved and regulated by Medicare. The private insurers can charge different rates and offer a wider variety of services than are offered in traditional Medicare.  Though Medicare Advantage costs more in its startup phase, the idea is to save money in the long run by providing incentives for insurers to reduce costs.  But because the plan is market-based, the Obama administration wants to kill it. Obamacare eventually defunds it.

“New Hampshire has a high percentage of Medicare Advantage enrollees. Last month, 7,600 of them received notices that their coverage was being cancelled. Obamacare and another federal law passed in 2008, the Medicare Improvement for Patients and Providers Act, are killing Medicare Advantage to steer senior citizens back into regular Medicare, which offers fewer choices and is more heavily controlled from Washington.

“As a result, thousands of Granite State seniors are being forced to switch doctors because they have to switch coverage.

“This is just a taste of what is to come if Obamacare takes effect in full force.  Its regulations will so skew the private insurance market that millions will lose the coverage they have and be forced into plans preferred by bureaucrats in Washington.  They will lose access to their doctors, too. It would make a lot more sense to reform the health insurance market by working to give people more control over their own care, not less.”

 

Key Take-Aways  Medicare Advantage (MA) beneficiaries are beginning to feel the effects of Obamacare policy. The President’s government takeover of healthcare law cuts $206 billion in funding from MA plans. MA beneficiaries may be forced into FFS plans or less desirable MA plans.