Latest News on the Medicare Advantage Program

Medicare Advantage bill receives bipartisan support in the House of Representatives

More than 340 members of the U.S. House of Representatives, led by Brett Guthrie (R-Ky.), Tony Cárdenas (D-Calif.), Earl Blumenauer (D-Ore.) And Mike Kelly (R-Pa.) , signed a letter late last week to the Medicare and Medicaid Service Centers urging the agency to maintain stability with Medicare Advantage, saying it offers affordable, high-quality health coverage.

A total of 346 representatives signed the letter, surpassing the previous record of 339; this accounts for 80% of the room. It comes as CMS prepares its annual rate-setting process, in which the agency will announce key decisions regarding funding for Medicare Advantage beneficiaries for the 2023 plan year.

In the letter, lawmakers urged CMS to “provide a stable rate and a policy environment that ensures that Medicare Advantage can continue to provide affordable, high-quality, patient-centered coverage that our voters trust every day. “. They continued to express a desire to work with CMS “to ensure that, through Medicare Advantage, tens of millions of older adults continue to have access to comprehensive and affordable health coverage options.”

The letter from Congress follows the Morning Consult poll which shows that 92% of Medicare Advantage beneficiaries consider the support of a candidate for the program to be important in winning their vote.


Urging CMS to maintain the stability of the Medicare Advantage program, Kaiser Family Foundation statistics show that enrollment in MA has almost doubled in the last decade, with more than 43% of beneficiaries of Medicare who chose to enroll.

The signatories also highlighted CMS’s own data showing that 90% of those enrolled in MA are in a plan with a quality rating of four or more stars. They maintained MA “offers consistently better care and value that provides beneficiaries with more coordinated access to high-quality providers and less avoidable visits to the hospital and emergency department.”

Lawmakers added CMS with additional statistics indicating 41% fewer avoidable acute hospital stays among MA recipients, as well as higher rates of use of preventive services, compared to traditional Medicare. It also has an appeal among different socioeconomic subgroups, with 40% of enrollees earning less than $ 25,000 a year.

During the pandemic, Medicare Advantage enrollees experienced a 19% lower hospitalization rate compared to original Medicare, lawmakers said.

“As a result of care coordination and greater flexibility in plan benefit offerings, Medicare Advantage enrollees have more access to the care and support they need, as well as additional benefits that help them manage your health, ”the letter says. “This access to high-quality care has helped older adults and people with Medicare Advantage disabilities stay healthy and safe during the pandemic.”

Lawmakers called on the administration to provide a stable rate and policy environment for Medicare Advantage, including the protection of important benefits, such as programs focused on addressing health equity, health risk assessments, and home and value-based insurance design.

“We are committed to ensuring that our more than 27 million Medicare Advantage-dependent components can count on the stability of the program and not face uncertainty about its benefits or premiums next year,” they wrote.


Insurers are expanding their Medicare Advantage offerings at a decent rate, and Humana announced last fall that it would launch a new Medicare Advantage Preferred Provider Organization (PPO) plan in 37 rural counties in North Carolina in response to market demand in the eastern part of the state. .

The insurer, however, is drastically lowering its Medicare Advantage enrollment estimates for 2022 due to a large number of cancellations during the last enrollment period, revealing in a recent submission to the Medicare Advantage Stock Exchange and Stock Exchange than the old projection of 325,000 to 375,000 new members of MA. it has shrunk by 150,000 to 200,000 new members.

Humana also expects MA membership to be generally flat this year, as she does not anticipate gaining or losing large accounts.

For now, other insurers remain impertinent. UnitedHealthcare, which already has significant market control with its MA plans, said it will strengthen its space deployment by expanding its MA plans by 2022, adding a potential of 3.1 million members and reaching 94%. of Medicare-eligible consumers in the U.S.

For the third year in a row, health insurance company Cigna is expanding its Medicare Advantage plans, growing in 108 new counties and three new states: Connecticut, Oregon and Washington, which will increase its geographic presence by nearly 30%.

Centene also participated in the event, expanding MA to 327 new counties and three new states: Massachusetts, Nebraska and Oklahoma. This represents a 26% expansion of Centene’s MA footprint, with supply available to 48 million potential beneficiaries in 36 states.

CMS said in late September that the average premium for Medicare Advantage plans will be lower in 2022 at $ 19 a month, compared to $ 21.22 in 2021. However, Part D coverage increases to $ 33 per month. month, compared to $ 31.47 in 2021.

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