insurers lobby for medicare advantage reforms amid rising costs and market changes

Insurers are concerned about the criticism of Medicare Advantage (MA) from lawmakers, despite strong support for the program among seniors.

Benefits of Medicare Advantage

The Better Medicare Alliance (BMA) and other organizations are promoting the benefits of MA and countering detractors who cite issues like narrow provider networks and prior authorization requirements.

Recent actions by the Centers for Medicare & Medicaid Services (CMS) have raised concerns within the industry, including a cut to the MA benchmark payment rate.

Impact on Plan Designs

Insurers predict that this reduction will lead to more restrictive plan designs and a decrease in available plans across various markets.

The Blue Cross Blue Shield Association emphasizes the need to strengthen MA rather than diminish it, as recent rate notices have not kept pace with rising healthcare costs.

Changes in the Industry

The industry is preparing for significant changes that may impact product offerings and benefits.

Some insurers are already announcing plans to exit certain markets, which could affect membership.

Regional Disparities

The landscape for Medicare Advantage is shifting, with regional disparities in premium increases and plan reductions.

Insurers are focusing on chronic special needs plans (C-SNP) for specific health conditions, which may impact the availability of long-term services and support.

Plan Closures and Lobbying Efforts

Plan closures will require new plan searches for some beneficiaries.

Lobbying efforts by BMA, AHIP, and the Blue Cross Blue Shield Association have increased, with significant investments in health policy priorities.

Political contributions during the 2024 campaign cycle reflect a strategic approach to influence, with different organizations supporting candidates from both parties.

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