The contradictory nature of Washington lawmakers was on full display this past week as they lobbied the Centers for Medicare and Medicaid (CMS) not to cut reimbursements to privately run Medicare Advantage plans while allowing the budget sequester to curtail funding for Medicare cancer patients.
Medicare Advantage gets juiced
As CMS was considering a more equitable reimbursement methodology for Medicare Advantage plans run by private health insurance companies they were hit with a fusillade of lobbying from groups aligned with private insurance and congressional lawmakers. The final ruling from CMS was not the proposed 2.3% decrease but a 3.3% increase.
Fair payment sought
CMS buckled to the fear mongering of groups like the Association for Health Insurance Plans (AHIP) that members of Medicare Advantage plans MAY have to pay more for health benefits IF capitation rates, the monthly reimbursement by CMS to the private MA plan on behalf of each enrolled Medicare beneficiary, were aligned to more closely reflect what CMS pays on behalf of people in Original Medicare.
Pump up the private companies
At a time when Republicans have pegged the unbridled funding entitlement programs as a scourge to our national debt, many were out calling for an increase in funding. Of course, this funding doesn’t go directly to the public, but they are payments to privately run health insurance companies. It was no surprise that many of insurance companies (UnitedHealth Group, Human, Aetna) got a boost in their stock price as the federal government will pay them more money in 2014.
Cutting Medicare patients
As private for profit insurance companies were rewarded with high stock prices, Medicare cancer patients were facing disruptions in their treatment. The budget sequester is cutting what Medicare reimburses for cancer fighting drugs. This reduction in reimbursement has led many community cancer treatment facilities to begin denying existing and new patients treatment with the expensive chemotherapy drugs. This has left Medicare cancer patients scrambling to find another facility or hospital to continue their treatment.
Profits over people
If groups such as AHIP and companies that administer private Medicare Advantage plans really cared about the Medicare population they would be fighting just as hard to over turn the ridiculous sequester cuts to chemotherapy as they did to save their monthly payments from CMS. But these groups are not really concerned about Medicare. They are more concerned about profits for private insurance companies. Victims of the sequester cuts are on their own unless they add to the bottom line of Medicare Advantage plans.