Senators Warren, Merkley Criticize Insurance Companies for Medicare Advantage Scare Tactics, “Outsize Profits,” “Exorbitant” Executive Pay Packages
Centers for Medicare and Medicaid Services’ (CMS) Proposed Medicare Advantage Payment Rule Will More Accurately Reflect Cost of Care “It is outrageous that industry groups, on your behalf, are putting your plan’s enormous profits over care for seniors.”
Washington, D.C. – U.S. Senators Elizabeth Warren (D-Mass.) and Jeff Merkley (D-Ore.) sent letters to the top seven Medicare Advantage (MA) insurers – Humana, Centene, UnitedHealthcare, CVS/Aetna, Molina, Elevance Health, and Cigna – regarding their questionable claims that the Centers for Medicare and Medicaid Services’ (CMS) 2024 proposed Medicare Advantage payment rules would hurt beneficiaries. The lawmakers are asking the insurers to explain why the changes proposed by (CMS would lead the companies to increase premiums or reduce benefits for beneficiaries at a time when they are raking in enormous profits and paying millions to their executives and shareholders each year.
Last month, CMS released its 2024 proposed Medicare Advantage payment rates, which included updates to the MA risk adjustment model that would help ensure payments accurately reflect the cost of providing care to beneficiaries enrolled in MA. CMS makes these adjustments on a yearly basis and updates are “especially necessary given years of investigations uncovering rampant abuse in the MA program,” the lawmakers wrote.
“In 2022, the seven major Medicare Advantage health care insurers – UnitedHealthcare, CVS/Aetna, Cigna, Elevance Health, Humana, Centene, and Molina – brought in revenues of $1.25 trillion and reported total profits of $69.3 billion, a 287% increase in profits since 2012,” continued the lawmakers. “But rather than investing in benefits for patients, these seven health insurers instead spent $26.2 billion on stock buybacks.”
Insurance industry groups, including Better Medicare Alliance and America’s Health Insurance Plans, have engaged in scare tactics, claiming that CMS’s proposed payment rule – which would slightly increase payments to MA plans in 2024 – would hurt beneficiaries by raising premiums and reducing benefits.
“Medicare Advantage currently provides health care for more than 30 million seniors and people with disabilities, and these enrollees deserve quality and affordable health care, not threats from insurers that are making billions in profits,” concluded the lawmakers. “Despite the outrageous profits your company and the other major health insurers bring in from Medicare Advantage, industry groups are still working to scare seniors and people with disabilities into opposing changes that will reduce waste, fraud, and abuse.”
Given these outsized profits and the long history of corporate profiteering in the MA program, the lawmakers are requesting a response from insurers no later than March 29, 2023.
Senator Warren has raised concerns about waste, fraud, and abuse in MA and fought to crack down on corporate profiteering:
- In March 2023, at a hearing of the Senate Finance Committee, Senator Warren defended CMS’s proposed adjustments to the 2024 MA payment rates, pushing back against giant insurance companies and their lobbyists who are peddling misinformation to protect their billions in profits and scare beneficiaries into opposing the rule.
- In April 2022, Senator Warren and United States Representatives Katie Porter (D-Calif.), Rosa DeLauro (D-Conn.), and Jan Schakowsky (D-Ill.) led their colleagues in sending a letter to CMS Administrator Chiquita Brooks-LaSure highlighting concerns about overpayments to Medicare Advantage plans.
- On February 2, 2022, during a hearing of the Senate Finance Subcommittee on Fiscal Responsibility and Economic Growth, Senator Warren called out big pharma and insurance companies’ tricks to squeeze taxpayers and Medicare beneficiaries.
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