March 28, 2023

Warren Sounds Alarm on Insurers Extracting Billions from Medicare, Driving Up Premiums

Medicare Beneficiaries to Pay $145 Billion in Increased Premiums from 2023-2031 Because of Games Medicare Advantage Plans Use to Overcharge Medicare

Warren Calls on Centers for Medicare and Medicaid Services (CMS) to Finalize Rule Ensuring Payments to Medicare Advantage Plans Accurately Reflect Cost of Care

Text of Letter (PDF) | Expert Analysis (PDF)

Washington, D.C. – U.S. Senator Elizabeth Warren (D-Mass.) sounded the alarm on a new analysis by policy experts showing that all Medicare beneficiaries – including those enrolled in Traditional Medicare (TM) – are paying higher premiums due to overpayments in the Medicare Advantage (MA) program. Senator Warren is highlighting these findings in a new letter to the Centers for Medicare and Medicaid Services (CMS) and calling on the agency to finalize its proposed rule to ensure payments to MA plans accurately reflect the cost of care. 

“I write today to bring your attention to new information revealing that seniors and people with disabilities enrolled in Traditional Medicare (TM) are paying higher premiums because of the tricks that Medicare Advantage (MA) plans use to squeeze billions of extra dollars out of the Medicare program,” wrote Senator Warren. 

“These new findings from economists and health policy experts revealed that Medicare overpayments to MA plans will ultimately cost Medicare beneficiaries $145 billion in increased premiums over the next eight years. Approximately 45 percent of that amount, or $65 billion, will be paid by enrollees in TM, who do not receive any of the supplemental benefits or supposed efficiencies in MA, yet are responsible for subsidizing these overpayments to private insurance companies,” continued Senator Warren.

In February, CMS released the Calendar Year 2024 Advance Notice (Advance Notice) of Methodological Changes for Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (the Advance Notice). The rule includes routine technical updates, improvements, and recalibrations that would result in an average increase of 1% to MA payments for 2024. Without any change, over the next 8 years, experts predict Medicare will pay MA plans $960 billion more than what it would otherwise pay if beneficiaries remained in TM. Taxpayers will be responsible for 85% of this amount, but Medicare beneficiaries will pay $145 billion through increased Part B premiums, with approximately 45%, or $65 billion, being paid by TM beneficiaries.

Senator Warren expressed her support for finalizing the Advance Notice and called on CMS to take additional steps to strengthen the integrity of the MA program. 

Senator Warren has raised concerns about waste, fraud, and abuse in MA and fought to crack down on corporate profiteering so that Medicare beneficiaries get the care they deserve: 

  • In March 2023, Senators Warren and Merkley (D-Ore.) sent letters to the top seven Medicare Advantage insurers regarding their questionable claims that the CMS 2024 proposed Medicare Advantage payment rules would hurt beneficiaries. 
  • In March 2023, at a hearing of the Senate Finance Committee, Senator Warren defended CMS’s proposed adjustments to the 2024 Medicare Advantage 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 March 2023, Senators Warren and Sherrod Brown (D-Ohio) led a letter to U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra, and CMS Administrator Chiquita Brooks-LaSure and Deputy Administrator Meena Seshamani, supporting CMS’s efforts to thoroughly examine current MA practices and strengthening and finalizing proposals related to MA to reduce excessive and unwarranted payments to MA plans and improve care delivery for beneficiaries.
  • 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 Brooks-LaSure highlighting concerns about overpayments to Medicare Advantage plans. 
  • In March 2022, Senator Warren and Representative Pramila Jayapal (D-Wash.) led a letter to HHS and CMS, calling on CMS to end private insurers’ profiteering of Medicare Advantage.
  • 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.