Medicare Advantage Hypocrisy
A new paper argues that Medicare Advantage plans have been overpaid by hundreds of billions of dollars since 1985. Two things are worth noting about the article. First, the paper was written by three leaders of, and is being promoted by, Physicians for a National Health Program – a radical liberal group arguing for single-payer health care. So the idea that this group would claim private health plans are overpaid is not news; in fact, it was a virtual certainty.
Second, the paper on several occasions attacks Medicare Advantage risk adjustment methods: “Risk adjustment does not and cannot work in the setting of for-profit MA plans….There is no evidence that risk adjustment works or can work in the dynamic reality of profit-seeking health care insurers.” This argument would sound slightly more genuine were it not for this paragraph included in Section 1343(b) of Obamacare:
(b) CRITERIA AND METHODS.—The Secretary, in consultation with States, shall establish criteria and methods to be used in carrying out the risk adjustment activities under this section. The Secretary mHyay utilize criteria and methods similar to the criteria and methods utilized under part C or D of title XVIII of the Social Security Act. Such criteria and methods shall be included in the standards and requirements the Secretary prescribes under section 1321.
In other words, Obamacare explicitly grants HHS the authority to impose the risk adjustment methods currently being used in Medicare Advantage – the exact same methods that the paper claims undermine traditional Medicare. And if those Medicare Advantage risk adjustment methods are as flawed as the paper claims, then that means Obamacare itself is likely to fail.
Other liberal organizations are likely to seize upon this paper’s headline figure about Medicare Advantage plans receiving hundreds of billions in “unjustified overpayments” – without embracing the paper’s other argument, which is that risk adjustment, and therefore Obamacare’s Exchanges, are bound to fail. But cherry-picking only certain talking points is disingenuous. The fact is that this “study” was written by advocates of socialized medicine, and its pre-conceived conclusions are as dubious as its’ authors political views.