Discussion: Q & A about Medicare Advantage

From Molly Janczyk, October 23, 2009
Subject: RE: Greg: Medicare overpayments have been a threat to the system?

Thank you, Greg.

From Greg Nickell, October 23, 2009
Subject: RE: Greg: Medicare overpayments have been a threat to the system?

Ms. Janczyk:

It is highly unlikely that future changes to the government’s Medicare Advantage subsidy rates would occur on any schedule other than on an annual basis. For 2010, the government subsidy rates for our Medicare Advantage plan, the Aetna Medicare Plan (PPO), have been set.

As subsidy changes in future years, particularly if it declines as we anticipate it will, STRS Ohio is set to conduct an annual analysis to determine whether the value of the Aetna Medicare Plan (PPO) for the next year still exceeds the value of returning to a self-insured Plus plan scenario. When and if the answer becomes no, STRS Ohio already has provisions and contracts in place to move the health care plan back to a self-funded arrangement that utilizes Traditional Medicare just like we have in 2009.

Sincerely,

Greg

Molly Janczyk to Greg Nickell, October 23, 2009
Subject: Greg: Medicare overpayments have been a threat to the system?

What happens if Medicare Adv Plans are cut back by Wash

From RH Jones, October 23, 2009
Subject: Medicare overpayments have been a threat to the system?

To all:

This is an answer to my question from my Congresswoman Betty Sutton (D). I think she's doing a great job.

RHJones, CORE member

From: Congresswoman Betty Sutton
To: Bob Jones
Sent: Thursday, October 22, 2009
Subject: Responding to your message

October 22, 2009

Dear Mr. Jones,

Thank you for contacting me to express your concerns about the Medicare Advantage program.

Like you, I believe that Congress has a responsibility to be a good steward of taxpayer funds and to protect programs that are vital to the well being of our seniors. The Medicare program has been providing affordable, quality health care to older Americans for decades. However, excessive payments to the Medicare Advantage program are threatening the administration of the entire Medicare program while the private insurance industry keeps these overpayments as profits. Insurance companies continue to manipulate the Medicare Advantage program in order to increase their profits. This in turn results in inefficient service, coverage and payments for increased profits being passed back on to the taxpayer.

The Congressional Budget Office and the Medicare Payment Advisory Commission have found that private insurance companies are paid around 12 percent more than it would cost the traditional Medicare program to cover the same beneficiaries. These overpayments are a serious threat to the financial outlook of the Medicare program. Not only will the overpayments accelerate the Medicare Trust Fund's insolvency date by two years, but the Medicare beneficiaries themselves will have to shoulder the excess costs?"an additional $2 per month in Part B premiums.

It is unfair to ask our seniors to bear this burden. Rather than contributing to the health insurance industry's windfall profits, these funds could be better used to sustain the Medicare program, reduce Medicare premiums, increase assistance for lower-income Medicare beneficiaries, and provide increased oversight to prevent abusive private plan marketing schemes.

I believe that our seniors deserve better. At a time when concerns have been raised about the long-term financial stability of the program, it is critical for us to target and eliminate areas of wasteful spending. The Medicare Advantage program was originally conceived as a program through which private insurance companies would be able to offer similar or better services to beneficiaries for reduced cost, not as a source of extra profits for these companies. As you know, Congress is currently in the process of reforming health care and is examining ways in which to provide more access to quality and affordable care to all Americans. In order to improve health care, excessive waste must be cut from programs that many Americans rely upon and enjoy. We must stop insurance companies from profiting as a result of abusive practices. All health care programs are being reviewed and a determination will be made about how efficiently and effectively to provide them.

I look forward to updating you about Congress' efforts to reform health care. Your input is valuable and I appreciate you contacting me with your concerns. Please do not hesitate to contact me if I may be of assistance in the future.

Sincerely,
Betty Sutton
Member of Congress