WASHINGTON, D.C. – (March 1, 2024) – In a new comment letter to the Centers for Medicare & Medicaid Services (CMS), AHIP President and CEO Mike Tuffin urged the agency to remedy proposed policy changes that would diminish the value and affordability of coverage and benefits that millions of Medicare Advantage and Part D beneficiaries depend on for better health outcomes and financial security.
“When tens of millions of seniors and people with disabilities renew their coverage in the fall of 2024, they are counting on the financial protections and critical benefits that only Medicare Advantage and Part D can provide,” said Tuffin. “We respectfully encourage CMS to ensure that MA and Part D coverage can continue to keep pace with beneficiaries’ expected medical needs so that any impacts on affordability, benefits or choices are minimized.”
AHIP’s comment letter addresses several critical policy reforms outlined in CMS’ 2025 Medicare Advantage and Part D Advance Notice. Among the top concerns is CMS’ proposed growth rate for the Medicare Advantage program (2.44%) which is insufficient to cover the cost of coverage and medical care for more than 33 million Medicare Advantage beneficiaries in 2025.
New data from MA health plans (representing 75% of the market) found quarterly year-over-year increases in beneficiaries’ total medical expenses throughout 2023, including a spike above 8% in the fourth quarter of 2023. These higher cost trends will likely continue into 2025 – a trajectory reinforced in a recent report from the Medicare Trustees – amid growing evidence that seniors will have elevated care needs in the upcoming year. These trends are substantially higher than the changes CMS is proposing to cover the cost of medical care for MA program enrollees.
As a result, the combined impact of CMS’ other proposals included in the Advance Notice will lead to significant variability and instability in MA coverage across geographic markets, including markets with a high number of MA beneficiaries, according to a new analysis from Wakely Consulting Group. These changes could lead to higher premiums and benefit reductions for those enrollees.
View AHIP’s full comment letter here.
Earlier this month, MA seniors, alongside health care leaders, stressed the urgency and importance of Congress and the Administration maintaining stability across the MA program, highlighting the program’s financial safeguards and personalized care programs as vital to their health. A super-majority of Senators along with House leaders representing diverse communities have also urged CMS to protect seniors’ coverage with the MA program providing a lifeline for a growing number of dual-eligible and low-income Medicare seniors and individuals with disabilities.