As Bernie Threatens, Insurers Respond With More Medicare Benefits

Democratic Presidential Candidates  Attend

HOUSTON, TX – APRIL 24: Democratic presidential candidate Sen. Bernie Sanders (I-VT) speaks to a crowd at the She The People Presidential Forum at Texas Southern University on April 24, 2019 in Houston, Texas. Many of the Democrat presidential

Undaunted by threats to implement a single payer form of “Medicare for All” that would put them out of business, health insurance companies are taking advantage of new federal rules to add new Medicare benefits.

Take Anthem, which last week said new supplemental benefits including those addressing social determinants of health have helped boost enrollment in its Medicare Advantage plans by nearly 14% to more than 1.1 million in the first quarter compared to the year-ago period. The operator of Blue Cross and Blue Shield plans in 14 states launched a “social determinants of health benefits package” earlier this year that allows seniors enrolled in its Medicare Advantage plans to get coverage for “healthy meals, transportation, adult day care and in-home personal care,” Anthem CEO Gail Boudreaux said.

But U.S. Sen. Bernie Sanders and some Democrats running for the presidency in 2020 are advocating a single payer version of Medicare for All that would replace the private healthcare system.

Sanders and others argue the single payer version of Medicare for All would eliminate co-payments, deductibles and allow Americans to pick the doctors they want free of insurance company restrictions and provider network rules. Sanders plan would cover a “robust set of benefits” including long-term care as Vox pointed out earlier this month and there would be a transition period for Americans to move to government-run Medicare as envisioned by the Vermont Senator.

The arguments of Sanders and supporters of single-payer Medicare are up against a tide of seniors picking private plans and new rules from the Trump administration that have gradually changed regulations to allow private insurers to expand Medicare Advantage and offer more benefits.

Anthem is the latest health insurer to show record growth in the number of seniors who are signing up for Medicare Advantage plans, which contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines with some also offering vision, dental care and wellness programs. This year, Medicare Advantage enrollment across the country rose to more than 22 million.

Industry analysts see the additional supplemental benefits helping to attract even more seniors to Medicare Advantage with some reports projecting nearly 40 million seniors – or half of the nation’s Medicare population – to be enrolled in such plans within the next five years. Such projections are based on Medicare Advantage being continued by Congress and the next White House.

Meanwhile, insurers say the new rules from the Centers for Medicare & Medicaid Services (CMS) offer those eligible for Medicare more choices.

“With new flexibility introduced for 2019, Medicare Advantage plans were given even more runway to introduce innovative solutions that improve seniors’ health while reducing costs,” said Keith Fontenot, executive vice president, policy & strategy, America’s Health Insurance Plans, which represents the health insurance industry and companies including Anthem, Cigna, Centene and several Blue Cross and Blue Shield companies. “Addressing the social barriers that hinder people from getting and staying healthy is an important way health insurance providers increasingly care for the whole person.”

Health plans and providers, too, say the new rules will make it difficult for a future Congress or White House to upend private Medicare Advantage.

“The ability for Medicare Advantage plans to provide more holistic benefits in community settings will continue to drive Medicare Advantage market share as these new benefits, such as medically-tailored meals, transportation to a grocery store, and home improvements, address consumer needs beyond the traditional benefits offered through traditional Medicare,” said Brenda Schmidt, CEO of Solera Health, a company that connects patients and insurers to chronic disease prevention providers. “This increases the value that plans bring to their enrollees, making it difficult to make a case for uprooting them.”


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