For decades, politicians like Vermont Senator Bernie Sanders have been calling for a national takeover of healthcare. Though this is generally eschewed by most Democratic politicians, who assure the American people with a wink and a smile that they would never support socialized medicine, nearly all of the Democrats’ healthcare proposals move us ever closer to Sanders’ disastrous healthcare utopia.
The most recent squeeze aimed at our healthcare system is the Centers for Medicare & Medicaid Services (CMS) proposal to overhaul Medicare Advantage support services and the compensation received by its brokers. The devastating effect on seniors and beneficiaries cannot be understated.
While superficially aimed at enhancing consumer protection, the proposed rule’s deeper implications suggest a more covert agenda: stifling the growth of Medicare Advantage and shifting the landscape toward a more monopolized and less competitive healthcare model. Evidently, consumer choice is out and one-size-fits-all is in.
The crux of the proposal involves CMS fixing the compensation that licensed health insurance agents and brokers receive for providing their Medicare Advantage services to seniors. It also places price caps on administrative payments that Medicare Advantage plans currently make at fair-market value to third-party health insurance brokerages for essential agent, broker and beneficiary support services.
These payments ensure agents and brokers have the necessary resources to operate their businesses. They cover services such as providing state-of-the-art technology tools, compliance assistance, and licensing and training support. They also help beneficiaries with carrier-agnostic plan comparisons, general enrollment guidance, and continuing plan support.
Small firms, independent agents and brokers, who already operate on narrow margins and depend heavily on the now-threatened compensation and support structures, would be disproportionately burdened.
The potential exit of these smaller, highly regulated entities from the market would drastically reduce competition, innovation and quality of service. Large carriers would be left to take on the expense of providing these services and offering seniors their plans — and only their plans. Beneficiaries would be left with far fewer choices and significantly higher premiums, directly contradicting the goals of affordability and accessibility in senior healthcare.
The proposed changes jeopardize the high satisfaction rates among Medicare Advantage beneficiaries, which are as high as 94 percent and are a testament to the current system’s success.
While the intentions behind the CMS rule are presented as strengthening consumer protection and ensuring fairness, the potential consequences reveal a different story.
In light of these concerns, it is crucial for lawmakers to call on CMS to retract this proposed rule. As healthcare providers are expected to abide by the Hippocratic Oath’s promise to “first, do no harm,” those formulating Medicare policy should do likewise and not advance so-called patient protection policies that, in effect, cause harm.
Their responsibility is to find a consensus on alternative solutions that preserve affordability and beneficiary choice without compromising the growth, success and popularity of Medicare Advantage or taking further steps in a march toward a thoroughly socialized healthcare system.