Medicare Advantage Is A Diamond In The Government Healthcare Rough


A record 28.4 million seniors get their insurance through Medicare Advantage, according to a new analysis by the Kaiser Family Foundation. They account for nearly half of all eligible Medicare beneficiaries.

And that share will likely increase. The Congressional Budget Office predicts that more than 60% of the total Medicare population will be in Medicare Advantage plans by 2032.

That’s anathema to progressive Democrats, who are singularly focused on expanding government’s control over the healthcare market. They’re holding hearings to attack Medicare Advantage and trying to cut spending on the program.

The broadsides against Medicare Advantage are really just attempts to claw back many of the benefits seniors currently enjoy—and to force them into one-size-fits-all government coverage.

Unlike traditional Medicare, which is administered by the federal government, Medicare Advantage plans are administered by private insurers. The government pays them a fixed rate to supply a suite of benefits—including hospital, outpatient, and often prescription drug coverage—to each enrollee.

Since Medicare Advantage insurers must compete for seniors’ business, they’re incentivized to provide patients quality care at the lowest possible price.

Nearly every Medicare Advantage plan offers benefits traditional Medicare doesn’t, such as vision, hearing, and dental coverage. In fact, 97% of Medicare Advantage plans offer vision benefits. Roughly 94% provide hearing coverage, and more than 90% offer dental benefits. Some even cover transportation and meal costs.

If traditional Medicare enrollees want those benefits, they have to pay out of pocket or buy supplemental insurance. Supplemental plans can cost up to $4,800 annually.

And that’s in addition to the premiums and other out-of-pocket expenses associated with traditional Medicare, which cost the average beneficiary roughly $5,000 each year.

Patients enrolled in Medicare Advantage pay a fraction of those costs. They spend $1,965 less, on average, in premiums and out of pocket than traditional Medicare enrollees.

Medicare Advantage is also better at meeting the needs of underserved communities. Black and Hispanic beneficiaries are more likely to report receiving routine care like mammograms, flu shots, and blood pressure and cholesterol screenings when enrolled in Medicare Advantage as compared to traditional Medicare.

Some research suggests that routine care is helping reduce health disparities. One study in the Journal of the National Cancer Institute concluded that the higher rate of mammography in some Medicare Advantage plans was associated with the “reversal of disparities observed” for Hispanic women in traditional Medicare.

The high-quality care offered by Medicare Advantage extends to patients of all races, backgrounds, and health statuses. A review of nearly 50 studies in Health Affairs found that “Medicare Advantage outperformed traditional Medicare in most studies comparing quality of care metrics.”

During the COVID-19 pandemic, seniors with Medicare Advantage experienced fewer hospitalizations, fewer COVID-related deaths, and greater continuity in access to routine care than those with traditional Medicare.

Together, the data reveal that Medicare Advantage provides more equitable access to comprehensive health care at a lower cost. One might think such a program would be appealing to a party that claims to want to reduce health inequities and make care more affordable.

But left-leaning Democrats are fixated on the fact that the government spends 4% more on each Medicare Advantage beneficiary than each enrollee in traditional Medicare. They claim that extra money lines the pockets of private insurers—and have threatened to pull funding from the program to finance other progressive initiatives.

Doing so wouldn’t just force more patients onto traditional Medicare and subject them to lower-quality, expensive care. It would also deliver less bang for the buck of taxpayers.

Medicare Advantage covers all Medicare-required benefits for 24% less than traditional Medicare does. Insurance companies use those savings to provide more comprehensive care for enrollees, contributing more than $32 billion in additional value to beneficiaries and the government each year.

The value of Medicare Advantage far outweighs its costs. To make our healthcare system more equitable and affordable, we must bolster the program—not erode it.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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