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Protecting Medicare Advantage

Protecting Medicare Advantage
By Congresswoman Renee Ellmers
The State of Healthcare 2014 - The Washington Times
March 26, 2014

Medicare Advantage is under siege. For the past three years, the Obama administration has carried out an orchestrated attack on the funding for Medicare Advantage and the cost-saving mechanisms that have allowed it to provide important care for our seniors. They are doing this in order to divert funding for the aptly-named Affordable Care Act (Obamacare) - a law which has already forced millions of Americans off their health plans and caused premiums to skyrocket.

This is no secret. Back when this terrible law was rushed through the Democrat-led Congress in 2009, the law mandated that there be a way to pay for it. After increasing taxes to unprecedented levels, there was still the need to find additional funding for the law that everyone knew would raise premiums, cost jobs and destroy the doctor-patient relationship. The Obama administration needed more money and they found it in Medicare Advantage - to the tune of $200 billion - and now they are looking for even more.

In February, the Centers for Medicare and Medicaid Services (CMS) proposed a new rule to cut Medicare Advantage funding in 2015 by at least 5.9 percent after gutting the program by 6.7 percent last year. As a result, our seniors are currently facing higher out-of-pocket-costs, limited access to providers, and reduced benefits. Because of these harmful cuts, 2013 saw an unprecedented exodus of Medicare Advantage plans from the market - the first market exit in nearly five years.

Through Medicare Advantage, medical professionals deliver higher quality care using tools that enhance patient-provider communications. This has reduced hospitalizations by over 20 percent and decreased individual patient health care costs by thousands of dollars each year. The heightened collaboration among participants also allows providers to identify treatment gaps and deliver much-needed follow-up care to beneficiaries, leading to a reduction of emergency room visits by 20 to 30 percent.

This program was designed to foster competition and use free-market mechanisms to drive down costs and provide greater options. It helps providers coordinate care for patients through innovative programs that manage complex chronic conditions, promote wellness and prevention, and deliver other benefits beyond those available under fee-for-service Medicare. Yet the cuts proposed by CMS will cripple our seniors' ability to make ends meet.

According to a recent report by Oliver Wyman, the 2015 cuts could lead to benefit reductions and premium increases of $35 to $75 per member per month, including plan exits from local markets. This means that many beneficiaries could lose access to Medicare Advantage plans. Nationwide, that number comes to 15 million. In my home state of North Carolina alone, nearly half-a-million seniors could see their plans cut due to this misguided and dangerous policy. Moreover, the 2015 cuts would also have a disproportionate effect on beneficiaries with low incomes, including the 41 percent of Medicare Advantage enrollees with annual incomes below $20,000.

This is completely unacceptable. That's why this month I sent a letter to CMS that was co-signed by eighteen of my colleagues on the House GOP Doctors' Caucus - calling on the Obama administration to account for this unnecessary intrusion. Because of CMS, our seniors will see a dramatic change in the program's funding this year, which includes the $200 billion that is scheduled to be removed over the next ten years to pay for Obamacare.

This fight will continue until our government realizes that we have a responsibility to maintain and support the promises we have made to our citizens. As a proud supporter of Medicare Advantage, I believe it is our duty to protect it for the sake of American seniors. Robbing our seniors of the benefits they earned to pay for a takeover of our health care system betrays that promise, and I for one will do everything I can to stop it.

-- Mrs. Ellmers is serving her second term as U.S. Congresswoman representing North Carolina's second district in the House of Representatives. She currently serves on the House Energy and Commerce Committee and is Chairman of the Republican Women's Policy Committee.