But before lawmakers even come together around a single proposal, insurance industry lobbyists are running TV ads and calling allies in Congress, reinforcing how politically risky the cuts could be for Democrats, who hold a slim majority in both chambers and can hardly afford to lose the senior vote.
Doug Heye, a GOP strategist who was director of communications for the Republican National Committee in 2010, sees parallels with the affordable care bill debate, when Republicans hammered Democrats for cutting Medicare Advantage payments to pay the law, and said the party could do it again.
âRepublicans almost always find it difficult to talk about health care unless they can talk about what they are against,â he said. “It gives them a great opportunity to speak out about what they are against in a way that might resonate with voters.”
Industry-allied groups – the Better Medicare Alliance, the Coalition for Medicare Choices and the conservative nonprofit America Next – have spent $ 2.6 million on TV ads opposing Medicare Advantage cuts since. spring, and the rhythm of these advertising purchases is accelerating, according to AdAnalytics data analyzed by POLITICO.
“It will be [insurance] plans to make it as toxic as possible, âsaid an industry insider close to the negotiations, who spoke with POLITICO in the background to speak out freely on the sensitive discussions. “We know members are already telling leaders, ‘We can’t accept the attack ads saying we’re cutting Medicare.’ They know that the public will not distinguish between private and public parties.
The Better Medicare Alliance, which receives funds from insurance companies and is behind a nationwide advertising campaign, also runs targeted ads in the home districts and states of the Moderate Democrats that are considered votes. swing potentials, such as Senator Catherine Cortez Masto (D -Nev.) and Reps Vicente Gonzalez (D-Texas), Cindy Axne (D-Iowa), Jared Golden (D-Maine) and Antonio Delgado (DN.Y.) .
“Did you think you could sneak in?” Trying to increase our premiums, we disrespect, âthe ads say. “We’re Watching You.”
UnitedHealth Group, the largest player in the industry, declined to discuss its lobbying efforts. Humana, the second tallest, did not respond to a request for comment.
The Coalition for Medicare Choices, an organization led by lobby group America’s Health Insurance Plans, spent more than $ 140,000 on three national ads aired in September and October that tout the 27 million seniors enrolled in private plans and warn lawmakers: t cut their care.
The coalition also held meetings between Medicare Advantage registrants and moderates in the House and Senate, as well as Senate Majority Leader Chuck Schumer.
âAs Congress turns its attention to a budget plan to strengthen America’s safety net, it is important to ensure that Medicare Advantage is not aimed at paying other government expenses,â said David Allen, Door – speech of the AHIP, in an e-mail to POLITICO.
Discussions over proposed Medicare Advantage cuts are mostly taking place in the Senate and have been given a new lease of life as moderates balk at proposals to raise taxes for high-income workers and businesses or lower the prices of expensive drugs.
Senate Budget Chairman Bernie Sanders (I-Vt.), Longtime Medicare Advantage critic that supports efforts to expand traditional Medicare, told POLITICO cuts to the program are underway discussion, although he declined to give details.
Raymond James analyst Chris Meekins predicts cuts of $ 100 billion to $ 150 billion in Medicare Advantage over 10 years are likely. A recent report by the HHS Inspector General that 20 of 162 Medicare Advantage companies generated a disproportionate share of government payments through questionable medical examinations and client risk assessments could increase scrutiny of the program , he noted.
Health care experts from left-wing think tanks like Brookings and the Center on Budget and Policy Priorities have been urging lawmakers to tackle the sector for years, arguing that plans overcharge taxpayers, underperforming for patients, and threaten Medicare’s long-term solvency.
Matthew Fiedler, a member of the USC-Brookings Schaeffer Initiative for Health Policy, says there are several ways Democrats can save “a few hundred billion dollars” without harming the millions of patients enrolled in the plans, for example by lowering the benchmark. reimbursement rate that the government pays to private insurers.
But political risks and resistance from the insurance industry, which insists the cuts hurt registrants, could nullify any momentum for policy fixes.
âIt’s reasonable to look at the potential savings there, as it has proven to be very profitable – perhaps more profitable than it should be,â said House Budget Speaker John Yarmuth. (D-Ky.), Who announced he was stepping down from Congress at the end of his term. “I can only get in trouble saying this because Humana is based in my hometown and it’s 65% of their business.”
Any proposal that affects the results of the country’s largest insurers will face long chances. Even before a plan was made, a bipartisan group of senators, including Joe Manchin (DW.Va.), Kyrsten Sinema (D-Arizona) and five other Democrats who were friends of the industry, Biden administration warned they would block all cuts.
“We will fight in any way we can” to protect Medicare Advantage, Senator Jacky Rosen (D-Nev.), Who signed the letter, told POLITICO.
Because efforts to tackle Medicare Advantage meet such entrenched bipartisan opposition, some insurers are reluctant to draw too much attention to the problem or run ads that could “endanger relations” with Democrats. said a healthcare lobbyist who requested anonymity in order to discuss customer issues. Instead, they are focusing their attention on helping aid with other Democratic priorities, like the expansion of Medicaid.
Some plans believe that “if they launch a lot of activity it could actually backfire on them,” she said. âIt could bring Medicare Advantage more into the conversation. “