Is Biden about to cut Medicare Advantage again? If so, it could be bad for Ohioans especially

Word on the street in Washington, DC, is that the Biden administration is going to cut Medicare Advantage for the second time in the Biden presidency following last year’s “reforms” that did indeed amount to, well, cuts.

At a meeting of the Medicare Payment Advisory Committee last week, Dr. Brian Miller, M.D., a member of that committee, said this:

It’s not lost on me that this discussion is coming immediately prior to the CMS Medicare Advantage rate notice, which we can expect to see in the coming days to weeks… The chair has noted he is in regular communication with CMS leadership. This gives the appearance — that MedPAC is an independent, thoughtful policy organization — is being hijacked for partisan political aims, while the organization’s analysis appears to be slanted to arrive at a foregone conclusion, in order to set up political cover for a massive MA rate cut. I note the many intellectual inconsistencies in this document, which I have spent untold hours reviewing, that result in intellectual somersaults.

So the rumor is out, and on the record now. But if the cuts occur, it could be especially bad for Ohioans.

Here’s the first reason why: According to healthinsurance.org, 54 percent of Ohio seniors use Medicare Advantage, not traditional fee-for-service Medicare. So any cuts would affect them, and affect them more than the population at large, where a slightly lower 51 percent use Medicare Advantage.

Here’s the second reason why: While progressives in Washington, DC, are rumored to have pushed a narrative that Medicare Advantage is bad for rural hospitals in part because it helps them attack Medicare Advantage, which they see as benefiting private insurers (even though studies show it actually benefits taxpayers, and entitlement programs themselves by keeping them solvent for longer), a study is being circulated that indicates that if anything, Medicare Advantage has helped shore up hospitals in rural areas. While the study didn’t assess Ohio specifically, it did assess neighboring Michigan, and it seems logical that the same findings would apply in Ohio, much of which is rural (check out the districts of Rep. Bill Johnson and Rep. Troy Balderson, to say nothing of Rep. Jim Jordan’s).

Conservatives like Republican Rep. Kevin Hern have speculated that the reason Democrats want to cut Medicare Advantage is because it helps them move the country towards a Medicare for All system. Whether or not that is really what is going on here is up to readers to decide.

What is clear is that Democrats do think traditional fee-for-service Medicare is “better” than Medicare Advantage, even though that only seems to be true as seen through the narrow philosophical lens of progressive ideology, and in dollars-and-cents terms perhaps for some health care providers. That is because traditional Medicare pretty much pays out whatever a health care provider bills whereas Medicare Advantage plans save money by requiring prior authorization of some procedures before providers can bill for them. Neither rationale is likely to be very persuasive in a state Trump won by 8 points in 2020 and where people are very frustrated with inflation and price hikes after what we’ve seen in the past few years.