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MA Windfall Payments:  A Source of Help for  Low-Income Children  And Seniors? Presentation to the TriCaucus Ron Pollack Families USA May 11, 2007
Medicare Advantage Plans How much do seniors from communities of color rely on MA plans?
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],without Medicaid or employer coverage without Medicaid or employer coverage
BUT . . . Study Excludes Half of Minority and Low-Income Seniors   Those  with Medicaid or employer coverage  were left out. How many is that? ,[object Object],[object Object],[object Object],[object Object],Source:  AHIP 2007
Traditional Medicare:  Still the Choice of Seniors MA   Traditional Medicare Hispanic seniors  25%  75% Asian seniors  14%  86% African-American seniors  13%  87% Low-income seniors  10%  90% Source: AHIP 2007   3X 6X 8X 9X
Whose  Advantage? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Do Windfall Payments = Extra Benefits? Some portion goes to enhance benefits and reduce beneficiaries’ out-of-pocket costs  BUT ,[object Object],[object Object],[object Object]
Where Does the Windfall Go? ,[object Object],[object Object],[object Object],Source:  Wall Street Journal , April 30, 2007 and Humana 2006.
What Do Overpayments Mean for Medicare? ,[object Object],[object Object],[object Object],[object Object],[object Object],Source: Richard Foster, CMS 2007
Bush Administration and  Republican Congressional Leaders Why so intent on protecting windfall overpayments? Two words . . . P R I V A T I Z E Medicare
The Conservative Game Plan ,[object Object],[object Object],[object Object],[object Object],[object Object]
Think We’re Kidding?   Newt Gingrich: “ Now, we don’t get rid of [traditional Medicare] in Round 1 because we don’t think that’s politically smart.  But we believe  it’s going to wither on the vine   because we think people are voluntarily going to leave it . . . .” Source: Gingrich 1995
No, We’re  Not  Kidding   ,[object Object],[object Object],[object Object],[object Object],[object Object],Source:  New York Times , June 26, 2003
A Brief History of Medicare Advantage Early 1980s:  Private plans introduced to Medicare to save money. 1983 to 1997:  Plans paid at 95% of traditional fee-for-service rate.  ,[object Object],1997 to 2003:  Congress changes funding formula.  ,[object Object],2003 and on:  Congress changes payments to MA plans. 2004-2005. ,[object Object],[object Object]
Why Private MA Plans Cost So Much ,[object Object],[object Object],[object Object],[object Object]
What’s the Alternative? Invest in Kids and Seniors
Improve Protections for  Low-Income Seniors ,[object Object],[object Object],[object Object]
Percent of Low-Income Seniors, by Race Hispanic API African American White 19.9% Source: Kaiser Family Foundation 2007 23.2% 12.6% 7.9%
Investing in America’s  9 Million Uninsured Children ,[object Object],[object Object],[object Object],[object Object],Source: Families USA
Hispanic API African American White Percent of Children Uninsured, by Race Source: Census 2005 21.9% 12.5% 12.1% 7.2%
What Fiscal Commitment Do We Need?   ,[object Object],[object Object],[object Object],[object Object],[object Object]
Meeting Pay-Go Requirements Finance, Energy & Commerce, and Ways & Means Committee leaders agree: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Key questions to ponder: Is it better to overpay MA insurers . . .   OR  Is it better to overpay MA insurers . . .   OR   Is it better to overpay MA insurers . . .   OR Is it better to overpay MA insurers . . .  OR Stop Medicare’s privatization? Subsidize poor seniors? Reduce premiums? Cover uninsured kids?

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Medicare Advantage Plans

  • 1. MA Windfall Payments: A Source of Help for Low-Income Children And Seniors? Presentation to the TriCaucus Ron Pollack Families USA May 11, 2007
  • 2. Medicare Advantage Plans How much do seniors from communities of color rely on MA plans?
  • 3.
  • 4.
  • 5. Traditional Medicare: Still the Choice of Seniors MA Traditional Medicare Hispanic seniors 25% 75% Asian seniors 14% 86% African-American seniors 13% 87% Low-income seniors 10% 90% Source: AHIP 2007 3X 6X 8X 9X
  • 6.
  • 7.
  • 8.
  • 9.
  • 10. Bush Administration and Republican Congressional Leaders Why so intent on protecting windfall overpayments? Two words . . . P R I V A T I Z E Medicare
  • 11.
  • 12. Think We’re Kidding? Newt Gingrich: “ Now, we don’t get rid of [traditional Medicare] in Round 1 because we don’t think that’s politically smart. But we believe it’s going to wither on the vine because we think people are voluntarily going to leave it . . . .” Source: Gingrich 1995
  • 13.
  • 14.
  • 15.
  • 16. What’s the Alternative? Invest in Kids and Seniors
  • 17.
  • 18. Percent of Low-Income Seniors, by Race Hispanic API African American White 19.9% Source: Kaiser Family Foundation 2007 23.2% 12.6% 7.9%
  • 19.
  • 20. Hispanic API African American White Percent of Children Uninsured, by Race Source: Census 2005 21.9% 12.5% 12.1% 7.2%
  • 21.
  • 22.
  • 23. Key questions to ponder: Is it better to overpay MA insurers . . . OR Is it better to overpay MA insurers . . . OR Is it better to overpay MA insurers . . . OR Is it better to overpay MA insurers . . . OR Stop Medicare’s privatization? Subsidize poor seniors? Reduce premiums? Cover uninsured kids?