The Future of Medicare Advantage

On July 9, 2008 the standoff in congress over a critical vote ended as Democrats got the necessary votes needed to overturn the Bush administration edict to reduce Medicare payments to doctors by 10.6 percent. Hoping to close the issue before the July 4th Holiday the Democrats fell one vote short of gaining cloture, but thanks to Senator Ted Kennedy, as well as the support of 8 Republicans who switched their vote in support of H.R.6331 the bill past 69-30. Under prior agreement, the measure will now go to the President. This will be a tough situation for the President. Two thirds of both the House and the Senate have now opposed his position which is more than enough to override a veto. It will be a few weeks before all the details are known, but here are a few changes that we know will more than likely take place. The new bill however does answer some immediate questions such as…

How will the new bill affect the future of Medicare Advantage?

Given the fact that these measures will eliminate Medicare rate cuts for doctors, the Medicare Advantage program will absorb the cost through reduction of payments. Also MA plans must have provider networks in 2011, and not just deemed providers.

How will the upcoming enrollment period be affected by the new legislation?

For the upcoming season most of the changes focus on new marketing rules Medicare Advantage and PDP plans. There are also changes that will affect Medicare Supplements or Medigap plans, but mostly the bill calls for new sales and marketing practices for the 2009 season.

How will seniors who are currently enrolled in a plan be affected?

As it relates to currently enrolled MA patients and the new bill it’s still too early to say exactly how the new legislation may impact client coverage. The new bill does not call for any changes at this time, but may call for the shift of some healthcare cost from the government onto seniors and the disabled.

For now we will have to wait and see just how the decision by our elected officials will totally affect the Medicare environment. The hope is that by the time the bill becomes law that an economically fair compromise is reached. A fair compromise could help to ease the minds of both patients and agents, but above all secure the future of the Medicare Advantage program.


Demetrius Smith
http://synergyone.ning.com/profile/DemetriusSmith
deesmithds@yahoo.com