Monday, July 22, 2019

Insurers Making It Tough For Sanders And Warren To End Private Medicare


Bruce Japsen Senior Contributor Jul 21, 2019, 08:30am
As health insurance companies expand into new regions offering privatized Medicare Advantage coverage and enroll more seniors, it could make the case for single payer more difficult for Democrats on the 2020 Presidential campaign trail.
Health insurance companies continue to announce record growth in their Medicare Advantage businesses with UnitedHealth Group, the nation’s largest health insurer, announcing last week that its Medicare Advantage enrollment jumped by 400,000 seniors to eclipse 5 million. Meanwhile, other health insurance companies are announcing plans to expand into new states and counties to sell Medicare Advantage coverage to seniors for 2020 and beyond.
This enrollment growth and geographic expansions come while U.S. Sens. Bernie Sanders of Vermont, Elizabeth Warren of Massachusetts and some other Democrats running for the presidency in 2020 are advocating a single payer version of Medicare for All that would replace the private insurance system. Sanders and others argue the single payer version of Medicare for All would eliminate co-payments, deductibles and allow Americans to pick the doctors they want free of insurance company restrictions and provider network rules.
But health insurers and analysts who follow the industry say the increasing enrollment and expansions mean it will be less likely for Congress and a future White House to replace Medicare Advantage given seniors continue to sign up for such coverage in record numbers.
“There is zero chance the Bernie/Warren plan gets enacted. Zero,” says John Gorman, a healthcare consultant who worked in the Clinton administration as Assistant Director, Office of Managed Care at HCFA, now known as the Centers for Medicare & Medicaid Services.
“Never in the history of this nation have we annihilated a $3 trillion industry and we’re not about to start with insurers,” Gorman added. “If there’s going to be ‘Medicare for All’ it will be Medicare Advantage for all.”
UnitedHealth ended the second quarter with 5.19 million Medicare Advantage enrollees compared to 4.79 million in the year-ago period, the insurer said last week in announcing the company’s second-quarter earnings.
UnitedHealth’s Medicare Advantage enrollment is the latest positive growth sign for such plans, which contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines with some also offering vision, dental care and wellness programs. And now insurers are rolling out more supplemental benefits in their Medicare Advantage plans following rule changes implemented.
Several big Medicare Advantage players, including executives from UnitedHealth, CVS Health and its Aetna health insurance unit, Humana and top officials from the Trump administration are speaking this week at the Better Medicare Alliance's Medicare Advantage Summit in Washington on the benefits, strategies and challenges ahead for the program.
Gorman projects the Medicare Advantage program will “represent over half of all” Medicare beneficiaries by 2025. “The infrastructure is built for it to handle many, many more, if United’s enrollment numbers are any indication,” Gorman said.
A recent study by L.E.K. Consulting projects enrollment of seniors in Medicare Advantage could reach 70% of those between 2030 and 2040. Insurers could be ahead of those projections.
UnitedHealth is the first major insurer to report quarterly earnings and related growth in the second quarter. Other insurers, including Humana, Anthem and CVS Health’s Aetna health insurance unit are expected to report their results and Medicare Advantage growth over the next month.
Health insurers are also beginning to announce where, exactly, they plan to grow and attempt to attract new Medicare Advantage customers.
Take Oscar Health, a relatively young health insurance company perhaps best known for sales of individual coverage under the Affordable Care Act, has been planning for more than a year enter the Medicare Advantage business. Last week, Oscar executives said they plan to roll out their first Medicare Advantage plans in Houston and New York for 2020, pending regulatory approval.
“We already know that Oscar’s tools are accessible to people of all ages and are capable of making the health care experience easier for everyone: 76% of our members who are 63-years-old and over already have digital accounts with us, and 83% of them have reached out to their concierge teams,” Oscar chief executive and co-founder Mario Schlosser said in announcing the expansion into Medicare Advantage. “We know these tools will be useful for our new Medicare Advantage members as well, whether they’re searching for a doctor on our mobile app, contacting their personalized Concierge team for guidance, or consulting a doctor via telemedicine.” 

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