Kaiser Family Foundation Issues Report Comparing Cost-Related Problems for Medicare Advantage Enrollees and Beneficiaries in Traditional Medicare

The Kaiser Family Foundation (KFF) recently compared costs faced by Medicare Advantage (MA) plan enrollees to those in traditional Medicare in a report entitled “Cost-Related Problems Are Less Common Among Beneficiaries in Traditional Medicare Than in Medicare Advantage, Mainly Due to Supplemental Coverage” (June 2021) – also see KFF’s press release announcing the study entitled “Black Medicare Beneficiaries Are More Likely Than White Beneficiaries to Have Cost-Related Problems with Their Health Care, Across both Traditional Medicare and in Medicare Advantage Plans” (June 25, 2021).

The report notes that while 42% of all Medicare beneficiaries were enrolled in MA plans in 2021, there is “higher enrollment among some subgroups of beneficiaries than others. In 2018, half of all Black and Hispanic beneficiaries were enrolled in a Medicare Advantage plan, compared to 36% of White beneficiaries.” Among other things, though, the report found that rates of cost-related problems are higher among beneficiaries in MA than in traditional Medicare, and “[a]mong Black beneficiaries specifically, a larger share of those in Medicare Advantage reported cost-related problems than those in traditional Medicare (32% vs. 24%).”

With a focus on health equity and cost-related health care problems faced by beneficiaries, the report included several key findings (the following is excerpted directly from the report, with links removed):

• “Overall, about one in six Medicare beneficiaries (17%) reported a cost-related problem in 2018, with a somewhat lower rate among traditional Medicare beneficiaries (15%) than Medicare Advantage enrollees (19%), attributable to a lower rate of cost-related problems among the majority of traditional Medicare beneficiaries with supplemental coverage (12%) […]. The rate of cost-related problems is highest (30%) among traditional Medicare beneficiaries without supplemental coverage, who account for about 10 percent of the Medicare population.
• A smaller share of Black beneficiaries in traditional Medicare (24%) than in Medicare Advantage (32%) reported cost-related problems. Rates of cost-related problems were lower among Black beneficiaries in traditional Medicare with Medicaid and other forms of supplemental insurance (20%).
• One in five Hispanic beneficiaries overall reported a cost related problem (21%) and the share was similar among those in traditional Medicare with supplemental coverage (18%) and Medicare Advantage (22%).
• The share of Black Medicare beneficiaries reporting cost-related problems was higher than among White beneficiaries in both traditional Medicare and Medicare Advantage. Additionally, the difference in the share of Black beneficiaries reporting cost-related problems in Medicare Advantage compared to traditional Medicare with supplemental coverage was larger than for White beneficiaries.
• Half of Black Medicare Advantage enrollees in fair or poor self-assessed health reported cost-related problems, compared to one-third of Black beneficiaries in traditional Medicare overall and just over one-fourth of Black beneficiaries in traditional Medicare with supplemental coverage.”

In order to address the inequities highlighted in the KFF report, the Center for Medicare Advocacy asserts that the Medicare program must exert greater oversight of and strengthen consumer protections in the Medicare Advantage program. Further, in order to provide real, meaningful choices for all Medicare beneficiaries, Congress must expand rights to purchase Medigap supplemental insurance policies, including to people under 65.