Harvard Pilgrim Health Care has notified customers that it will drop its Medicare Advantage health insurance program at the end of the year, forcing 22,000 senior citizens in Massachusetts, New Hampshire, and Maine to seek alternative supplemental coverage.
“We became concerned by the long-term viability of Medicare Advantage programs in general,’’ said Lynn Bowman, vice president of customer service at Harvard Pilgrim’s office in Quincy. “We know that cuts in Medicare are being used to fund national health care reform. And we also had concerns about our ability to build a network of health care providers that would meet the needs of our seniors.’’
The decision by Wellesley-based Harvard Pilgrim, the state’s second-largest health insurer, was prompted by a freeze in federal reimbursements and a new requirement that insurers offering the kind of product sold by Harvard Pilgrim — a Medicare Advantage private fee for service plan — form a contracted network of doctors who agree to participate for a negotiated amount of money. Under current rules, patients can seek care from any doctor.
Wisconsin Republican Paul Ryan has defended Medicare Advantage as a free-market reform to Medicare, and Florida Senate GOP candidate Marco Rubio has made repealing Obamacare and protecting Medicare Advantage part of his plan to "protect seniors"
For more on Medicare Advantage, see Fred Barnes's November 2009 piece on the program:
Medicare Advantage (MA) is the crown jewel of government health care programs. It allows seniors to choose a health insurance plan that fits their needs. It gives them extra benefits, including eyeglasses and hearing aids, and pays for preventive care such as physical exams. Under MA, seniors don't need to buy supplementary Medigap insurance. It covers prescription drugs, in many cases beyond what the regular Medicare prescription drug program does. It requires lower deductibles and copayments, and thus is more affordable. Roughly one in four Medicare beneficiaries has signed up for MA. That's 10.6 million seniors. A disproportionately high percentage of them are poor African Americans and Hispanics.
You'd think President Obama and his congressional allies would love MA. It provides almost everything they've been demanding in health care for years. But Obama is trashing it. He claims it will give $177 billion in "overpayments" to insurance companies over the next 10 years. He wants to cut that amount from Medicare Advantage. The Democratic bill drafted by Senate Finance Committee chairman Max Baucus would cut $113 billion. House Democrats would slash $160 billion.
Frugality, however, is not their motive for bludgeoning MA. There are three things about it that Obama and Democrats loathe: (1) It's a Republican program, enacted as part of President Bush's prescription drug bill in 2003; (2) it brings free market competition and private, profit-making insurers into Medicare; (3) it uses a pool of money they'd rather spend on other programs.
