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Celebrating 35 years of making Medicare more accessible, affordable, and equitable!

Julie Carter

Senior Federal Policy Associate

Lawmakers Raise Medicare Plan Finder Concerns

This week, a bipartisan group of leaders from the U.S. House of Representatives Committees on Energy & Commerce and Ways & Means sent a letter to the Centers for Medicare & Medicaid Services (CMS) expressing concerns with the redesigned Medicare Plan Finder (MPF). The letter points to errors that advocates and Medicare counselors experienced when using the new tool to help beneficiaries compare and select Medicare Advantage and Part D prescription drug plans during Fall Open Enrollment. In the letter, the leaders urge CMS to ensure that people with Medicare who relied on MPF information to choose a plan this year are held harmless and have the opportunity to make changes to their coverage in 2020.

New Data Show Very Few People with Medicare Choose to Switch Plans Each Year

A new data note from the non-profit Kaiser Family Foundation (KFF), however, reveals that very few people with Medicare end up switching plans during the fall. Among MA and PDP plan enrollees who did not receive low-income subsidies, fewer than 8% of people enrolled in MA plans chose to switch to another MA plan in 2016. The pattern is similar for standalone drug plans–just over 8% switched from one PDP to another. This could mean that beneficiaries have reviewed and are happy with their coverage, but it might highlight a more troubling reality– people may not know they can switch plans or may find the process of comparing plan options too burdensome.

Poll Finds Many Americans Worried about Health Care Costs and Struggle to Afford Care

A recent poll and study by Gallup and West Health found that most Americans are worried about rising health care costs, and many are also concerned about bankruptcy from major health events. Older adults have somewhat more confidence about their access to quality care than younger people, but they still experience difficulty with affordability, especially when it comes to paying for prescription drugs. These findings and more are an important indicator that more must be done to bring down health care costs.

Upcoming Medicare Additions for Treatment for Opioid Use Disorder

The Centers for Medicare & Medicaid Services (CMS) recently finalized a rule that expands Medicare coverage for Opioid Use Disorder (OUD). Recent legislation, the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, established a pathway for this more comprehensive Medicare coverage of OUD services. Beginning on January 1, 2020, Medicare Part B will cover OUD treatment—including methadone for Medication Assisted Therapy (MAT)—furnished by an Opioid Treatment Program (OTP) under a bundled payment mechanism. This means a significant improvement in access to OUD care for people with Medicare, including for those who are dually eligible for Medicaid.

Court Blocks Sweeping Rule that Would Negatively Impact Patient Access to Care

This week, a federal court blocked a Trump administration rule that would have allowed health plans and providers to refuse to provide certain types of care they disagreed with on moral or religious grounds. Set to take effect on November 22, the rule would have permitted individuals to deny care even in circumstances where performing the refused service was a significant portion of their jobs, and even where the refusal could prevent patients from receiving the service altogether.

Big Changes May Be in Store for Medicare Part D

Some changes are in store for Part D in 2020 and policymakers are contemplating even more. The Kaiser Family Foundation (KFF), a nonpartisan nonprofit focused on national health issues, recently outlined what the program will look like next year under current law, and under recent legislative and administrative proposals.