Doggett Opening Statement at Joint Health and Oversight Subcommittee Hearing on Medicare Advantage
(As prepared for delivery)
I am so pleased this committee is finally addressing some genuine waste and abuse. Early in the reconciliation process, I led several colleagues in urging Republican leadership to focus on waste in the Medicare Advantage program rather than cutting coverage. While that request went unanswered, today we have an opportunity to start paving a new path toward fiscal responsibility. A path that protects taxpayers’ hard-earned dollars and their access to care.
Medicare Advantage was sold as a program to save taxpayer dollars and improve quality of care, but I have found that it is largely disadvantages—never saving taxpayers a penny and vastly outspending Traditional Medicare. While some of us have differing views concerning the value MA plans add, I know we are all concerned with wasteful overpayments and assuring the long-term promise of Medicare for future generations.
The nonpartisan, independent Medicare Payment Advisory Commission, or MedPAC, estimates taxpayers will spend 20% more this year for people in Medicare Advantage than if they had been enrolled in Traditional Medicare. That amounts to $84 billion in waste this year alone. And these funds don’t just impact Medicare’s long-term finances. Every single enrollee is paying an average of $198 more in Part B premiums this year because of overpayments to MA insurers.
What are consumers getting for all of this money? Outrageously, many are just facing care delays and denials, fewer and fewer provider options, and poor customer service. For providers, MA is becoming more trouble than it’s worth. Austin surgeon Dr. Elisabeth Potter was pulled out of surgery to talk to a UnitedHealth representative about an authorization she’d already received for the procedure she was in the middle of performing. When she fought back, United sought to discredit her and is denying coverage for her surgery center—driving her into enormous debt as she turns to GoFundMe to keep her practice afloat. Stories like hers are why I have urged the Justice Department to expand its investigation into United to closely examine every allegation of fraud, waste, and abuse, including reported denials of necessary hospitalizations.
For years, I have heard from hospitals, home health agencies, and other providers who are experiencing increasing administrative burdens, delays in reimbursement, and smaller payments that are falling below what Traditional Medicare would have paid. Together with Dr. Murphy, we authored the Prompt and Fair Pay Act, new, bipartisan legislation filed yesterday to ensure MA plans at least pay what Traditional Medicare would have for covered items and services. Our bill also establishes prompt payment requirements modeled after requirements in Part D. It is supported by the National Rural Health Association, LeadingAge, America’s Essential Hospitals, American Academy of Family Physicians, American College of Physicians, and others.
Last month, we also filed bipartisan legislation along with Chairman Schweikert to address an outrageous loophole that permits MA plans to receive premiums and capitated payments from dually enrolled veterans who receive all or most of their care through the VA. Researchers estimate this loophole will cost the VA over $350 billion over the next decade as taxpayers pay for care twice—once to the MA insurer which pockets the money and a second time to the VA, which actually delivers the care but is wrongly prohibited from recouping their costs. We authored the bipartisan GUARD Veterans’ Health Care Act to stop this waste and ensure the VA can bill MA for veterans’ care, in the same way that they do other commercial insurers. Our bill is widely supported by the VFW, Medicare consumer groups, and unions serving veterans.
I appreciate the support of Dr. Murphy and Chairman Schweikert in these measures and know they remain committed to additional bipartisan work to end waste and abuse in the MA program, to ensure a sustainable program for future generations, stabilize provider payments, and improve the delivery of health care for all Medicare enrollees. I hope that this hearing will be swiftly followed by a markup on our legislation and other urgent items to take the disadvantage out of MA.
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