Doggett Opening Statement at Markup of H.R. 4093

(As prepared for delivery)

Long ago, with rare bipartisan support, Congress created an independent, objective source of advice.  That nonpartisan entity is called the Medicare Payments Advisory Commission, or MedPAC. The big insurance companies, who are profiting so excessively from Medicare Advantage, don’t like that objective advice, which shows that taxpayers are being forced to pay them too much. And so today, their supporters are urging us to ignore the independent advice and essentially cook the books.

Taxpayers are expected to spend up to $700 billion next year on Medicare Advantage private insurance.  Ensuring this program is working well is one of the most important fiscal issues facing this Committee.  With Medicare expected to run a deficit in just 7 years, triggering automatic provider payment cuts and threatening benefits, this legislation undermines MedPAC’s work and offers yet another unfair advantage to Medicare Advantage insurers. 

First promoted by Newt Gingrich as a way to “let Medicare wither on the vine,” saving taxpayer dollars and improving the quality of care, Medicare Advantage has never saved a penny. Not only MedPAC, but also the Congressional Budget Office, the Committee for a Responsible Federal Budget, and several other nonpartisan researchers and entities have repeatedly shown that every year MA private insurance costs billions more than Traditional Medicare. These dollars lost to giant insurers could instead be used to extend Medicare solvency or to offer better Medicare for more Americans, such as by extending coverage of dental, vision, and hearing, as I have urged.

Even a study by Humana, the second largest MA insurer, found evidence of significant favorable selection, where healthier, less costly consumers are disproportionately enrolled in MA plans while sicker, more costly consumers are steered to Traditional Medicare. Humana’s findings account for billions in overpayments. Medicare Advantage is the most profitable plan private insurers sell.

Insurers get all the advantage while consumers are disadvantaged by prior authorization and narrow networks that so often prevent them from seeing the doctor of their choice. The flashy supplemental benefits, like payments for rent and groceries, are often merely a marketing tool as consumers discover fine print caveats that they are not qualified for every benefit or receive only limited coverage.  As insurers collect higher overpayments for minimal value, every Medicare enrollee pays more in Part B premiums.

Yet, this bill directs MedPAC to provide a lopsided study on the supposed value of MA with no analysis of its limitations or the value of Traditional Medicare’s coverage of the doctor of your choosing, limited prior authorization, and other benefits. Instead, MedPAC is instructed to promote MA and offer recommendations for even more incentives for these private insurers.

If we yield to Big Insurance now, every other industry stakeholder that has a complaint about MedPAC’s findings will come to this Committee to skew results and interfere with their work. You might as well set taxpayer dollars on fire at the same time as you toss out dozens of important recommendations to combat fraud, waste, and abuse, and improve program efficiency. This bill doesn’t achieve Apples to Apples data analysis, it cooks the books to give the scent of apple pie while masking a burnt, rotten core.

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