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Biden should expand Medicare Advantage, not cut it 

AP Photo/Pablo Martinez Monsivais, File
This Nov. 8, 2018 file photo shows a page from the 2019 U.S. Medicare Handbook in Washington. (AP Photo/Pablo Martinez Monsivais, File)

In his State of the Union address, President Biden declared, “Social Security and Medicare are a lifeline for millions of seniors. Americans have been paying into them with every single paycheck since they started working.”

He added, “If anyone tries to cut Medicare, I will stop them. I will not allow them to be taken away. Not today. Not tomorrow. Not ever…I won’t cut a single Social Security or Medicare benefit.”

Biden is right. But unfortunately, his Centers for Medicare and Medicaid Services has already cut and plans further cuts to the most popular program by which seniors access medical care — that is, through Medicare Advantage. This is both a policy and political mistake for Democrats.

A majority of eligible seniors choose to get their benefits through Medicare Advantage, a public-private partnership. They choose a health plan that fits their needs and the government pays the insurance provider a fee. For about the same cost to taxpayers as traditional Medicare, which only covers doctors and hospital stays, Medicare Advantage covers hospitals, doctors, catastrophic care, prescriptions, vision, hearing, and dental coverage, and can even include transportation to medical appointments, gym memberships, and delivered meals after a stay in the hospital.

It would be extremely difficult to cover all this through traditional Medicare. When the plan to expand Medicare to include hearing, vision, and dental coverage was scored, it was estimated to cost at least $350 billion over 10 years. In fact, the thinking is reversed; research shows that if traditional Medicare was more like Medicare Advantage, the program’s solvency could be extended by 17 years.

So in fact, Medicare Advantage is the best way for Democrats to expand access to quality and affordable healthcare, while also the fortifying traditional Medicare program.

Even more important than the cost, Medicare Advantage helps seniors achieve better health outcomes. NIH research shows that “Medicare Advantage was associated with more preventive care visits, fewer hospital admissions and emergency department visits, shorter hospital and skilled nursing facility lengths-of-stay, and lower health care spending. Medicare Advantage outperformed traditional Medicare in most studies comparing quality-of-care metrics.”

We should celebrate improved health outcomes as well as lower out of pocket costs within Medicare Advantage. It explains why the program has been growing in popularity every year and is now chosen by most eligible enrollees, up to nearly 33 million. Further, Medicare Advantage is a critical program to many disadvantaged communities, including Hispanic and African American seniors. According to the research, “Medicare Advantage enrollees were more likely to have incomes below $20,000 per person, live in urban areas, and have lower levels of education.”

A majority of seniors in the big blue states of California and New York choose Medicare Advantage. And critically, that’s also true for swing states that voted for Trump in 2016 but switched to President Biden in 2020 — Arizona, Georgia, Michigan, Pennsylvania, and Wisconsin. It is well known that seniors vote at the highest rate of any age cohort.  

Because Medicare Advantage fulfills Democratic values, offers more services, better health outcomes, and is popular among our voters, it makes no sense at all for CMS to continue cutting Medicare Advantage. And our candidates cannot defend these cuts on the campaign trail.

Sadly, some of the most progressive elements of the party have sent a letter to the administration calling for further regulations and restrictions on this popular program. These are not frontline Members of Congress. They are not going to make the difference when it comes to taking back the House and increasing our party’s majority in the Senate. Listening to them would not be good policy or good politics.

The Democratic Party should embrace Medicare Advantage, not cut it.

Jason Altmire, a former Democratic member of Congress from Pennsylvania from 2007 to 2013, is an adjunct professor at the Texas Tech University Health Sciences Center. He has been an executive in both the hospital and health insurance industries.

Tags Jason Altmire Joe Biden medicare Medicare Advantage

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