'Misleading': Alarm raised about Medicare Advantage 'scam'

Democratic U.S. lawmakers on Tuesday joined senior citizens, people with disabilities, and healthcare campaigners at a Capitol Hill press conference to kick off a week of action demanding Congress move to stop abuses by so-called Medicare Advantage programs peddled by profiteering insurance companies and "reclaim Medicare."

"We are here to raise the alarm about Medicare Advantage. We are here to protect our Medicare," Sen. Elizabeth Warren (D-Mass.) said to robust applause.

"This year, for the very first time, more than half of all beneficiaries are enrolled in Medicare Advantage instead of traditional Medicare," she continued. "But Medicare Advantage substitutes private insurance companies for traditional Medicare coverage, and that private coverage is failing both Medicare beneficiaries and taxpayers."

"Not only do Medicare Advantage insurers rip off the government, they routinely deny care to patients who need it."

"It's all about the money," Warren said. "Private insurers are in Medicare Advantage to play games to extract more money from the government."

"Experts estimate that Medicare Advantage insurers will receive more than $75 billion in overpayments this year alone, and that's the real punch to the gut," she continued. "Not only do Medicare Advantage insurers rip off the government, they routinely deny care to patients who need it."

"Seniors and people with disabilities who rely on Medicare deserve better," the senator affirmed. "We can strengthen traditional Medicare, and by doing that, we can save money and we can use some of those savings to expand benefits, like hearing, dental, and vision... and add an out-of-pocket cap for all beneficiaries... and lower the eligibility age for Medicare."

"Medicare money should be spent to deliver services for people," Warren added, "not to boost profits for insurance."

Rep. Rosa DeLauro (D-Conn.) said that "it is time to call out so-called Medicare Advantage for what it is. It's private insurance that profits by denying coverage and using the name of Medicare to trick our seniors."

Universal healthcare activist Ady Barkan, who founded the advocacy group Be a Hero—an event sponsor—asserted that "healthcare is a human right, and Medicare should be a rock-solid guarantee to that fundamental right."

"It should be a beacon of mutual responsibility and solidarity in the wake of 50 years of neoliberal ideology—a pillar of love, standing tall in a world too often dominated by greed," he added. "Health insurance corporations are doing everything they can to destroy this vision. That's why Be A Hero is leading this week of action to fight back."

Like the lawmakers, Alex Lawson, executive director of the advocacy group Social Security Works, blasted "bad actors in Medicare Advantage" who he said "are delaying and denying the care seniors and people with disabilities need."

"Corporate insurance is designed to generate profits by delaying and denying care, harming and killing patients instead of providing care," Lawson added.

Among the patients who spoke at Tuesday's event were Jen Coffey, who described to the barriers she's faced while seeking lifesaving care for complex regional pain syndrome caused by breast cancer under a UnitedHealthcare Medicare Advantage plan.

"I'm tired of talking to insurance employees who get to override the care and medications my doctors order while having not one shred of medical knowledge to make that decision with," she said. "I want medical freedom where my care decisions are made by my providers and me, not a representative reading out of a manual or a computer algorithm."

Wendell Potter, who heads the Center for Health and Democracy, repeated the common refrain that "so-called Medicare Advantage is neither Medicare nor an advantage. It is simply another scheme by the insurance companies to line their pockets at the expense of consumers by denying and delaying care."

"The healthcare market is confusing for consumers and the misleading branding of calling private insurance Medicare only makes this worse," Potter stressed.

Zenei Triunfo-Cortez, a registered nurse and president of the National Nurses United union, implored Congress "to take immediate action to prevent delays and denials of care in Medicare Advantage" and "support improvements to traditional Medicare and the expansion of traditional Medicare to cover every person living in the United States."

Earlier this year, Democratic U.S. Reps Mark Pocan (Wis.), Jan Schakowsky (Ill.), and Ro Khanna (Calif.) reintroduced legislation that would prohibit insurance companies from using the word "Medicare" in their health plans.

Progressive lawmakers have also criticized President Joe Biden for delaying promised curbs on Medicare Advantage plans amid heavy insurance industry lobbying.