Is Sebelius Trying to Kill Medicare Advantage for Special Needs Patients?

Like the ObamaCare exchanges, [Medicare] offerings feature higher premiums and worse benefits, as well as insurers that are competing in fewer markets and shrinking their physician networks.

According to federal data, average consumer premiums are jumping by about 5% above the underlying rise of health costs. Three of every five counties have fewer options than they did this year, most of them in the South and Midwest. A recent Lerrink Swann research note for the nine major publicly traded insurers concludes their premiums are 26% higher and maximum out-of-pocket costs — a proxy measure that is inversely proportional to benefit generosity — have climbed by 22%.

About one of 20 seniors on Advantage had to switch plans because their old coverage was cancelled, but the damage has been particularly acute in a category called special needs plans, or SNPs. More than 1.5 million people were covered by about 500 of these plans in 2013, but the consultants at Avalere Health report that 13% were wiped out.

Liberals want to zero out about 80% of SNPs and allow them only for end-stage renal disease, AIDS and mental disabilities that require patients to be institutionalized. Everyone else is supposed to be shifted into new government-controlled, provider-side “reforms” that were part of ObamaCare. (WSJ)

Comments (19)

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  1. Dennis says:

    It will be interesting in the future if the quality of health care will be able to keep up with the rising costs of premiums.

  2. Charlie says:

    With SNP’s only to be available for those ill enough to be institutionalized, government controlled coverage will not be a sufficient substitute for those who previously relied on SNP’s.

  3. Dee says:

    Less options and higher premiums will become highly problematic for consumers with high cost health care needs.

  4. Allen says:

    “About one of 20 seniors on Advantage had to switch plans because their old coverage was cancelled”

    So much for plans not being cancelled

  5. John Fembup says:

    I think the administration is trying to kill Medicare Advantage. All of it. “Period.”

    The chosen tactic is the death of a thousand cuts. This is one of the cuts – just another sneaking step in the preferred direction, carefully sliced so as not to awaken the majority.

    • Dennis Byron says:

      It’s not just this administration. Killing Medicare choice has been in the Democratic Party platform explicitly or implicitly since 2000 (when Part C was called Medicare +Choice) and perhaps before that when what is now Part C was just a bunch of demo projects.

      • Dennis Byron says:

        I should have added that this Democratic Party opposition to Part C and Medicare choice in general is somewhat ironic because I think of it as the brainchild of Reishchauer and Aarons