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If you did not receive an email with the NRLN President’s Forum message or an Action Alert posted on this home page, possibly you mistakenly “unsubscribed” on one of our emails or you have a new email address. You will no longer hear from us unless you “re-subscribe”. To "subscribe" or “re-subscribe”, click here.



Bill Kadereit, pres
PRESIDENT'S
           FORUM

(click here for previous FORUM articles )

 

New NRLN Whitepaper on Medicare Advantage

You probably know that that I have been writing whitepapers and sharing Forum and FOCUS newsletter messages about the NRLN’s concern that taxpayer subsidies paid to Medicare Advantage (MA) insurance companies are being used to move Medicare toward privatization.

I have completed a new NRLN whitepaper on this issue. Click here to access the whitepaper. I hope you will read the entire 18 pages. Tables and charts illustrate and magnify new findings. If you do not take the time to read the entire whitepaper, I urge you to at least read the 3-page Executive Summary which includes one page of the NRLN’s proposals to Congress on MA plans and original Medicare.

The NRLN’s primary concern has always been for its members and all seniors who see the TV commercials about MA plans and good deals that are “FREE.” But taxpayer dollars are subsidizing private insurance companies in the form of rebates and bonuses that fund reduced deductibles and copays, pay for drug plans and new “chronic” benefits to the 26 million MA enrollees that are denied to the 44 million original Medicare beneficiaries. The NRLN is advocating this is unfair and discriminatory.

The NRLN fully supports competition from private healthcare plans and understands the financial challenges ahead for Medicare and the federal budget. However, we lobby against legislated subsidies and restrictions placed on original Medicare Fee-for-Service (FFS) just to preserve the notion that private insurance plans are more effective. Sooner or later these subsidies could dry up, causing insurers to abandon MA plans.

I recognize that you may have an MA plan and like it. Possibly, your plan is one of the better MA-PPO plans that four million seniors have from their former employer or union. PPO plan benefits are usually not network restricted and premiums are negotiated and less dependent on rebates.

It is critical that seniors who have an MA plan and prospective new MA enrollees fully understand the 12 months rule. While MA plan participants can switch to original Medicare after 12 months, they must meet pre-existing conditions and other underwriting requirements to qualify for Medigap supplemental coverage. Rejections are common. Those who do qualify with restrictions may have to pay excessive premiums.

I want to share with you some realities in the whitepaper obtained from reliable sources such as the Medicare Payment Advisory Committee (MedPAC), the Medicare Trustees, the Health and Human Services (HHS) Inspector General and the Congressional Budget Office (CBO) who produce non-partisan reports on Medicare and MA to members of Congress and the President.

  1. Healthcare costs are rising four times faster than the number of new Medicare enrollees;
  2. After 23 years and over $350 billion in rebates paid to MA plans, their annual payments per enrollee are 103% of enrollees in original Medicare;
  3. Congress uses income (not payroll) tax dollars to pay MA insurers rebates of $122 a month per enrollee;
  4. In 2020, of the $271 billion in payments to be made to MA plans, $35 billion, or 13%, are rebate payments.

The whitepaper states that the Medicare Advantage Quality Bonus Plan (QBP) is used as a vehicle to divert federal income tax dollars to insurance companies. This 1–5-star plan awards the low 1-star rated plans a 50% rebate, a direct subsidy and a squandering of taxpayer dollars. Ridiculous!

The MedPAC has reported to Congress that QBP is unprofessionally derived and administered. The HHS Inspector General has stated that QBP provides “wrong or improper payments.” Yet Congress continues to subsidize MA plans.

I call the QBP program a HOUSE OF CARDS and the achilles heel of Medicare privatization! Please click here to read the NRLN’s whitepaper on MA. If you have a problem with this link, click on the Legislative Agenda tab at the top of this page and select NRLN whitepapers.

Bill Kadereit, President
National Retiree Legislative Network

 

HOW YOU CAN HELP

  • SUBSCRIBE to receive periodic emails,
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According to the authors of H.R. 3107, Improving Seniors’ Timely Access to Care Act, each of the private insurance companies providing Medicare Advantage (MA) plans has a unique way of handling its requirement for prior authorization. Tell your members of Congress that when MA plan participants need critical medical care, doctors and support staff should be spending their time working with patients instead of having to haggle with insurance companies over whether they can do their jobs. Click here to access the Action Alert.

 

Source for Coronavirus Information

Coronavirus.gov is the source for the latest information about COVID-19 prevention, symptoms, and answers to common questions. USA.gov has the latest information about what the U.S. Government is doing in response to COVID-19. Click here for Medicare information on COVID-19.

Click here for more NRLN messages on the Coronavirus.

 

report card NRLN Provides New “Report Card” Feature on Members of Congress

Do your Senators or Representative support bills that help retirees? Check it out here!

 

PHARMA CONTRIBUTIONS TO CONGRESS

money How much did your U.S. Representatives and Senators take as campaign contributions from the Pharmaceutical and Health Products Industry for their recent election campaigns and the current 2019-20 one? Could this be a reason why bills to reduce the price of prescription drugs are not being passed? Click here to see data that the NRLN has compiled from OpenSecrets.Org, Center for Responsive Politics. All Senators and Representatives are now shown by state and amount for ease of reviewing your state's delegation.

 

NRLN members are saving big with the Free Health Savings Rx Card℠

The NRLN has arranged to offer you a Health Savings Rx Card™, at NO COST, that offers you and your family savings on prescription drugs, plus vision and hearing services and products.Click here to access the Rx Savings Card℠ website.

 

Adobe® Reader® is required to view some documents. Please download free copy by clicking here.

 

amazon smile AmazonSmile Program to Benefit the American Retirees Education Program (AREF)

The NRLN board created the American Retiree Education Foundation (AREF) in 2014 as a 501(c)(3) tax-deductible, nonprofit education foundation to expand the research and educational reach of the NRLN and to enable NRLN to sharpen its focus as an organization lobbying for the passage of federal legislation and regulations that benefit retirees.

For example, the white paper on Protecting Pension Assets which is used to educate members of Congress on the need for legislation to prevent pension plan sponsors from using plan assets for non-pension expenses was funded by AREF.. Access the white paper here.

You can help fund the AREF without costing you anything extra when you make a purchase online from Amazon through its AmazonSmile program. Click here to learn more about AmazonSmile.

IN THE NEWS...

The articles and opinion pieces below are for information and are not necessarily a reflection of the NRLN’s position on issues. The NRLN is nonpartisan and its positions on retirement issues are presented in its Legislative Agenda and white papers that can be accessed from the Legislative Agenda tab.

2021 Health Plans Granted Leeway To Limit Consumers’ Benefit From Drug Coupons
By Michelle Andrews; Kaiser Health News ~ Jul 06, 2020

What Seniors Should Know Before Going Ahead With Elective Procedures
By Judith Graham; Kaiser Health News ~ Jul 06, 2020

Second Stimulus Checks Now Possible, Says McConnell
From Zack Friedman; Forbes ~ Jul 06, 2020

Opinion: Americans leave large cities for suburban areas and rural towns
From Kristin Tate; The Hill ~ Jul 05, 2020

5 Reasons Social Security Benefit Cuts Could Be Happening Sooner Than Expected. Will you be left with smaller checks?
By Christy Bieber; The Motley Fool ~ Jul 05, 2020

Opinion: SNAP increases for older adults should be a bipartisan no-brainer
From Bob Blancato; The Hill ~ Jul 04, 2020

Opinion: Why drug costs for older Americans should be capped in pandemic's wake
From Susan Peschin; The Hill ~ Jul 02, 2020

Trump Admin Scales Back Mandate That Health Insurers Cover COVID Tests
By Josh Kovensky; Talking Points Memo ~ Jul 02, 2020

Retirees, Beware These Tax Traps on Social Security and Medicare
By Neal Templin; Barron’s ~ Jul 02, 2020

Where Is My Tax Refund? Why It May Be Late And When To Expect It
From Jim Wang; Forbes ~ Jul 01, 2020

This one change could undermine the retirement security of millions of Americans
By Alicia H. Munnell, MarketWatch – June 30, 2020

More than 300 organizations, physician groups push Congress to take action on telehealth policies
By Heather Landi; FierceHealthcare ~ Jun 30, 2020

House Passes Bill To Expand ACA But Republican Senate Unlikely To Follow
Via KHN Morning Briefing; Kaiser Health News ~ Jun 30, 2020

The SEC’s Brokerage Advice Rule Kicks In
By Ross Snel; Barron’s ~ Jun 30, 2020

Social Security is under pressure, senior citizens are battling a health crisis — it’s not easy aging in America
By Alessandra Malito; MarketWatch ~ Jun 30, 2020

The Other Shoe Drops: Gilead’s Outrageous Pricing Of Remdesivir
From William A. Haseltine; Forbes ~ Jun 29, 2020

The year 2020 might look hard but Nokia is doing well
Via “Marin”; Nokiamob~ Jun 28, 2020

Nokia lands a few much-needed wins
By Scott Bicheno; Telecoms.com ~ Jun 23, 2020

US 'likely' to see shortage of pharmaceutical drugs if coronavirus outbreak continues, intelligence report finds
By Olivia Rubin & Josh Margolin; ABC News ~ Jun 28, 2020


Via KHN Morning Briefing; Kaiser Health News ~ Jun 23, 2020

Sad But True: The Real Solution to Social Security's Looming Financial Crisis
By Dan Caplinger; The Motley Fool ~ Jun 27, 2020

Trump administration asks Supreme Court to scrap Obamacare
By Darryl Coote; United Press International ~ Jun 26, 2020

Medicare Advantage, Part D ERSD Rules Could Boost Costs

Study sees 'probable' higher heart risk for new Amgen osteoporosis drug
By Vishwadha Chander; Reuters ~ Jun 24, 2020

Doctors Concerned Rural Health Care Will Be Affected By Trump’s Visa Freeze
Via KHN Morning Briefing; Kaiser Health News ~ Jun 24, 2020

Hospitals must disclose actual prices for tests and procedures, court rules
Via Associated Press; MarketWatch ~ Jun 24, 2020

U.S. hospitals lose legal challenge to Trump price transparency rule
By Jonathan Stempel; Reuters ~ Jun 23, 2020

IRS Clarifies Rules on Who Qualifies for Coronavirus Hardship Loans, Withdrawals From Retirement Accounts
By Daisy Maxey; Barron’s ~ Jun 23, 2020

US appeals court reinstates lawsuit against IBM retirement plan committee
By Jonathan Stempel; Reuters ~ Jun 22, 2020

Opinion: Will You Get A Stimulus Check If You’re On Social Security Or SSDI?
From Jeff Rose; Forbes ~ Jun 22, 2020

Opinion: Stimulus Check Still Hasn’t Arrived? This May Be Why
From Jennifer Barrett; Forbes ~ Jun 21, 2020

CMS Orders Medicare Advantage Plans, MACs to Cover COVID-19 Tests Under New Nursing Home Guidance
By Alex Spanko; Skilled Nursing News ~ Jun 20, 2020

President Trump is reducing healthcare costs for Americans with diabetes
By Marie Stroughter; LifeZette ~ Jun 19, 2020

J.D. Power gives Medicare Advantage plans bad marks on communicating with members
By Robert King; FierceHealthcare ~ Jun 18, 2020

Opinion: Can We Fix ‘The Price We Pay’ For Medicare? A New Book Shows Some Ways Forward
From Elizabeth Bauer; Forbes ~ Jun 18, 2020

50% of Seniors Don't Get to Keep Their Social Security Benefits in Full. Here's Why.
By Maurie Backman; The Motley Fool ~ Jun 17, 2020

Walmart Opening More Healthcare Services ‘Super Centers’
From Bruce Japsen; Forbes ~ Jun 17, 2020

Court strikes down Trump rule that drugmakers disclose price
By Ricardo Alonso-Zaldivar; The Associated Press ~ Jun 17, 2020

HHS Doled Out $50 Billion to Firms Accused of Medicare Fraud
By David Kocieniewski & Caleb Melby; Bloomberg ~ Jun 16, 2020

Opinion: In Latest Healthcare Deal, Walmart Buys CareZone’s Digital Prescription Technology
From Bruce Japsen; Forbes ~ Jun 15, 2020

A ‘Medigap’ policy picks up some costs that Medicare won’t. Here are tips for choosing one
By Sarah O’Brien; CNBC ~ Jun 15, 2020

As insurance companies take over pension plans, are your payments at risk?
By Gretchen Morgenson; NBC News ~ Jun 14, 2020

DOL Throws 401k Investors To The Wolves
From Edward Siedle; Forbes ~ Jun 13, 2020

What Could Be In The Next Stimulus Bill’s “Menu Of Options?”
From Jim Wang; Forbes ~ Jun 13, 2020

White House ‘Very Seriously Considering’ Throwing Weight Behind Another Stimulus Package
Via KHN Morning Briefing; Kaiser Health News ~ Jun 12, 2020

Failure To Update Address Cost IRA Owner Over $10,000
From Denise Appleby; Forbes ~ Jun 11, 2020

U.S. states accuse 26 drugmakers of generic drug price fixing in sweeping lawsuit
By Diane Bartz & Jonathan Stempel; Reuters ~ Jun 10, 2020

U.S. Treasury chief says considering more direct payments in next coronavirus aid bill
By David Lawder; Reuters ~ Jun 10, 2020

Republicans prepare to punt on next COVID-19 relief bill
By Jordain Carney; The Hill ~ Jun 10, 2020

FBI warns hackers are targeting mobile banking apps
By Maggie Miller; The Hill ~ Jun 10, 2020

Opinion: Strong economic numbers mean Congress has to pause spending
From Adam Brandon, ; The Hill ~ Jun 10, 2020

FCC proposes record $225 million fine for massive robocall campaign
By David Shepardson; Reuters ~ Jun 09, 2020

When A Doctor No Longer Accepts Medicare, Patients Left Holding The Bag
By Carmen Heredia Rodriguez; Kaiser Health News ~ Jun 09, 2020

Deep-Pocketed Hospitals That Received Aid Are Still Paying Executives Millions As They Cut Staff Positions
Via KHN Morning Briefing; Kaiser Health News ~ Jun 08, 2020

Fragmented Sleep Linked To Chronic Inflammation And Hardened Arteries
From Marla Milling; Forbes ~ Jun 06, 2020

Medicare Advantage plans face 'double whammy' of pent-up care demand and risk scores: experts
By Robert King; FierceHealthcare ~ Jun 05, 2020

Opinion: IRS Urges Non-Filers To Register To Get Stimulus Checks By Year-End
From Kelly Phillips Erb; Forbes ~ Jun 04, 2020

Growing Number Of Insurers Offering Premium Discounts As They Rack Up Savings During Pandemic
Via KHN Morning Briefing; Kaiser Health News ~ Jun 04, 2020

What The Pandemic Has Meant For These Older Adults
From Chris Farrell, NA; Forbes ~ Jun 04, 2020

IRS faces obstacles with remaining stimulus checks
By Naomi Jagoda; The Hill ~ Jun 03, 2020

Tax Day is coming soon. What you need for July 15
Don't forget: July 15 is the new Tax Day.

By Darla Mercado; CNBC ~ Jun 04, 2020

Social Security Services and Scams
By Tammy Flanagan; Government Executive ~ Jun 04, 2020

CDC Was Viewed As World’s Premier Health Agency. How Did It Stumble So Badly?
Via KHN Morning Briefing; Kaiser Health News ~ Jun 03, 2020

Top House, Senate lawmakers warn HHS over slow health provider aid payouts
By Adam Cancryn; Politico ~ Jun 03, 2020

HHS Has Yet To Allot Nearly $100 Billion In Aid To Hard-Hit Hospitals, Health Clinics
Via KHN Morning Briefing; Kaiser Health News ~ Jun 03, 2020

Private Equity Gets a Big Win With U.S. Nod to Tap 401(k) Plans
By Benjamin Bain; Bloomberg ~ Jun 03, 2020

How to plan for a smaller Social Security check
By Robert Powell; USA Today ~ Jun 03, 2020

Telehealth spending to reach $250 billion in 2020
By Alex Kacik; Modern Healthcare ~ Jun 02, 2020

Insurers concerned over how CMS will calculate Medicare Advantage star ratings in next two years
By Robert King; FierceHealthcare ~ Jun 02, 2020

BCBS sues CVS over inflated drug prices
By Thomas McParland; BenefitsPRO ~ Jun 02, 2020

California AG Seeks More Power To Battle Merger-Hungry Health Care Chains
By Rachel Bluth; Kaiser Health News ~ Jun 02, 2020

Composite multiemployer plans fare better during economic stress – study
By Hazel Bradford; Pensions & Investments ~ Jun 02, 2020

Supreme Court Decision in Thole v. U.S. Bank Has Major Implications for Pensions
By John Manganaro; Plansponsor ~ Jun 01, 2020

Democratic Super PAC Uses Familiar Political Play To Hit Trump On Medicare
By Victoria Knight; Kaiser Health News ~ Jun 01, 2020

Coronavirus Surprise: IRS Allows Midyear Insurance And FSA Changes
By Michelle Andrews; Kaiser Health News ~ Jun 01, 2020

Supreme Court Limits Pension Plan Lawsuits
5-4 decision announced today in Thole v. U.S. Bank shuts door on wide range of fiduciary breach lawsuits by limiting the circumstances under which pension plan participants can sue

By Brian Anderson; 401KSpecialist ~ Jun 01, 2020

Opinion: The real reason Social Security is in crisis
From Brett Arends; MarketWatch ~ Jun 01, 2020