Insurance industry moves to restrict provider networks in Medicare Advantage plans will come under scrutiny Wednesday on Capitol Hill. A hearing of the health subcommittee of the House Committee on Energy and Commerce, which is chaired by Rep. Joe Pitts (R-Pa.), will highlight Republican charges that cuts in the Patient Protection and Affordable Care Act are restricting seniors' access to preferred physicians.
President Barack Obama promised Medicare enrollees they would see no changes to their benefits under the ACA. While Medicare Advantage plans must offer every benefit guaranteed by Medicare, insurers in many states are responding to cuts in the extra payments for Advantage plans by cutting back on the extra benefits that had been offered to entice seniors into the plans. They are also tightening provider networks.
That's causing anxiety among some elderly beneficiaries, who are afraid they won't be able to keep their current doctors. “Despite the president's repeated promise, seniors across the country are losing access to their doctors and many more may see a change in the availability of their plans,” reads the description for the congressional hearing.
Before passage of the ACA, Medicare paid insurers an average of 14% more than traditional Medicare enrollees for individuals who enrolled in private plans. That disparity was reduced to 4% for 2013, according to the Medicare Payment Advisory Commission.
Despite widespread warnings that cutting Medicare Advantage would undermine the program, it experienced double-digit enrollment growth in recent years. Currently, 27% of all Medicare enrollees are in private MA plans.
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