Proposed changes to Medicare Advantage could lead to higher out-of-pocket expenses and reduced benefits for 30 million Americans, including nearly 250,000 seniors in Nevada, according to a new study.
The study by health care consulting and analytics firm Avalere Health states that funding changes could lead to premiums that are more than $900 per year higher for Nevadans — the largest increase in the country — or to deep cuts in benefits.
The Better Medicare Alliance highlighted the study, which it commissioned, at a news briefing on Wednesday.
“The cuts could threaten important benefits, such as transportation to medical appointments, healthy meals, vision exams, and preventative dental work,” Mary Beth Donahue, the advocacy group’s president and CEO, said in a statement.
“President Biden must honor his promise to protect Medicare by reversing these cuts,” she said.
The Biden administration on Feb. 1 proposed changes to Medicare Advantage, an alternative to original Medicare where private insurers contract with the federal government to provide health insurance benefits.
“If there are changes to the program, they cannot jeopardize Nevadans’ health care access,” Sen. Catherine Cortez Masto, D-Nev., told Politico this month. She said she was confident that the White House understood this.
Cortez Masto and Sen. Jacky Rosen, D-Nev., signed a bipartisan letter from senators in January urging the administration to continue support for the Medicare Advantage program.
The Centers for Medicare & Medicaid Services, known as CMS, did not provide comment Wednesday on the study. Kaiser Health News has reported that CMS has estimated an approximate 3 percent reduction in payments to Medicare Advantage insurers. However, the federal agency has said that other modifications to the program would yield a 1 percent increase in spending per person this year.
Matt Kazan, managing director for Avalere, said that CMS is making policy changes that modify its risk adjustment model, “which reimburses health plans based on how sick or healthy their enrollment is,” and that affect payment based on the quality of a plan.
The Avalere analysis shows that changes could lead to premiums that are $76.05 higher a month and $912.58 higher a year for Nevadans who choose Medicare Advantage.
The average premium for Nevadans this year is $3.78 a month, or $45.36 annually. The changes would lead to premiums of $79.83 each month, or $957.96 a year, if the same level of benefits is maintained, according to the study.
Nationwide, the average annual premium increase would be $540, according to the study.
The administration’s proposed Medicare changes could disproportionately affect seniors and individuals with disabilities living on a fixed income, who are less likely to be able to afford higher premiums, according to the alliance.
An estimated 52 percent of Medicare Advantage beneficiaries live on an annual income of less than $25,000, compared with 38 percent of original Medicare beneficiaries, the Alliance said.
Medicare Advantage plans may include hearing, dental and vision care benefits that are not provided by original Medicare.
About 46 percent of Medicare-eligible Nevadans have enrolled in Medicare Advantage, according to the alliance.
Contact Mary Hynes at mhynes@reviewjournal.com or 702-383-0336. Follow @MaryHynes1 on Twitter.