This is going to blow your mind.
A group of Democratic senators led by Elizabeth Warren is pushing the Centers for Medicare and Medicaid Services to rein in abuses from Medicare Advantage insurers as the Trump administration considers a policy that would enroll more seniors in the program. The senators allege that Medicare...
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A group of Democratic senators led by Elizabeth Warren is pushing the Centers for Medicare and Medicaid Services to rein in abuses from Medicare Advantage insurers as the Trump administration considers a policy that would enroll more seniors in the program.
The senators allege that Medicare Advantage is rife with waste, fraud and abuse, and CMS should focus on shoring up the program, rather than enrolling more individuals in it. They argue CMS should do so by adopting the congressional Medicare advisers’ recommendations to rein in the program.
“CMS must do more to preserve the Medicare program’s mission of providing older adults and people with disabilities with affordable, high-quality health care,” the senators wrote in a Wednesday letter to CMS Administrator Mehmet Oz, referring to the 2027 proposed payment rate for Medicare Advantage plans.
Lawmakers signing the letter in addition to Warren, D-Mass., include Cory Booker, D-N.J., Richard Blumenthal, D-Conn., Richard J. Durbin, D-Ill., Edward J. Markey, D-Mass., Jeff Merkley, D-Ore., Bernie Sanders, I-Vt., and Tina Smith, D-Minn.
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They say that changes are essential in light of the Trump administration’s floated policy to enroll more Americans in Medicare Advantage. Last month,
Stat reported that Medicare Director Chris Klomp said that CMS is considering models that would automatically enroll beneficiaries into Medicare Advantage, and individuals could opt into a different service arrangement.
“Aside from the numerous financial problems and patient care concerns such a proposal raises, it also very likely violates the requirements for any Centers for Medicare and Medicaid Services Innovation Center models to reduce taxpayer spending,” the Democrats wrote of Klomp’s proposal.
Shifting all seniors to Medicare Advantage as a default option was first proposed in The Heritage Foundation’s Project 2025 as part of a larger effort to encourage more competition between Medicare Advantage and private plans.
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MedPAC estimates that overpayments to Medicare Advantage could reach $76 billion in 2026 and $1.3 trillion over the next decade, all while seniors enrolled in the program receive worse care compared to traditional Medicare. The Democrats say that by overlooking the fact that Medicare Advantage enrollees are typically healthier than the average Medicare enrollee, the federal government systematically overpredicts the program’s spending, leading to overpayment.
