Mailbag: No DCEs! Rein in Medicare Advantage

October 2021

One evening a year, Halloween-costumed children come to your door disguised as scary or cute avatars hoping you will give them a small treat.

About 90 days a year, Medicare Advantage companies come to your door or mailbox disguised in glossy ads, offering to make health care in your retirement years carefree, hoping you will give them a huge treat.

Advantage plans, like all commercial health insurance plans and unlike traditional Medicare, must prioritize company profits above your health. They lavishly lobby Congress with your Medicare money, they garner unjustifiably high per-member payments from Medicare funds, and they keep more than they should. They then exaggerate (upcode) your diagnoses so they can charge more. Upcoding not only dramatically increases their income but also adds preexisting conditions to your record.

When you become too ill to stay within the narrow networks and drug formularies of your Advantage plan, your added preexisting conditions make it very expensive to return to traditional Medicare. The Advantage plans drain money from traditional Medicare and threaten its solvency as an added insult.

Scarier than any Halloween movie is this: The Centers for Medicare & Medicaid Services are under the radar developing Direct Contracting Entities (DCEs) which would force you into a commercial equivalent of Medicare Advantage, possibly without your knowledge. Thus would end the effective, practical, much-loved, publicly funded and publicly controlled traditional Medicare we have known since 1965. Please tell your U.S. legislators, CMS Administrator Brooks-LaSure and DHS Secretary Becerra, “No DCEs! Rein in Medicare Advantage!”

Mike Huntington

Corvallis, OR