Fred Schulte, KFF Health News and Maia Rosenfeld and David Hilzenrath
Judging by greater than 16,400 feedback lately posted on a federal authorities web site, you’d suppose there was a groundswell of older Americans demanding that federal officers hike funds to their Medicare Advantage medical insurance plans.
Yet about 82% of the feedback are similar to a letter that appeared on the web site of a secretive advocacy group referred to as Medicare Advantage Majority, a knowledge evaluation by KFF Health News has discovered.
The “dark money” group doesn’t reveal its funders or a lot else — aside from to say it’s “dedicated to protecting and strengthening Medicare Advantage” and is “powered by hundreds of thousands of local advocates nationwide.”
“Our campaign provides information and offers tools for concerned Americans to use to reach decision makers,” spokesperson Darren Grubb mentioned in an electronic mail. The group has spent greater than $3.1 million on tons of of Facebook advertisements since September 2024, in response to Facebook’s Ad Library, a database of the social media firm’s on-line advertisements.
There’s little question well being insurers are sad with a January proposal from the Centers for Medicare & Medicaid Services, or CMS, to maintain Medicare Advantage reimbursement charges primarily flat in 2027 — far lower than they anticipated from the Trump administration.
Medicare Advantage plans differ from conventional Medicare as a result of personal insurance coverage firms administer them. The insurance coverage enroll about 35 million members, greater than half the individuals eligible for Medicare. The plans provide issues like imaginative and prescient and drug protection, however Medicare Advantage insurers limit the hospitals and medical doctors that sufferers can use and require prior approval for numerous procedures.
CMS is about to announce a remaining determination by early subsequent month on the speed proposal. The company solicited public comments on the proposal from Jan. 26 by means of Feb. 25 to present events and the general public an opportunity to air their views.
Medicare Advantage Majority, which says the speed proposal quantities to a “cut” in companies and warns of dire penalties for seniors ought to it undergo, accounted for a minimum of 13,522 of the 16,422 feedback revealed as of March 12.
The proposed fee plan “puts my access to care at risk,” the group’s template letter to policymakers reads partly. “If the investment made by Washington in the Medicare Advantage program is nearly flat year-over-year, I could lose benefits I rely on every day, including affordable prescriptions, capped out of pocket costs, and access to trusted doctors and specialists.”
“Medicare Advantage is not optional for me. The cost protections alone have saved me thousands of dollars and made my health care manageable. Without this program, I would face higher costs, fewer providers, and fewer benefits at a time when I can least afford it,” the letter states.
Critics warn that these kinds of campaigns might create a deceptive impression of grassroots help, particularly when it’s not clear who’s financing them.
“It puts a different spin on a massive groundswell of comments to know all are being driven by one specific organization,” mentioned Michael Beckel, director of cash in politics reform for Issue One, a bunch that seeks to restrict the affect of cash on authorities coverage and laws.
“There’s no way for the public to know what wealthy donors or special interests are funding dark money groups like this,” he mentioned. “That means there’s no scrutiny of who’s really calling the shots.”
Some well being care coverage specialists, who’ve lengthy argued that the federal government overpays Medicare Advantage plans by tens of billions of {dollars} yearly, imagine business teams or their surrogates routinely overstate potential detrimental impacts of fee choices they don’t like.
“The plans always say that the sky is falling,” mentioned Matthew Fiedler, a well being care coverage professional with the Brookings Institution. “The industry has a lot of money at stake here. They try to exert pressure on policymakers any way they can.”
At the identical time, even critics concede that a few of the hundreds of thousands of individuals enrolled in Medicare Advantage plans may face service cuts if insurance coverage firms usually are not happy with authorities funds.
“It is legitimate for people to be worried,” mentioned Julie Carter, counsel for federal coverage on the Medicare Rights Center, a bunch that advocates for older adults and other people with disabilities.
Her group argues that Medicare Advantage plans have by no means attained anticipated price financial savings and as an alternative have been overpaid for years a minimum of partly as a consequence of “actions to maximize profits.” She mentioned the well being plans “are supposed to be saving money, not taking extra.”
People struggling to pay well being care payments might have little use for the coverage debate in Washington.
“If it wasn’t for being able to have this program, I really wouldn’t be able to afford any kind of medical services, to be honest,” mentioned EsterAlicia Rose, 75, who works on the entrance desk of a resort in Pagosa Springs, Colorado. She mentioned she signed the Medicare Advantage Majority type letter to succeed in policymakers.
Kathy Lovely-Marshall, 66, a retired nurse who lives in Brookville, Ohio, did too. She mentioned she receives “a lot of perks” from her plan, equivalent to dental care, eyeglasses, and prescriptions.
“All those things are a big plus as far as I am concerned,” she mentioned. “I’m very happy with the plan I have.”
But Corenia Branham, 90, a widow and most cancers survivor who lives in Alum Creek, West Virginia, mentioned she desires nothing to do with Medicare Advantage plans run by personal medical insurance firms. She mentioned she didn’t flip in any of the 4 type letters beneath her title, which have been posted on-line by CMS on Feb. 23 and signed, “Miss Corenia Branham Branham.” It’s not clear why her final title is signed twice.
Branham mentioned she’s not on Medicare Advantage and doubts she may depend on it for wanted care.
“I wouldn’t recommend it to nobody,” she mentioned. “I sure don’t want anything to do with it.”
Grubb, the Medicare Advantage Majority spokesperson, disputed that account. He mentioned Branham responded to an advert on Facebook. On Feb. 6, she “completed the form with her information and chose to send her comment to CMS as well as to her representatives in Congress and the White House,” he mentioned.
Other Medicare Advantage advocacy teams have stepped up advert campaigns as the speed determination looms.
The Better Medicare Alliance, whose “allies” embrace a spread of well being insurers, well being care suppliers, and shoppers, is urging seniors to “Tell Washington to Stand Up for Medicare Advantage.”
“We’ve mobilized beneficiaries to write letters and make phone calls, and we’ve run digital ads on streaming platforms,” spokesperson Susan Reilly mentioned.
Reilly mentioned that this yr roughly 3 million seniors “were forced to find new coverage” as a result of plans both shuttered operations or left some areas.
She additionally mentioned Medicare Advantage plans have “scaled back” advantages equivalent to providing transportation to medical appointments, diet help, and dental and imaginative and prescient protection, whereas over the previous two years beneficiaries have confronted a median $900 enhance in out-of-pocket maximums.
“We do view this as especially serious,” Reilly mentioned. “This isn’t a single bad year; it’s the cumulative effect of years of underfunding and policy disruption from the previous administration that has left the program increasingly vulnerable.”
As of March 12, CMS mentioned it had obtained 46,884 feedback however had posted solely 16,422 on-line.
CMS spokesperson Catherine Howden mentioned the company would make extra feedback public “as soon as practicable.”
“The agency focuses on reviewing the substance of timely submissions and does not speculate on volume, sentiment, or potential impact of comments while the comment period is open/under review,” she mentioned in a press release.