Democrats Must Protect Medicare Advantage Programs

Over the next few months, Democrats in Congress, working with the White House, will engage in some of the most consequential lawmaking the nation has seen in decades. I applaud President Joe Biden’s “Build Back Better” plan to tackle the pandemic experience and reshape the economy to improve the lives of working-class Americans.

I wholeheartedly support this endeavor, because our current economic model is allowing most of the profits from commerce to be distributed to a limited segment of a broad group whose contributions facilitate these profits. Many of the largest U.S. corporations no longer pay any (or barely any) taxes to state, local or federal authorities. Yet, wages for the working classes have stalled. This means many in the wealthy class are not paying their fair share. The result: crumbling infrastructure, underpaid civil servants, and too many of our fellow Americans are being left behind.

While I whole-heartedly support the Build Back Better plan, I also believe some of the language could have unintended consequences and must be executed in such a way that doesn’t simply fund new programs at the expense of important existing programs that already help underserved communities.

One such program that is being considered, as a revenue creator for the Build Back Better plan, is Medicare Advantage (MA). I would ask our leaders to take some more time to look at the implications this would have on our nation’s most vulnerable communities.

Since 1965, the Medicare program has been a guarantee to Americans that they will have health insurance coverage as they get older. In a country where most health coverage is tied to employment, this is a vital lifeline for Americans when they retire. This is especially accurate for working- and middle-class Americans who may have spent years uninsured or under-insured.

More recently, MA was envisioned as a more comprehensive program that also covered certain benefits known to keep seniors healthy, and not covered by traditional Medicare.

Understand, MA is essentially a government funded health-insurance program that is managed by private insurers. The private insurers are paid a set amount to provide comprehensive care, and there are safeguards put in place by the government to ensure better healthcare outcomes for those seniors enrolled in MA. I support strengthening those important incentives. After all, we can always demand government vendors perform better. However, I believe diminishing MA by reducing payments to insurers would have unintended consequences and harm MA beneficiaries, most of whom are people of color.

Additional data for our nation’s leaders to consider is that MA is used heavily by minority populations in the U.S. In fact, Black and Hispanic beneficiaries are more likely to enroll in MA than anyone else. According to statistics, 49% of Black and 53% of Hispanic Medicare beneficiaries enroll in MA. Hence, any cuts to MA could disproportionally hurt minorities.

Again, the primary reason most people enroll in MA is to access the supplemental benefits attached to program, including vision, dental and mental health benefits. During a pandemic, should Congress be considering cutting funding for programs that help middle-class and underserved Americans gain access to these benefits? How does this align with the overall vision of the Build Back Better program to protect and improve the lives of the working classes?

I will continue to support President Biden’s Build Back Better plan; however, I encourage the President and Congress to consider the points I’ve raised. Ensuring our economy benefits the working classes would be transformational, but it should not be achieved by cutting seniors’ benefits and important programs such as MA.

Tammy Boyd JD, MPH is Chief Policy Officer and Counsel to the Black Women’s Health Imperative and former U.S. Congressional Health Policy Advisor to U.S. Rep. John Lewis.