Bill > S2465

This resolution respectfully urges the United States Congress to protect patients and Traditional Medicare (TM), which refers to the original, federally administered healthcare insurance program for those over 65 and individuals with certain disabilities, from Medicare Advantage (MA) plans, which are private insurance plans that replace TM. The resolution highlights concerns that MA plans, which now cover over half of eligible Medicare beneficiaries, are aggressively marketed without full disclosure of costs and benefits compared to TM, have not resulted in savings for the program, and can ultimately cost enrollees more when they become seriously ill. It also points out that MA plans often have narrower provider networks, require prior authorizations that can lead to denied care, and have exacerbated healthcare inequality by disproportionately enrolling disadvantaged populations into plans that may offer worse coverage. Furthermore, the resolution criticizes MA plans for practices like "upcoding" (making patients appear sicker to increase payments), "cherry-picking" healthier enrollees, and using utilization management to delay or deny care, all of which inflate insurer profits without necessarily improving healthcare services. The resolution calls for legislative and administrative actions to increase transparency and accountability of MA plans, conduct more audits for fraud and overpayments, strictly regulate marketing, prohibit profit-driven practices that harm patients, ensure access to specialty care, require employers to offer TM as an option for retirees, prosecute improper payments, and redirect funds from MA plans to strengthen Traditional Medicare.

Health and Social Services

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