The health insurance industry took advantage of Washington’s infamous revolving door last week when it named former Rep. Allyson Schwartz of Pennsylvania, perceived by many to be a liberal Democrat, as the face of its latest K Street-operated front group.
Schwartz, a former five-term member of Congress who made an unsuccessful bid for Pennsylvania governor last year, announced in an email blast Tuesday that she had found work again, not back home but back inside the Beltway. “Today I will begin as President and CEO of the Better Medicare Alliance,” she told her “friends and supporters.”
The Better Medicare Alliance is a so-called 501(c)(3) nonprofit that appears to have been created with funding from insurance companies by APCO Worldwide, a Washington influence firm with a long history of running front groups for its clients. I worked with APCO on several projects during my years at Cigna.
The Better Medicare Alliance’s raison d’etre is to widen the federal spigot of taxpayer dollars already gushing into the bank accounts of insurance companies that operate Medicare Advantage plans, those privately run alternatives to traditional Medicare. Enrollment is concentrated in a small number of companies, among the biggest of which are for-profit insurers UnitedHealth Group, Humana and Aetna.
As the Center for Public Integrity has reported extensively over the past year, the federal government for years has overpaid Medicare Advantage insurers, which has enabled the companies to better reward their shareholders. Insurance firms have also used the overpayments to add benefits not covered by traditional Medicare, like hearing aids, and to offer lower copayments.
Insurers that participate in the Medicare Advantage program devote big chunks of their advertising and sales budgets to lure seniors away from the traditional Medicare program, which costs taxpayers less. For many seniors, the marketing is irresistible. Enrollment in Medicare Advantage plans jumped 10 percent between 2013 and 2014. Thirty percent of Medicare’s 54 million beneficiaries are now in a Medicare Advantage plan.
Insurers insist that Medicare Advantage plans represent a good value for seniors and the country. They say, for example, that because of the managed care techniques they use, they are better able to coordinate care for seniors with chronic conditions.
A downside rarely mentioned is that many doctors and health care facilities, including nursing homes, refuse to participate in Medicare Advantage provider networks. Other providers that might want to participate are often excluded. My own mother didn’t fully appreciate the consequences of her Medicare Advantage plan’s limited network until recently. She decided to switch back to traditional Medicare so she could go to a nursing home of her choice with high quality ratings.