The annual Medicare Advantage dance avoids the bigger issues of entitlements

MEAN OLD Washington is out to get granny again — or at least that’s the impression created by ad campaigns on TV and the Internet, in which seniors warn, in heart-rending terms, of impending “cuts” to the Medicare Advantage program. What’s really going on is pretty routine — though, as is often the case in Washington, routine is not quite the same thing as sensible.

Medicare Advantage is a $150-billion-a-year federal program that pays insurance companies to enroll elderly and disabled clients in managed-care plans — unlike traditional Medicare, which reimburses providers on a fee-for-service basis. About 17 million people participated in the program in 2015, 31 percent of those who were eligible for Medicare. Intended as a more efficient alternative, Medicare Advantage has always been controversial, plagued by various forms of system-gaming and perverse incentives. Democrats are especially critical of its per capita costs, which are higher than those of traditional Medicare. Yet it remains popular because many seniors prefer its all-in-one benefit packages to traditional Medicare’s fragmented “parts.” The Affordable Care Act squeezed Medicare Advantage’s federal funding — but enrollment, contrary to expectations, kept growing.

– The Washington Post

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