Ramón Castellblanch Professor Emeritus Public Health San Francisco State December 2 2021 Private Insurers Impact on Medicare Profittaking Not risktaking as claimed Not coordinating care as claimed ID: 931122
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Privatizing MedicareUndermining Medicare-for-All
Ramón Castellblanch
Professor Emeritus, Public Health
San Francisco State
December 2, 2021
Slide2Private Insurers’ Impact on Medicare
Profit-taking
Not risk-taking as claimed
Not coordinating care as claimed
Slide3Private Insurer Profiteering off of Medicare
Authorized by “Medicare Modernization” Act (2003)
Cherry-picking counties with highest rebates
Allowed by “Affordable Care” Act (2010)
Upcoding risk, generating Medicare overpayments
Lake Wobegon Star-ratings: all above average, raising Medicare overpayments
Slide4Privatization Plan A Marketing Private Medicare
What they tell you
Dental, vision coverage
What they don’t tell you
Prior authorization coverage restrictions
Minimal end-of-life care
Higher Medigap costs when disenrolling from private Medicare
Slide5Privatization Plan B Automatic Enrollment in Private Medicare
Geo model
By geographic areas
Planned by Trump
Blocked by Biden
GPDC model (2021)
By “high-need” beneficiaries
Congressmembers Porter (CA), Doggett (TX),
Pocan
(WI), Pascrell (NJ) Oppose
Under Biden, GPDC pilots underway in 38 states
Not accepting applications for new pilots
Slide6Private Insurers Undermining Public Medicare as Base for Medicare-for-All