Should Seniors Be Able to Keep Medicare Plans that the Government Says are Crummy? (H.R. 2506)

What is H.R. 2506?

(Updated January 28, 2020)

This bill seeks to preserve insurance coverage for seniors by allowing them to keep the plans that they’re currently using.

Specifically, this bill would prevent the Centers for Medicare and Medicaid Services (CMS) from canceling any contracts (through Medicare Advantage) for plans that failed to meet its standards. Contracts that don't meet the "minimum quality rating" would keep that immunity until 2019. 

CMS has announced that starting in 2017, it will not renew contract agreements that have not scored at least three stars under the five-star rating system. This bill basically saves contracts that would not be able to keep running in 2017 and 2018 under current law. 

Argument in favor

This bill would keep seniors from losing their health coverage. It protects a very vulnerable population — maybe their plans are below Medicare's standards, but that is better than no health care at all.

Argument opposed

This bill allows seniors to stay with subpar health coverage contracts, leaving some of America’s most vulnerable and honored citizens in a precarious position. Instead of putting the problem off until 2019, Congress needs to agree on a real solution.

Impact

Seniors, people with disabilities, and other on Medicare Advantage plans, their insurance providers (if they had a plan through a private insurer), the Dept. of Health and Human Services, the Centers for Medicare and Medicaid Services, and people who evaluate Medicare plans.

Cost of H.R. 2506

In its cost estimate of this bill, the CBO notes that very few people are in plans that don't meet the minimum quality ratings. That said, running a sub-optimal plan still saves money, and allowing those plans to continue would "reduce direct spending by $30 million over the 2016-2025 period."

Additional Info

Of Note: According to Sponsoring Rep. Vern Buchanan (R-FL), 10,000 seniors in his Sunshine State could lose their coverage, due to the Medicare ranking system. According to the Ripon Advance, most of the programs that would be cut serve low-income seniors.

So how are Medicare programs rated? The CMS ranks them on a five star scale based on things like how hygienic a facility is kept, and how many staff there are relative to the needs of patients.

President Obama announced changes to the system in 2014 after an investigation by The New York Times found that the rankings system was pretty inconsistent. Whereas before, the ratings relied heavily on self-reporting, the new changes would involve state inspectors more regularly.

Media:

• Sponsoring Rep. Vern Buchanan (R-FL) Press Release
  
• CBO Cost Estimate
• The New York Times
  
• The Ripon Advance