The chair of a congressional advisory commission defended a recent estimate of Medicare Advantage overpayments at a Washington lobbying event on Tuesday, emphasizing that the numbers reflected a careful review of available data and that the findings were meant to inform policymakers rather than to politicize the program.
The advisory body reported that the government will spend 14 percent more, $76 billion, this year on seniors who choose the private option than if those beneficiaries were enrolled in traditional Medicare, according to the commission’s estimate.
Speaking at the Better Medicare Alliance gathering, the chair explained that the panel is not trying to make the private program look bad. Its aim is to support competition and provide research that can guide reform discussions, offering a data-driven perspective that lawmakers can use when weighing policy options. He added that the commission’s work is intended to be transparent and open to scrutiny from all sides of the debate.
“We hope that as we put evidence out there and raise issues and questions out there, that stakeholders will engage with them in serious fashion and provide meaningful, substantive feedback. There are opportunities for us to refine our methods and to improve our work, and we’re aspiring to do that,” he said.
Insurers countered that the estimate inflates costs. They pointed to a January CMS analysis that shows a much lower overpayment figure and cited industry-funded studies that claim the private option saves taxpayers by delivering care more efficiently.
Industry and Legislative Pushback
Republicans on the House Ways and Means Committee advanced a bill that would require the commission to produce two separate spending analyses: one that includes the effect of favorable selection and another that does not.
The chair, who previously served on the board of two private plans and teaches medical ethics at the University of Pennsylvania School of Medicine, emphasized a desire for open dialogue with the sector. He noted that his experience in both the private and academic worlds provides a unique perspective that can bridge gaps between policymakers, providers, and payers.
MedPAC’s goal “is to track new evidence, is to refine our methods, and we have tried very hard to make that transparent, to show sometimes I think in exhaustive detail, the methodological detail underlying our work. To allow folks to critique it, hopefully to understand it, and ultimately to improve it,” Navathe said. “And we have seen that the Better Medicare Alliance recently, for example, has offered that critique, and that’s okay.”