In it, but not of it. TPM DC

Did Health Care Reform Hurt The Private Insurance Part Of Medicare? Apparently Not


"At the time the Affordable Care Act was passed, Republicans in Congress said the bill would virtually end the Medicare Advantage program," declared senior White House staffer Nancy-Ann DeParle. "Those predictions turned out to be wrong. Medicare Advantage is stronger than ever -- offering more seniors better benefits, higher quality care and lower costs."

The basis for this GOP claim during the health care reform debate was that the ACA's $500 billion in Medicare provider cuts included $136 billion in pay reductions under Medicare Advantage. But, at least for now, those cuts -- along with other payment reforms -- appear to have made the program more competitive and efficient.

"The new law's massive Medicare cuts will fall squarely on the backs of seniors, millions of whom will be forced off their current Medicare coverage," House GOP leaders wrote in their 2010 "Pledge To America" manifesto. Screeds against the payment reductions were a regular feature of Republican speeches in Congress during the debate over the law.

The Medicare Advantage program, created in 1997, allows beneficiaries to opt out of the single-payer plan and instead receive government-subsidized private insurance at an extra cost to them. About one in four seniors are currently on it. The basis of the steep ACA cuts was research that showed Medicare was over-paying the private plans.

Congressional Republicans didn't ultimately seem too troubled by health reform's Medicare cuts: they overwhelmingly voted to retain them last year as part of the Paul Ryan budget.