Watch PSARA Co President Jeff Johnson lay out PSARA’s Plans for getting Medicare out of the Hands of Private Equity by Leveling the Playing Field
Traditional Medicare was created in 1965 as a public good to provide a national health care system for seniors and the disabled in the United States and has proven to be our most efficient and effective public health care program with administrative costs accounting for only 2-3% of Medicare spending.
However over the last 20 years the federal government has created various for-profit privatized health care programs within Medicare including Medicare Part D (prescription drugs), MediGap (Part B) (supplemental plans to cover Medicare’s 20% copays), and Medicare Advantage (Part C) which is permitted to take up to 15% of every Medicare dollar for administration and profits for managing Medicare claims.
Additionally, the Trump administration doubled down on privatizing Medicare through the Direct Contracting Pilot, rebranded under the Biden Administration as ACO-REACH, which allows private equity firms and Wall Street companies to take up to 25% or more of every Medicare dollar for administration and profits for managing Medicare claims.
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Recent reports by the HHS Inspector General, academic researchers, and investigative journalists have uncovered wide-ranging fraudulent practices, confirming that upcoding, delaying medically necessary care, and the denial of claims by insurers and other private businesses managing Medicare claims, together account for defrauding the Medicare Trust Fund and Medicare beneficiaries of many billions of dollars annually.
PSARA is working with groups across the nation that recognize privatization of Medicare is unacceptable and are fighting for major changes to fix it. Our campaign to terminate Medicare privatization and to protect and strengthen traditional Medicare is grounded in the following seven goals:
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1. Expose and educate PSARA members, policy makers, and the wider public on how Medicare Advantage plans, Medicare Shared Savings plans, and other “innovative” reimbursement plans are undermining traditional Medicare, fleecing the Medicare Trust Fund and taxpayers, and delaying and denying critical care to seniors.
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2. Level the playing field by allowing Medicare to offer the same level of benefits to beneficiaries as the Medicare Advantage plans.
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3. Require private insurers and companies to pay back to the Medicare Trust Fund, with interest, the money they stole and make restitution to the Medicare beneficiaries to whom they delayed or denied care.
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4. Remove fraudulent actors from the Medicare system.
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5. The DCE/ACO REACH pilot can and should be terminated immediately. Until then, no further corporate participants should be allowed into the pilot.
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6. Allow Medicare beneficiaries to move from Medicare Advantage plans to traditional Medicare during the annual open enrollment periods seamlessly.
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7. Support Reps. Pocan and Khanna’s bill, the Save Medicare Act, relabeling Medicare Advantage plans “alternative private health plans” and fining private insurers that use Medicare in plan titles or advertisements.
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PSARA’s goal is to create a movement around protecting and strengthening traditional Medicare, ending Medicare as a profit center for private enterprise, and building a sound foundation for Medicare for All. We hope you will join us in this fight.