By JEFF JOHNSON
Special to The Stand
(Feb. 23, 2023) — This past year, Puget Sound Advocates for Retirement Action (PSARA) waged an aggressive campaign to convince the Biden administration to terminate the DCE/ACO REACH Medicare pilot program from beginning on Jan. 1, 2023. This pilot program allows more than 200 private, for-profit companies to manage traditional Medicare claims, opening the door to the complete privatization of Medicare.
While PSARA has not yet been successful in stopping the pilot, we organized an impressive list of advocates who support our efforts. Over 120 Washington state organizations, including the Washington State Democratic Party, a number of Democratic legislative districts, the Washington State Labor Council, UFCW 3000, IAM 751, IBT 117, Seattle City Council, NOW, Health Care Is a Human Right Coalition, immigrant and human rights organizations, and faith-based organizations have joined us. In addition, community leaders from 101 communities around Washington State have signed on to the campaign.
At the national level, PSARA has been working with Social Security Works, Physicians for a National Health Program, Labor Campaign for Single Payer, and Congresswoman Pramila Jayapal.
We have learned that the privatization crisis in Medicare is far greater than the DCE/ACO REACH pilot. According to whistleblower testimony, research and findings from Congress, reports from the Inspector General at Health and Human Services, and articles in the New York Times and other journals, privatization in the form of Medicare Advantage programs and Medicare Shared Savings programs have engaged in systemic fraud of the U.S. government and taxpayers, resulting in significant theft from the Medicare Trust Fund and a precipitous drop in the quality of health care and the quality of life for seniors.
In the year 2020 alone, it is estimated that these programs, and the private insurance companies that run and own them, defrauded Medicare of $12 billion — enough money to pay for vision and hearing for every American over the age of 65.
Consequently, PSARA is expanding our campaign beyond the DCE/ACO REACH pilot program.
As Congress muddles through the next two years, PSARA will use this time to educate, organize, and expose our members, political and community leaders, and the wider public on the threat privatization poses to traditional Medicare and how and why we need to terminate Medicare privatization in all of its forms. Each issue of PSARA’s newsletter, The Advocate, will have a lead article dedicated to explaining some aspect of the crisis facing Medicare, and we will invite national experts to work with us on quarterly educational webinars.
PSARA will work with a coalition of national partners to build a critical and strategic mass of political leaders who understand that privatization is destroying Medicare and are willing to fight to end Medicare privatization.
Our campaign to terminate Medicare privatization and to protect and strengthen traditional Medicare is grounded in the following seven goals:
1. The DCE/ACO REACH pilot can and should be terminated immediately. Until then, no further corporate participants should be allowed into the pilot.
2. 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.
3. Allow traditional Medicare to offer the same level of benefits to beneficiaries as the Medicare Advantage plans are allowed to offer, e.g., dental, vision, hearing, after-care home visits, transportation to medical appointments, gym memberships, etc.
4. Allow Medicare beneficiaries to move from Medicare Advantage plans to traditional Medicare during the annual open enrollment periods seamlessly, by requiring Guaranteed Issue of Medigap Policies (federal and state level), regardless of pre-existing conditions and without price gouging.
5. 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.
6. Remove fraudulent actors from the Medicare system.
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.
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.
Jeff Johnson is Co-President of PSARA and a retired President of the Washington State Labor Council, AFL-CIO. This column, the first in a series of columns about Medicare privatization, previously appeared in PSARA’s The Advocate and is published here with the author’s permission.