Talking Points: 9 December 2024

A deeper dive on an issue driving the healthcare reform conversation.

Week in Review

MEDICARE ADVANTAGE Seniors feel the impact of back-to-back years of cuts to Medicare Advantage.

Quick takeaway: Two years of cuts to the Medicare Advantage (MA) program have led to fewer options, higher costs, and reduced supplemental benefits.

Digging deeper: 33 million American seniors – more than half of the eligible Medicare population – now choose MA plans over original Medicare. 

Unfortunately, data shows that successive years of cuts to the program have taken a considerable toll on MA, specifically:

• Beneficiaries are now left with fewer options to choose from, with some even losing their current coverage as a result of their MA plans having exited the market:
  • Over 60 percent of enrollees live in counties with fewer plan options in 2025 compared to 2024
  • More than 7 percent of enrollees (almost 2 million seniors) will be forced to choose a new coverage option for 2025
  • The number of MA plans offering prescription drug coverage (MA-PDs) decreased by 6 percent for 2025
• Beneficiaries in some states will see significant premium increases, with cost-sharing also increasing for others:
  • The average premium will increase more than an average of 10 percent in at least 18 states
  • The median maximum out-of-pocket levels will increase by 8 percent next year
  • The average deductible for MA-PDs will more than double from $103 in 2024 to $269 in 2025.
• While the vast majority of MA plans will continue to include dental, vision, and hearing coverage, payment cuts have reduced other supplemental benefit offerings:
  • The share of plans making an over-the-counter benefit available will drop from 86 percent this year to 73 percent next year
  • Plans offering nutrition benefits will decrease from 40 percent to 30 percent
  • Special Needs Plans serving specific enrollee populations, such as those dually eligible for Medicare and Medicaid or individuals with chronic diseases like diabetes or heart disease, will offer reduced benefits in 2025, including less access to medical nutrition therapy and in-home supports.

What it means: Despite these challenges, seniors continue to choose MA in growing numbers, pointing to the program’s ability to deliver enhanced services, increased access to care, and better value. 

This focus on coordinated care enables MA plans to not only outperform original Medicare, but deliver savings for beneficiaries and the government, while serving historically disadvantaged communities. 

It’s no wonder the program enjoys such broad bipartisan support. 

The Health Action Network includes everyday Americans—families, workers, businesses, patients, providers, neighbors, and friends. We are working together because we support market-based solutions that offer better healthcare choices and help build a stronger economy. The Health Action Network is an Elevance Health, Inc., initiative.