Friday, September 10, 2010

GAO Report on Medicare Mailer

Late yesterday the Government Accountability Office released its report on a request by Reps. Camp and Herger to analyze the Administration’s Medicare mailer to seniors.  Although the report concluded that the mailer did not constitute taxpayer-funded propaganda – which GAO has historically interpreted on a narrow basis – the analysis did find that the mailer “presented abbreviated information and a positive view of PPACA that is not universally shared.”  Relevant excerpts include:

“We note that the brochure provides information about PPACA generally that may not be directly relevant to the Medicare program or recipients of the brochure, and, in some instances, provides abbreviated information, omitting some program details.  For example, the section titled ‘Improvements Beyond Medicare That You and Your Family Can Count On’ refers to programs for which Medicare beneficiaries are likely to be ineligible, such as health coverage options for young people up to age 26 and a new long-term care insurance program that requires enrollees to work while paying premiums.”

The brochure does not provide beneficiaries with a comprehensive summary of changes to Medicare that will be implemented as a result of PPACA, and in several instances it provides abbreviated information that leaves out details about PPACA.  For example, the brochure states that ‘[i]nsurance companies will be prohibited from denying coverage due to a pre-existing condition for children starting in September, and for adults in 2014,’ but does not explain that this provision of PPACA, although broad, does not apply to all health plans.  A subset of health plans—grandfathered individual health insurance plans—are exempt.” (Of particular interest to seniors, but not stated in the brochure: Medigap plans are also exempt from PPACA’s prohibition on waiting periods for coverage of pre-existing conditions.)

“In our view, the brochure presents a picture of PPACA that is not universally shared.  For example, two government analyses have determined that PPACA reductions in Medicare Advantage may decrease enrollment and result in less generous benefit packages….In its discussion of ‘Improvements to Medicare Advantage,’ the brochure focuses on the more immediate effects of the provisions related to Medicare Advantage rather than the projected impact over the next 10 or more years, and does not mention the government analyses.”

“We noticed, also, that the brochure overstates some of PPACA’s benefits.  For example, it states that PPACA ‘increases the number of primary care doctors, nurses, and physician assistants,’ when PPACA, in fact, only provides incentives for such increases.”

“The brochure mentions that ‘guaranteed Medicare benefits won’t change—whether you get them through Original Medicare or a Medicare Advantage plan’…Beneficiaries who participate in Medicare Advantage are guaranteed original benefits, but the specific benefits beyond original Medicare offered by Medicare Advantage plans are not guaranteed and could change at a plan’s discretion.”

The GAO report comes a month after the non-partisan factcheck.org issued an analysis, entitled “Mayberry Misleads on Medicare,” concluding that a promotional campaign featuring Andy Griffith used “weasel words” regarding Medicare’s “guaranteed benefits” because “for millions of seniors, benefits won’t remain the same.”