A group of 13 Democratic House Representatives introduced a package of eight bills last week that would crack down on Medicare Advantage and strengthen traditional Medicare.
The package was introduced by Mark Pocan (D-Wisconsin) and cosponsored by Andre Carson (D-Indiana), Steve Cohen (D-Tennessee), Rosa DeLauro (D-Connecticut), Lloyd Doggett (D-Texas), Pramila Jayapal (D-Washington), Ro Khanna (D-California), Eleanor Holmes Norton (D-D.C.), Alexandria Ocasio-Cortez (D-New York), Jan Schakowsky (D-Illinois), Mark Takano (D-California), Shri Thanedar (D-Michigan) and Rashida Tlaib (D-Michigan).
The bills fall under three categories:
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1. Delays and denials of care
- Denials Don’t Pay Act: Disincentivizes MA plans from delaying and denying care through prior authorization requirements
- Right to Appeal Patient Insurance Denials Act: Helps patients receive needed care by automatically appealing denials
- Disclose Your Denials Act: Requires MA plans to disclose their delay and denial rates when advertising
2. Overcharging taxpayers
- Medicare Advantage Fraud Accountability Act: Bans companies from participating in MA if they’ve been convicted of defrauding the government
- Keep Medicare Costs Down Act: Requires MA plans to charge the government per beneficiary as much as or less than traditional Medicare
- Seniors’ Choice and Clarity Act: Limits the number of plans that MA companies can provide to just three a year
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3. Strengthening traditional Medicare
- Protecting Medicare Choice Act: Prevents Medicare Advantage from being set as the default option for seniors, which was proposed in Project 2025
- Find My Doctor Act: Requires CMS to create a national website that allows people to search for doctors by plan
“Only Medicare is Medicare. It is one of the most popular and important services our government provides,” Pocan said in a statement. “But for too long, private healthcare companies taking advantage of Medicare’s brand and popularity have tricked and wronged seniors. This package of commonsense, pro-patient reforms will bring greater accountability, transparency, and affordability to Medicare Advantage, while strengthening traditional Medicare and protecting patient choice. This package represents a strong step forward to protect seniors, save taxpayer dollars, and restore integrity to the Medicare program.”
The bills are endorsed by several organizations, including the Center for Health and Democracy, Just Care USA, Labor Campaign for Single Payer, Physicians for a National Health Program, Public Citizen and Social Security Works.
According to JustCare, a crackdown on Medicare Advantage is overdue.
“Medicare Advantage insurers profit from withholding medically necessary care, and can withhold care with near impunity. So, people enrolling in corporate MA plans are forced to gamble with their health and with their lives. They can’t avoid the bad actors. It’s time Congress protected older Americans and people with disabilities from bad actor Medicare Advantage insurers, as Congressman Pocan’s MA Bill package would do,” said Diane Archer, president and founder of JustCare.
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