March, 14 2024, 12:06pm EDT

Medicare Advantage Myth-Busting
This year, the majority of Americans eligible for Medicare coverage chose to enroll in private Medicare Advantage (MA) plans rather than Traditional Medicare. Insurance companies that run these MA plans spend significant sums of money to blanket seniors with marketing that highlights the supposed advantages of MA like low upfront costs, supplemental coverage, and other unique perks like subsidizing gym memberships. However, the ads leave seniors in the dark on the downsides of MA like heavily restricted networks that damage one’s choice of provider along with dangerous delays and denials of necessary care. At the same time, both the Biden Administration and many members of Congress from both parties have voiced support for the further privatization of Medicare through growing Medicare Advantage.
In this article, we will debunk several pervasive myths about MA that proponents and insurance giant owners push in their effort to continue privatizing Medicare at the expense of patients.
Myth #1: Medicare Advantage Is Medicare
The inclusion of the term Medicare in Medicare Advantage — otherwise known as Medicare Part C — is incredibly misleading, as the program is de facto government-subsidized private insurance.
Traditional Medicare is public insurance, where tax revenues are directly used to cover healthcare for seniors and some disabled people. It employs a fee-for-service (FFS) payment model, where the Centers for Medicare and Medicaid Services (CMS) directly pays for each covered service by a healthcare provider.
In contrast, MA consists of thousands of different plans mostly provided by health insurance giants like UnitedHealthcare and Humana. Seven large insurance companies accounted for 84% of MA plan enrollment in 2023. Rather than directly covering care as needed, the federal government pays lump sum Medicare dollars, known as capitated payments, to these private insurers for each patient. MA plans make money by spending as little as possible on patient care in order to keep as much of the leftover taxpayer money as possible.
In other words, MA is private insurance supported by government subsidies, and it is a form of managed care by health insurance companies. MA is not a government-managed public health insurance program like Traditional Medicare.
Myth #2: Medicare Advantage Saves Money
Medicare Advantage has never saved taxpayers money as a substitute for Traditional Medicare. In fact, according to the Medicare Payment Advisory Commission (MedPAC), taxpayers have spent more on financing MA than they would have if everyone was covered under Traditional Medicare.
In fact, Congress and CMS have been working to try to stop MA companies from gaming the system to steal taxpayer money. A 2023 study by the Physicians for a National Health Program (PNHP) estimates that CMS overpaid MA plans between $88-$140 billion in 2022 alone through various practices like pretending patients were sicker than they were along with targeting healthier, less costly seniors to enroll in their plans. Overpayments have also caused all Medicare beneficiaries to pay billions in higher Medicare Part B premiums.
Through taking taxpayer subsidies, MA has been significantly more profitable for insurance companies than the private plans offered to the rest of Americans. In 2021, MA companies had a gross profit margin of $1,730 per enrollee, which is more than double their profit margin on the individual market ($745). In 2023, Humana ended its entire commercial insurance business in order to entirely focus on government-funded programs like MA.
Some who claim MA saves money point to how MA spending is growing at a slower rate than Traditional Medicare. However, their point assumes that people enrolled in MA and Traditional Medicare share the same characteristics, which is false. MA targets and enrolls people who are healthier, less likely to use medical services, and, thus, less expensive to cover than those in Traditional Medicare.
Myth #3: Medicare Advantage Is Necessary To Save Beneficiaries Out-of-Pocket Spending
One of the primary appeals of Medicare Advantage is the idea that it saves beneficiaries money. However, this is highly dependent on how much care someone needs. The extent to which MA does save money for patients is not a natural result of its supposed superiority; it is due to intentional political sabotage and decision making.
Patients in both MA and Traditional Medicare have to pay a monthly premium for Medicare Part B ($174.40 in 2024). Then, Traditional Medicare covers 80% of costs for outpatient services. Beneficiaries are responsible for paying the remaining 20%, with no limit on out-of-pocket (OOP) payments. However, Traditional Medicare fully covers inpatient services such as hospitalization after a patient meets a deductible ($1,632 in 2024). For prescription drug coverage, Traditional Medicare beneficiaries pay a monthly premium for a Medicare Part D plan run by a private insurer ($40 average in 2023).
Traditional Medicare beneficiaries can purchase a supplemental Medigap insurance plan to cover most OOP spending (average monthly premium of $139 in 2023), which a plurality (41%) did in 2021. Eighty-nine percent of people in Traditional Medicare had some form of supplemental coverage in 2023, such as through Medicaid (19%) or their employer/union (31%).
In MA, premiums, coinsurance rates, and deductibles vary across the thousands of different plans. However, the average monthly premium is very low ($18.50 estimate for 2024), and many plans have $0 premiums. Additionally, CMS mandates that MA plans have an OOP spending limit. The average limit for in-network services was $4,835 in 2023; when accounting for both in- and out-of-network services, the average limit was $8,659. Ninety-seven percent of MA beneficiaries are in plans that incorporate drug coverage, and the average premium is $10 per month (73% of enrollees had no premiums for drug coverage).
For healthy individuals without need of expensive healthcare services and products, MA saves money due to its low premiums. However, while Traditional Medicare users with a Medigap plan spend more money upfront due to higher premiums, they can save thousands of dollars for expensive care that would reach their OOP limit if they were enrolled in MA.
However, many seniors simply cannot afford purchasing a Medigap plan, so they have little choice but to enroll in MA. In 2023, 52% of MA beneficiaries earned annual incomes around $25,000. Income limitations disproportionately lead Blacks (65%) and Latinos (69%) to choose MA compared to Whites (48%), as 78% and 81% of Black and Latino MA beneficiaries earn less than 200% of the federal poverty level, respectively.
Traditional Medicare beneficiaries without any form of supplemental coverage (11% of Traditional Medicare users in 2021) most certainly have to pay more for healthcare due to Part A deductible and the lack of any OOP cap. However, the lack of an OOP cap in Traditional Medicare is entirely a result of politics and can be changed. While CMS requires MA plans to have an OOP cap, policymakers have elected not to create one for Traditional Medicare. Congress could legislate a $5,000 OOP cap for Traditional Medicare; this would cost just $39 billion annually or just 28-44% of the overpayments made to MA plans in 2022.
Considering the fact that MA has never saved taxpayer money, the history of billions of dollars in overpayments to MA plans, and the fact that Congress could cost-efficiently lower costs for those in Traditional Medicare, it is a myth that MA is necessary to save patients money.
Myth #4: Medicare Advantage Improves Health Outcomes
Through incentivizing the use of preventative care, Medicare Advantage’s capitated payment model should supposedly increase the health of its beneficiaries. However, there is not sufficient evidence to prove this. Additionally, the sickest patients opt for Traditional Medicare and low reimbursement rates decrease the willingness of healthcares providers to accept MA patients.
The Kaiser Family Foundation (KFF) reviewed existing studies and found that there is not strong evidence of widespread significant differences in health outcomes between Americans enrolled in MA versus Traditional Medicare. MA plans push patients to more preventative care visits, and they also incentivize beneficiaries to take on healthy habits like getting and using a gym membership. In contrast, Traditional Medicare is more likely to send its beneficiaries to higher-rated cancer facilities, nursing facilities, and home health agencies. Issues with data quality and differences in the populations who choose MA versus Traditional Medicare also render direct comparisons between the two programs quite weak.
Incentivized to spend as little as possible, MA plans pay healthcare providers less than Traditional Medicare. As a result, an increasing number of doctors and providers are declining to accept MA patients, further restricting MA networks and access to care. Additionally, lower payments can prevent doctors from providing the best quality care. In comparison, around 99% of non-pediatric physicians accept Traditional Medicare.
Medicare Advantage is a great option for relatively healthy beneficiaries who do not expect to need intensive care for serious illnesses and injuries. Capitated payments do incentivize MA insurance companies to save money by investing in healthy, preventative care and programs. At the same time, the model also incentivizes MA plans to avoid covering the highest quality care for the people most in need.
To restrict care that beneficiaries would otherwise receive in Traditional Medicare, MA companies delay and deny care through prior authorizations (PAs) and payment denials. In 2021, patients and their providers had to file 35 million PA requests in order to receive medical care. MA companies denied 2 million of these requests. People only bothered to appeal 11% of the time; however, those that did had a 82% success rate. In 2022, 94% of physicians surveyed by the American Medical Association reported experiencing PAs which caused delays to necessary care; 56% reported this occurring always or often. Eighty percent reported that PAs caused the abandonment of recommended treatment, and 33% reported that they caused a serious adverse event for their patients.
There are many reasons for poor health outcomes in the United State: lack of healthcare access, high costs, low income, poor diet, and lack of exercise to name a few. The strategy of giving lump sums of money — mostly to insurance giants — and incentivizing them to spend as little as possible is not supported with evidence of improved health outcomes and does not directly tackle these greater issues.
Myth #5: Medicare Advantage Offers Benefits That Traditional Medicare Simply Cannot Match
A primary selling point of MA plans is that they offer supplemental benefits — mainly coverage for dental, vision, and hearing care — that Traditional Medicare does not provide. While this is true, it is misleading because it does not reveal the quality of this coverage.
While the vast majority of MA plans offer supplemental benefit coverage, there isn’t evidence that their beneficiaries actually utilize dental, hearing, and vision services much more than people enrolled in Traditional Medicare. In fact, there is some evidence to the contrary regarding dental care. This is because MA supplemental “coverage” does not protect patients from having to spend significant sums of money out of their own pockets.
Most MA plans have high coinsurance rates along with low annual caps on how much insurance will cover. So, MA coverage predominantly doesn’t help patients with expensive dental, hearing, or vision treatments. This prevents many seniors from being able to afford care even though they technically have coverage. Ultimately, MA plans constantly advertise that they offer supplemental coverage, but they leave Americans in the dark on how little financial help they will actually receive.
Additionally, taxpayers and Traditional Medicare beneficiaries are effectively subsidizing these additional benefits. Not only has MA never saved taxpayer money, it is further depleting the Medicare Trust Fund and raising Part B premiums for all Medicare beneficiaries. These higher premiums and taxpayer overpayments allow MA companies to market supplemental benefits along with the aforementioned low premiums which attract healthier and lower-income seniors.
Instead of enriching MA companies, Traditional Medicare could provide dental, hearing, and vision benefits for less than $42 billion in 2025, which is 30-48% of the overpayments taxpayers made to MA in 2022. Unlike in MA, this coverage would not be limited to restricted provider networks.
Myth #6: Medicare Advantage Is Necessary To Lower Healthcare Spending
Healthcare spending overall and Medicare spending specifically increase every year more than inflation. The United States spends more money per capita than any other country on healthcare. The average cost of healthcare per person in other wealthy nations is roughly half as much as the United States.
To lower Medicare spending, proponents of Medicare Advantage tout the benefits of “value-based” care compared to Traditional Medicare’s FFS model. Critics claim that FFS incentivizes wasteful spending and opportunities for doctors to become rich by billing Medicare for services unnecessary to patient health.
In contrast, “value-based” care involves CMS giving lump sums of money (capitated payments) to MA companies for each patient, supposedly incentivising efficient healthcare spending on preventative care. Through spending less and, ideally, keeping patients healthier, MA companies get to keep more money.
While there are case studies of mission-driven organizations succeeding with capitated payments, this does not hold true for the large, for-profit insurance giants that dominate MA. Rather, the major MA companies’ primary goal is to maximize profit. Therefore, they typically take as much taxpayer money as feasible by gaming the system while restricting care in order to spend less and keep as much as possible.
However, the entire premise that reducing healthcare usage with a more restrictive insurance policy is the best means to lower healthcare spending is baseless. The United States does not use healthcare services more than the other countries who spend far less, and the same is true for Medicare compared to similar foreign populations.
Then why is healthcare so expensive in the United States? Prices. Healthcare prices in the United States are significantly higher than other countries. This reality is a result of factors like market consolidation (lack of competition), patents, administrative waste, and more.
Rather than combat the large hospitals, pharmaceutical companies, private equity companies, insurance giants, and other powerful private interests who control armies of lobbyists and excesses of campaign cash, MA proponents provide a simple solution: make people get less care. This is a convenient solution which happens to also further enrich and get the blessing of dominant insurers like UnitedHealth Group.
All in All, Medicare Advantage Is a Scam
Congress created Medicare Advantage with the 2003 Medicare Prescription Drug Improvement and Modernization Act (MMA). After signing the bill into law, President George W. Bush boasted how MA would lower costs, expand benefits, afford seniors more choices, and improve quality of care. However, this supposed modernization of Medicare was really a scheme to privatize, gifting billions of dollars to insurance companies while seeking to end Traditional Medicare.
In reality, MA has never saved taxpayer money. Through gaming the system of capitated payments, MA insurance companies have reaped billions in overpayments — which have also increased the amount all Medicare beneficiaries pay in Part B premiums.
Through restricting care and taxpayer subsidies, MA plans do offer a lower cost alternative to Traditional Medicare, especially for beneficiaries who cannot afford a supplemental Medigap plan. Additionally, it can offer supplemental benefit coverage unavailable under Traditional Medicare, even if the quality of such coverage is poor and provides limited financial support. However, this reality is not because of its inherent design; it is a result of the political sabotage of Traditional Medicare. Congress can cap OOP expenses and provide supplemental coverage for Traditional Medicare with the same money it overpays to MA insurance giants lining their profit margins.
The only choices MA afforded seniors has been which private plan they want to choose. The program destroys beneficiaries’ choice of doctor due to restricted networks. Additionally, there is not sufficient evidence that MA significantly improves health outcomes while health providers are increasingly dropping MA plans due to low reimbursements, further limiting the number of providers MA patients can see. At the same time, current comparisons between MA and Traditional Medicare are unfair as long as policy makers refuse to fix the cost gaps in the latter.
Within both the Medicare and entire American populations, healthcare costs are rising at the same time as health outcomes are worsening, especially in comparison to peer nations. While MA is a convenient solution for insurance companies, it neither addresses the causes of high prices nor poor health outcomes.
MA proponents consistently point to the increasing share of beneficiaries who choose MA over Traditional Medicare as evidence of success. Along with millions of dollars spent on deceptive advertising by insurance companies, this is the consequence of policymaker’s failure to update Traditional Medicare.
It’s past time Medicare beneficiaries are given a real choice. Instead of overpaying insurance giants to the tune of hundreds of billions of dollars, Congress can cap OOP expenses at $5,000 annually and provide supplemental benefits in Traditional Medicare.
The Center for Economic and Policy Research (CEPR) was established in 1999 to promote democratic debate on the most important economic and social issues that affect people's lives. In order for citizens to effectively exercise their voices in a democracy, they should be informed about the problems and choices that they face. CEPR is committed to presenting issues in an accurate and understandable manner, so that the public is better prepared to choose among the various policy options.
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Trump Signs Executive Order to Advance 'Deeply Dangerous' Deep-Sea Mining
"The harm caused by deep-sea mining isn't restricted to the ocean floor: It will impact the entire water column, top to bottom, and everyone and everything relying on it," one campaigner warned.
Apr 24, 2025
Amid global calls for a ban on deep-sea mining to protect marine ecosystems, U.S. President Donald Trump on Thursday signed an executive order to advance the risky practice and "restore American dominance in offshore critical minerals and resources."
"The broad order avoids a direct confrontation with the United Nations-backed International Seabed Authority and seeks essentially to jump-start the mining of U.S. waters as part of a push to offset China's sweeping control of the critical minerals industry," notedReuters, which had previewed the measure aimed at attaining nickel, cobalt, copper, manganese, titanium, and rare earth elements.
"The International Seabed Authority—created by the United Nations Convention on the Law of the Sea, which the U.S. has not ratified—has for years been considering standards for deep-sea mining in international waters, although it has yet to formalize them due to unresolved differences over acceptable levels of dust, noise, and other factors from the practice," the agency reported.
Trump's order directs Cabinet members including Secretary of Commerce Howard Lutnick—whose department oversees the National Oceanic and Atmospheric Administration (NOAA)—to expedite the permit process and work on various related reports.
"Authorizing deep-sea mining outside international law is like lighting a match in a room full of dynamite—it threatens ecosystems, global cooperation, and U.S. credibility all at once."
Deep-sea mining is opposed by over 30 countries as well as academics and advocacy groups worldwide. Among them is Greenpeace USA, whose campaigner Arlo Hemphill said Thursday that "authorizing deep-sea mining outside international law is like lighting a match in a room full of dynamite—it threatens ecosystems, global cooperation, and U.S. credibility all at once."
"We condemn this administration's attempt to launch this destructive industry on the high seas in the Pacific by bypassing the United Nations process," Hemphill declared. "This is an insult to multilateralism and a slap in the face to all the countries and millions of people around the world who oppose this dangerous industry."
"But this executive order is not the start of deep-sea mining. Everywhere governments have tried to start deep-sea mining, they have failed. This will be no different," he added. "We call on the international community to stand against this unacceptable undermining of international cooperation by agreeing to a global moratorium on deep-sea mining. The United States government has no right to unilaterally allow an industry to destroy the common heritage of humankind, and rip up the deep sea for the profit of a few corporations."
No exaggeration, deep sea mining could cause the massive collapse of the entire deep sea ecosystem and food chain. This is an existential risk to every person on this planet. www.nytimes.com/2025/04/24/c...
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— Alejandra Caraballo (@esqueer.net) April 24, 2025 at 5:54 PM
Ocean Conservancy vice president for external affairs Jeff Watters also blasted the move, saying that "this executive order flies in the face of NOAA's mission. NOAA is charged with protecting, not imperiling, the ocean and its economic benefits, including fishing and tourism; and scientists agree that deep-sea mining is a deeply dangerous endeavor for our ocean and all of us who depend on it."
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He highlighted that "NOAA is already being threatened by this administration's unprecedented cuts. NOAA is the eyes and ears for our water and air. NOAA provides Americans with accessible and accurate weather forecasts; it tracks hurricanes and tsunamis; it responds to oil spills; it keeps seafood on the table; and so much more. Forcing the agency to carry out deep-sea mining permitting while these essential services are slashed will only harm our ocean and our country."
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As The New York Timesreported:
The executive order could pave the way for the Metals Company, a prominent seabed mining company, to receive an expedited permit from NOAA to actively mine for the first time. The publicly traded company, based in Vancouver, British Columbia, disclosed in March that it would ask the Trump administration through a U.S. subsidiary for approval to mine in international waters. The company has already spent more than $500 million doing exploratory work.
"We have a boat that's production-ready," said Gerard Barron, the company's chief executive, in an interview on Thursday. "We have a means of processing the materials in an allied friendly partner nation. We're just missing the permit to allow us to begin."
In response to the late March disclosure—which came during International Seabed Authority negotiations—Louisa Casson, senior campaigner for Greenpeace International, said that "this is another of the Metals Company's pathetic ploys and an insult to multilateralism. It shows that a moratorium on deep-sea mining is more urgently needed than ever. It also proves that the company's CEO Gerard Barron's plans never focused on solutions for the climate catastrophe."
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Casson stressed that "states, civil society, scientists, companies, and Indigenous communities continue to resist these efforts. Having tried and failed to pressure the international community to meet their demands, this reckless announcement is a slap in the face to international cooperation."
Less than a week later, the Norwegian deep-sea mining company Loke Marine Minerals declared bankruptcy—which Haldis Tjeldflaat Helle, a campaigner for Greenpeace Nordic, noted came "on the same day that we shut down a deep-sea mining conference in Bergen."
The Norwegian government in December halted plans to move forward with deep-sea mining in the Arctic Ocean, which Steve Trent, CEO and founder of the Environmental Justice Foundation, had called "a testament to the power of principled, courageous political action, and... a moment to celebrate for environmental advocates, ocean ecosystems, and future generations alike."
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"It's shocking to see the U.S. abandon its leadership role in advancing global health and humanitarian efforts."
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Apr 24, 2025
United Nations Secretary-General António Guterres on Thursday led calls for India and Pakistan to "exercise maximum restraint" as the nuclear-armed neighbors took tit-for-tat measures against each other in the wake of Tuesday's massacre of 26 people in Indian-occupied Kashmir.
Pakistan warned India that it was committing an "act of war" by suspending the landmark Indus Waters Treaty, which allows both countries to share the vital river system's flow. Pakistan announced the suspension of trade and closed its airspace to Indian flights. Both countries closed border ports of entry, canceled visas, and took other measures against each other.
India said it was downgrading relations with Pakistan, whom it blamed for supporting "cross-border terrorism" after gunmen killed 25 Indians and one Nepali and wounded at least 17 others at a popular vacation spot in Pahalgam, Kashmir on Tuesday.
"May sanity prevail between both nations."
A front group of the Pakistan-based militant group Lashkar-e-Taiba claimed responsibility for the attack, which killed mostly tourists.
Pakistani Defense Minister Khawaja Asif countered that his country's government believes "very strongly" that the attack "was a false flag operation."
Speaking Thursday, Stephane Dujarric, Guterres' spokesperson,
said that "we very much appeal to both the governments of Pakistan and India to exercise maximum restraint, and to ensure that the situation and the developments we've seen do not deteriorate any further."
"Any issues between Pakistan and India, we believe can be and should be resolved peacefully through meaningful mutual engagement," he added.
Progressives from both sides of the border echoed calls for restraint.
"We, the people of Kashmir, have already suffered so much over the years—and now, more than ever, we want peace to prevail in our homeland," Kashmiri social activist Jasib Shabir Bhat said on social media Wednesday. "We stand united for peace, for humanity, and for a better future for all."
Pakistani authori and activist Ehtesham Hassan wrote that "as a Pakistani who visited India and received immense love, I am devastated by the news from Pahalgam."
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