Bipartisan legislation to protect benefits and access to care for hundreds of thousands of seniors enrolled in Medicare Advantage plans in Upstate New York has been introduced in Washington.
Congresswoman Claudia Tenney (NY-24), Congressman Paul Tonko (NY-20), Congresswoman Elise Stefanik (NY-21), Congressman Joseph Morelle (NY-25), Congressman Nick Langworthy (NY-23), Congressman Brandon Williams (NY-22), and Congressman Marc Molinaro (NY-19) introduced a bill that would address Centers for Medicare and Medicaid Services (CMS) dramatic reductions in access and benefits by granting CMS the ability to adjust their benchmark amounts to account for local areas with wage indices that grew by 20 percent or greater. This needed relief will ensure regional, non-profit MA plans remain viable and safeguard enrollees’ robust benefits and access to quality care.
Last year, CMS made a needed adjustment to the wage index for Upstate hospitals, treating geographically rural and rural reclassified hospitals equally. This change led to wage index increases of 20-40% across Upstate New York. While this provided significant relief for hospitals that had been severely underpaid by the fee-for-service program, it inadvertently placed substantial financial pressure on regional Medicare Advantage (MA) plans, which are predominantly non-profit organizations. Because CMS did not account for these new costs in their benchmark rates for 2024, MA plans have experienced significant financial challenges that jeopardize plans’ ability to provide affordable, quality coverage to their beneficiaries. Without relief, the lawmakers said health plans will be forced to cut benefits and increase premiums for seniors who can least afford it.
“Our community’s seniors deserve continued access to affordable, high-quality healthcare,” said Congresswoman Tenney. “By adjusting the benchmark rates to reflect the increased costs faced by our regional plans, we can protect our seniors from losing essential coverage and experiencing higher premiums. This bill will ensure that Medicare Advantage plans continue to provide the robust benefits that so many members of our community rely on.”
“Ensuring our seniors have access to the most affordable health plans and are able to maintain their popular Medicare Advantage benefits is one of my top priorities which is why I am proud to co-lead this legislation to address the wage index reclassification,” said Congresswoman Stefanik.
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