Medicare Advantage plans looking to maintain no-premium models could face 50% cuts to supplemental benefits and $1,000 more in older adults’ cost exposure in 2027, according to February reports commissioned by health insurance trade association AHIP.
Wakely Consulting Group conducted the research. The groups evaluated how CMS’ proposed 0.09% 2027 payment increase for MA would play out for insurers and their beneficiaries. AHIP sent the findings to CMS in a Feb. 25 letter.
Here are six other takeaways from the reports:
- Wakely estimated the average change in the blended risk-adjusted benchmark across the country will be -0.29% in 2027.
- The total risk score impact is estimated to be -4.85%, per CMS.
- Payments for the nondual aged MA population — the biggest segment — would drop 5.72%.
- There would be a 15% cut in rebate dollars to lower premiums and cost-sharing, as well as to offer additional benefits, if the final rule went into effect.
- Premiums could increase $23 per month, resulting in a jump of more than $550 for a couple each year.
- About 70% of MA beneficiaries reside in counties predicted to face payment cuts, with rural counties carrying the burden. Oklahoma, Kansas, West Virginia, Alabama and North Dakota would be most affected by cuts to plans.
Over 100 organizations — along with insurer-backed Better Medicare Alliance, a Medicare Advantage advocacy group — recently called on CMS to revisit the policy.
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