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Chairman Herger Announces Hearing on Medicare Health Plans

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House Ways and Means Health Subcommittee Chairman Wally Herger (R-CA) today announced that the Subcommittee on Health will hold a hearing to examine the current status of the Medicare Advantage (MA) program and other health plans. The hearing will take place on Friday, September 21, 2012 in 1100 Longworth House Office Building, beginning at 9:30 A.M.

In view of the limited time available to hear from witnesses, oral testimony at this hearing will be from invited witnesses only. However, any individual or organization not scheduled for an oral appearance may submit a written statement for consideration by the Committee and for inclusion in the printed record of the hearing. A list of witnesses will follow.


Private health plans have served Medicare beneficiaries from the early years of the program. With 2003 legislation that increased plan payments, beneficiaries were provided with more plan options and enhanced benefits, resulting in millions of seniors choosing to join private Medicare plans. Recent data from the Centers for Medicare and Medicaid Services (CMS) indicates that there are currently over 13.5 million beneficiaries enrolled in private health plans, representing more than one in four Medicare beneficiaries.

According to the Congressional Budget Office (CBO), the Democrats' health law will cut $308 billion from the MA program over the next ten years. As a result of these cuts, the Medicare Trustees predict enrollment in MA will be cut in half by 2017 as compared to prior law. CBO estimates that those beneficiaries who remain in MA will lose $816 worth of extra benefits they would have otherwise received in 2019 alone.

The statutory authority for one type of Medicare Advantage plan, MA Special Needs Plans (SNPs), expires at the end of 2013. SNPs were created in the Medicare Modernization Act of 2003 (P.L. 108-173) with the goal of better coordinating care for and tailoring benefits to higher-cost and vulnerable beneficiaries, including dual-eligibles, those with chronic diseases, and the institutionalized. Approximately 1.5 million beneficiaries are enrolled in SNP plans.

Another type of Medicare health plan, Medicare Cost Plans, are paid based on the costs of delivering Medicare-covered services, rather than on a capitated and risk-based basis like MA plans. Congress has repeatedly delayed enforcing a provision that requires cost plans to withdraw from areas that have competition from two or more MA plans. This moratorium expires on January 1, 2013, which would affect the 2014 plan year. There are approximately 400,000 beneficiaries enrolled in cost plans.

In announcing the hearing, Chairman Herger stated, "More than one in four Medicare beneficiaries have chosen to receive their Medicare benefits through a private Medicare plan. Since 2003, enrollment in the Medicare Advantage program has tripled, which is a clear indication that many beneficiaries enjoy the additional benefits that are often provided by these private health plans. Unfortunately, the Democrats' health law slashed payments to the Medicare Advantage program by more than $300 billion over the next 10 years to fund ObamaCare. These cuts will significantly alter the program and jeopardize seniors' access to the health plans they rely on. Understanding the successful structure of the current MA program, and the challenges the program will face because of the Democrats' health law, is key to ensuring Medicare meets the needs of seniors now and into the future."


The hearing will examine the current status of the MA program, including SNPs and Medicare Cost Plans.


Please Note: Any person(s) and/or organization(s) wishing to submit for the hearing record must follow the appropriate link on the hearing page of the Committee website and complete the informational forms. From the Committee homepage,, select "Hearings." Select the hearing for which you would like to submit, and click on the link entitled, "Click here to provide a submission for the record." Once you have followed the online instructions, submit all requested information. ATTACH your submission as a Word document, in compliance with the formatting requirements listed below, by the close of business on Friday, October 5, 2012. Finally, please note that due to the change in House mail policy, the U.S. Capitol Police will refuse sealed-package deliveries to all House Office Buildings. For questions, or if you encounter technical problems, please call (202) 225-1721 or (202) 225-3625.


The Committee relies on electronic submissions for printing the official hearing record. As always, submissions will be included in the record according to the discretion of the Committee. The Committee will not alter the content of your submission, but we reserve the right to format it according to our guidelines. Any submission provided to the Committee by a witness, any supplementary materials submitted for the printed record, and any written comments in response to a request for written comments must conform to the guidelines listed below. Any submission or supplementary item not in compliance with these guidelines will not be printed, but will be maintained in the Committee files for review and use by the Committee.

1. All submissions and supplementary materials must be provided in Word format and MUST NOT exceed a total of 10 pages, including attachments. Witnesses and submitters are advised that the Committee relies on electronic submissions for printing the official hearing record.

2. Copies of whole documents submitted as exhibit material will not be accepted for printing. Instead, exhibit material should be referenced and quoted or paraphrased. All exhibit material not meeting these specifications will be maintained in the Committee files for review and use by the Committee.

3. All submissions must include a list of all clients, persons and/or organizations on whose behalf the witness appears. A supplemental sheet must accompany each submission listing the name, company, address, telephone, and fax numbers of each witness.

The Committee seeks to make its facilities accessible to persons with disabilities. If you are in need of special accommodations, please call 202-225-1721 or 202-226-3411 TTD/TTY in advance of the event (four business days notice is requested). Questions with regard to special accommodation needs in general (including availability of Committee materials in alternative formats) may be directed to the Committee as noted above.

Note: All Committee advisories and news releases are available on the World Wide Web at

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