NAACP may temper support for Medicare Advantage

The NAACP is shifting its approach after it took a controversial stand on private health plans offered through Medicare and received a cool response from Democrats on Capitol Hill.

The National Association for the Advancement of Colored People (NAACP) has been lobbying against a proposal, popular with senior congressional Democrats, to reduce federal funding for the private health insurance companies that provide health benefits to 8.3 million people under the Medicare Advantage program.

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But the group on Monday tried to explain its stance on Medicare Advantage in the context of its friendly positions on a variety of other healthcare issues under consideration by the Democratic Congress.

The NAACP “continues to be a strong advocate for expanded health care coverage for all Americans,” Hilary Shelton, the director of the group’s Washington bureau, wrote in a leader to House Ways and Means Committee Chairman Charles Rangel (D-N.Y.), House Energy and Commerce Committee Chairman John Dingell (D-Mich.) and Senate Finance Committee Chairman Max Baucus (D-Mont.).

The NAACP has taken some flak from the Hill for standing alongside the health-insurance industry, a longtime nemesis of Democratic politicians, on Medicare Advantage. Since wading into the debate by sending a letter to House members in
March, the NAACP has been trying to temper its support for Medicare Advantage.

“That letter is not always being offered in its full context,” Shelton told The Hill. “In hindsight, I wish I had done more to put in the broader context,” he added.

Shelton said that he has repeatedly reassured lawmakers who asked him whether cutting Medicare Advantage is out of the question by telling them that all programs “have got to be on the table.”

Proponents of the cuts contend that Medicare spends an average of 12 percent more per beneficiary under Medicare Advantage than it would cost to cover an individual under traditional Medicare.

The NAACP, the health-insurance industry, the Bush administration and many congressional Republicans counter that Medicare Advantage plans often provide benefits not available under traditional Medicare, such as the coordination of medical care for people with chronic diseases like diabetes.

Many Democrats view the expansion of Medicare Advantage under the Bush administration and the former Republican Congress as a decisive step toward the privatization of the entire Medicare program. The 2003 law that created the Medicare Part D prescription-drug benefit substantially increased funding for Medicare Advantage.

Moreover, the Democratic leadership is keen to find budgetary savings from Medicare to finance other priorities, such as expansions of Part D and the State Children’s Health Insurance Program.

In the March letter, Shelton expressed “deep concern” about plans to trim federal spending on Medicare Advantage.
“Reduced funding for the Medicare Advantage program would have a negative impact on the health and health care of millions of Medicare beneficiaries — particularly for low-income and minority beneficiaries,” Shelton wrote.

The NAACP reportedly had targeted its message to members of the Congressional Black Caucus. One high-profile member of that group made clear last week that he is sympathetic to neither the Medicare Advantage program nor the health
insurance industry.

“We shouldn’t be rewarding the insurance industry for deceiving and defrauding our seniors, we should be doing everything we can to stop them,” Sen. Barack Obama (D-Ill.) said during a presidential campaign stop at a senior center in Des Moines, Iowa, on Friday. Obama said he would cut $150 billion over 10 years from Medicare Advantage and use the money to pay for other healthcare programs.

Obama’s remarks followed media reports that some companies have engaged in misleading marketing practices to enroll Medicare beneficiaries in the more lucrative Medicare Advantage plans rather than the Part D plans they sought.

Obama took direct aim at health insurers and pharmaceutical manufacturers, charging that their lobbying clout has blocked changes to Medicare. “We don’t do that because we are not setting the agenda in Washington, insurance companies and drug companies are. That’s what people want to turn the page on,” he said, according to the Associated Press.

A spokeswoman for Obama’s campaign downplayed the differences between the candidate and the NAACP on Medicare Advantage. “It would be absolutely false to suggest that there is any bad blood between us,” Jen Psaki said. Shelton said he
never met with Obama or his staff to discuss Medicare Advantage.

Nevertheless, the NAACP’s alliance with America’s Health Insurance Plans (AHIP), the main lobbying group for health insurers, has been a source of consternation among some Democrats on the Hill.

Shelton’s March letter employed talking points similar to those used by AHIP. “[Medicare Advantage] plans …
disproportionately provide coverage to low-income and racial and ethnic minorities,” Shelton wrote.

The NAACP and the League of United Latin American Citizens also are formally allied with AHIP through the trade association’s Minority Advisory Committee. AHIP has touted the support of these groups and other minority groups and politicians, such as former Denver Mayor Wellington Webb (D), for its efforts to maintain financing for Medicare Advantage.

In an interview, Shelton expressed the NAACP’s support for Medicare Advantage but edged away from his emphasis on the proportion of African-Americans and other minorities in the program.

“It’s a good program. It’s been very helpful to a lot of people who happen to be African-American,” Shelton said. But he also noted, “The vast majority of African-Americans benefit from the traditional Medicare program.”

The NAACP estimates that 16 percent of Medicare Advantage beneficiaries are African-American, which is roughly equivalent to the proportion of the U.S. population that is black, Shelton said.

In the letter to the committee chairmen on Monday, Shelton also emphasizes that the NAACP understands the budgetary constraints facing Congress. “Under the pay-as-you-go rules that currently govern Congress … hard decisions will have to be made,” he wrote.