By Dave Stupor
U.S. Rep. Keith Rothfus, R-Sewickley, has introduced legislation designed to make it possible for seniors to switch between different Medicare Advantage plans.
The 12th district congressman, along with Rep. Kurt Schrader, D-Ore., proposed H.R. 2453, the Medicare Beneficiary Preservation of Choice Act of 2013, on Thursday. The bill calls for restoring an open enrollment period that, until 2011, allowed participants to change plans within the first three months of each year.
"It's a real simple bill," Rothfus said.
Rothfus' proposal would permit enabled seniors to switch plans once between Jan. 1 and March 31. The goal would be to provide participants a chance to see if different plans could meet their health care needs while allowing time to correct a selection mistake.
A similar plan previously existed. However, the Patient Protection and Affordable Care Act, also known as Obamacare, replaced the 90-day window with an annual 45-day period in which subscribers can disenroll from Medicare Advantage, but not actually make a move within the system.
"One of the bad parts -- and there are many bad parts -- of Obamacare was shortening opportunities for people to be enrolling in Medicare Advantage," Rothfus said. "Medicare Advantage is a program where you get your Medicare benefits, but you get them through a private insurer. You pay a little bit more of a premium, but it's a very effective program."
The Alliance for Retired Americans, an organization with more than 3 million members, supported the 45-day provision in Obama's health care act, feeling it protected the Medicare trust fund from being used to unnecessarily subsidize the insurance industry. "Big picture, (the Rothfus bill) is about a windfall for the insurance companies," said Richard Fiesta, the alliance's director of government and political affairs.
Another senior citizen advocacy group, the 60 Plus Association, has offered support for Rothfus' proposal.
"Given the complexity of selecting a health care plan, seniors should have the opportunity to switch plans and make a decision about which plan works best for them. Reinstating the Medicare Advantage open enrollment period is a commonsense solution that restores customer choice for seniors and ensures that they have the coverage that best meets their needs," said Jim Martin, chairman and founder of the 60 Plus Association.
There are more Medicare participants in Pennsylvania's 12th than any other congressional district in the country, according to Rothfus. Thirty-eight percent of the commonwealth's Medicare beneficiaries were enrolled in Medicare Advantage programs last year, the third-highest total of any state. Oregon was second with 41 percent.
"As representative of a state with the second highest enrollment in Medicare Advantage, I have seen the successes that stem from allowing our seniors greater access to health insurance plans that fit their specific needs," Schrader said. "This legislation would restore the open enrollment period, change the way we deliver Medicare Advantage to our beneficiaries and grant our seniors nationwide greater access in choosing a health insurance plan that best fits their situation."
Similar bills were introduced to the House and Senate in 2011. Sen. Bob Casey Jr., a Democrat, sponsored the Senate bill, which the state's other senator, Republican Pat Toomey, co-sponsored.
The 12th district's former congressman, Mark Critz, D-Johnstown, and Rep. Bill Shuster, R-Hollidaysburg, from the 9th district, co-sponsored the House version.
Both bills died in committee.
Rothfus feels the legislation has a better chance of passing now.
"I am hopeful that I'm going to be able to push this through this year. ... What do I think will be different about getting it through this time? The mere fact that Obamacare continues to be implemented and people are starting to notice the impact," said Rothfus.
This is the first piece of legislation of which Rothfus, a freshman, has been the primary sponsor.