We’re sounding the alarm: The No UPCODE Act will only disrupt care and affordability for seniors in Medicare Advantage. The No UPCODE Act represents a significant rollback of benefits and protections for over 34 million seniors and individuals with disabilities who rely on Medicare Advantage for affordable, coordinated care.
MAM is deeply committed to protecting the high-quality, affordable health care that Medicare Advantage provides over 50% of the Medicare beneficiaries. Preserving what works for them today is non-negotiable.
Seniors Want to Protect Medicare Advantage! According to recent polling, 86% of Medicare Advantage beneficiaries say they would be less likely to vote for a Member of Congress who supports cuts to Medicare Advantage. This is not just a policy issue—it’s a political liability.
Background: The No UPCODE Act reduces funding to the Medicare Advantage program – degrading the current affordability and benefits available for beneficiaries. Specifically, the bill cuts funding for in-home care programs, which would cause beneficiaries to lose access to care teams that manage chronic conditions and work to prevent costly complications. According to the Congressional Budget Office, the policies in this bill would result in fewer supplemental benefits, higher cost sharing and increased premiums for Medicare Advantage beneficiaries.
Disproportionate Impacts for Vulnerable and Medically Complex Medicare Beneficiaries:
- Chronic Conditions: This bill would reduce access to important tools and programs that are focused on supporting seniors with chronic disease such as diabetes, heart disease, and more. These tools are focused on reducing disease progression and preventing avoidable emergency room visits and hospitalizations.
- Rural & Homebound Seniors: Seniors who are homebound and live in rural areas would lose access to critical programs that provide needed primary care.
Low Income Beneficiaries: Low-income beneficiaries could lose access to important supplemental benefits such as healthy foods, dental, hearing, and vision benefits as well as reduced premiums and cost sharing.
Reality Check: Medicare Advantage is designed to manage chronic conditions and proactively coordinate care, especially for the growing number of beneficiaries with complex health needs. Medicare Advantage plans are reviewed and approved by the federal government, regularly audited by the Centers for Medicare and Medicaid Services (CMS) and must comply with strict regulatory requirements and standards.
Bottom Line: While there is policymaker interest in addressing waste, fraud, and abuse in government spending, supporters of proposals like the No UPCODE Act in Congress are exploiting the popularity of this goal as a backdoor route to cutting benefits and increasing costs for Medicare Advantage seniors. Proposals like this will pass billions in costs to over 34 million US seniors in the form of higher out-of-pocket costs and premiums – and that has an outsized impact on underserved populations.
A Broken Promise: President Trump campaigned on protecting Medicare Advantage. This legislation represents a reversal of that commitment and risks alienating a core constituency.