ANDREW LANGER: MedPAC’s War On Medicare Advantage – And Why Republicans Shouldn’t Fall For It

If there were ever a case study in how Washington’s permanent bureaucracy quietly steers policy regardless of who wins elections, it would be the Medicare Payment Advisory Commission, better known as MedPAC, whose recommendations could be about to strike a new blow for affordability and health benefits for American seniors.

On paper, MedPAC is an advisory body. It writes reports and crunches numbers. But its findings often become the foundation for congressional action, media narratives, and misleading budget assumptions that now affect the affordability of health coverage of more than 30 million seniors enrolled in Medicare Advantage.

That’s why President Donald Trump and Republican leaders in Congress should approach MedPAC’s claims regarding Medicare Advantage (MA) with clear-eyed skepticism. This is even more important today as some at the Centers for Medicare & Medicaid Services (CMS) are pointing to MedPAC in order to justify “flat” spending on MA next year even as the facts make crystal clear that medical costs continue to rise year over year.

If CMS’ proposal in the recent advanced rate notice is adopted, millions of American seniors will pay more for their health care next year while many benefits will be cut. An artificially constrained growth rate in the face of increased costs will have dire outcomes. It’ll mean less flexibility to offer supplemental benefits like dental, vision and prescription drug coverage, fewer plan choices, and higher out-of-pocket costs for seniors could be right around the corner.

For years, MedPAC has advanced a misleading storyline that Medicare Advantage, created and expanded under Republican reforms, is costing taxpayers more than traditional fee-for-service Medicare, even as many other studies demonstrate otherwise. This unelected commission routinely points to coding intensity, favorable selection, and payment differentials to argue that private plans are overcompensated and that changes should be made to reduce payments or restructure the program.

But here’s what rarely gets equal attention: those “overpayment” figures are not fixed facts. They are estimates based on assumptions that are deeply contested by outside researchers, CMS officials, and industry experts. Change the assumptions, and the gap shrinks. Interpret coding differences differently, and the numbers shift. Yet MedPAC’s estimates are often presented as settled truth, and much of the mainstream media — along with some anti-MA lawmakers — treats them as such.

The Wall Street Journal editorial page recently called out MedPAC’s posture toward Medicare Advantage, noting that the commission has been “co-opted” by progressives skeptical of private markets. A review of MedPAC’s staffing and membership history supports that concern.

In fact, a substantial share of MedPAC staff and commissioners have Democratic affiliations, Democratic voter registrations, or long histories of donating to Democratic candidates and committees. That directly undercuts the long-standing narrative that this is an ideologically neutral, purely technocratic institution. Medicare Advantage was designed to inject competition and consumer choice into Medicare — principles that many on the left have never fully embraced.

That worldview matters. When analysts already believe that private plans shouldn’t outperform government-administered models, they are more likely to interpret ambiguous data in ways that reinforce that skepticism.

Meanwhile, what do America’s seniors say?

Survey after survey shows that Medicare Advantage beneficiaries are overwhelmingly satisfied with their coverage. One widely cited report found that roughly 95% of MA enrollees report being satisfied with the quality of care they receive. Seniors value coordinated care, supplemental benefits, and the out-of-pocket protections that traditional Medicare often lacks. Those could all be hit if this freeze goes ahead. Less funding also means reduced access to doctors and fewer in-network specialists.

Enrollment in Medicare Advantage now exceeds half of all Medicare beneficiaries. That growth is not an accident. Seniors are voting with their feet. And those same seniors about to have their benefits harshly impacted, just ahead of a midterm election focusing on affordability.

Medicare Advantage was built on the idea that seniors deserve choice and that competition can improve care. Undermining it based on contested estimates, especially when seniors themselves are overwhelmingly satisfied, would be both a political and policy mistake.

If Medicare Advantage has weaknesses, fix them. If risk adjustment needs refinement, refine it. But don’t allow a Washington advisory body, heavily influenced by a liberal policy ecosystem that has long distrusted market-based reforms, to chip away at one of the most popular elements of modern Medicare and strike at seniors’ health care affordability in the process.

Trump has made it a central cause to confront entrenched, unelected power structures in Washington. He has spoken repeatedly about dismantling the so-called “deep state” – career bureaucracies that shape policy regardless of election outcomes.

The real test for Republicans is simple: Do they stand with unelected experts who view Medicare Advantage with suspicion – or with America’s 35 million seniors who have embraced it, and now could face cut benefits and higher prices in the months ahead?

Andrew Langer is President of the Institute for Liberty.

The views and opinions expressed in this commentary are those of the author and do not reflect the official position of the Daily Caller News Foundation.

(Featured Image Media Credit: Screen Capture/PBS NewsHour)