Medicare Advantage matters to seniors, disabled

There is growing concern among seniors, like me, healthcare professionals, and insurers about federal policy changes that could significantly reduce Medicare Advantage (MA) payments — changes being driven through the Centers for Medicare & Medicaid Services (CMS) as part of Congress’s ongoing effort to rein in Medicare spending.

If implemented as proposed, these changes could have serious consequences for Virginia seniors who rely on Medicare Advantage for affordable, accessible care.

Medicare Advantage is now the most common form of Medicare coverage nationwide, with a majority of seniors choosing MA over traditional Medicare. Unlike traditional Medicare, which is administered directly by the federal government, Medicare Advantage plans are offered by private insurers under strict federal oversight and fixed payment structures. These plans are required to meet quality benchmarks and, when they exceed them, must return value to beneficiaries in the form of enhanced benefits, lower premiums, or reduced cost-sharing.

CMS has proposed payment and risk-adjustment changes that would effectively reduce funding to Medicare Advantage plans, despite rising healthcare costs and growing enrollment. While these proposals are often described as “technical adjustments,” the practical effect is less funding flowing into MA plans — funding that currently supports preventive care, care coordination, supplemental benefits, and predictable out-of-pocket costs for seniors.

Supporters of these reductions argue they are necessary to control federal spending. But there is real concern that cutting Medicare Advantage payments will destabilize a program that millions of seniors depend on — not improve care. Medicare Advantage does not drain taxpayer dollars indiscriminately; it operates on a per-member, per-month payment model designed to encourage efficiency, preventive care, and better health outcomes.

Medicare Advantage beneficiaries consistently report high satisfaction with the program because it prioritizes access, affordability, and simplicity. Seniors value the ability to receive coordinated care, predictable costs, and preventive services without unnecessary bureaucracy. For many, Medicare Advantage offers benefits and protections that traditional Medicare simply does not provide without expensive supplemental coverage.

As discussions around the 2026 Medicare Advantage rate notice move forward, policymakers must recognize that predictable and adequate funding is essential to maintaining stability in the program. Changes made in Washington have real-world consequences, especially for seniors living on fixed incomes who cannot absorb higher costs or reduced access to care.

Access to stable, affordable healthcare — whether through Medicare Advantage or traditional Medicare — should be a shared priority across party lines. Policymakers should proceed with caution and ensure that any changes strengthen, rather than undermine, the healthcare options seniors have chosen and trust.

I encourage MA users to write members of Congress, too.

Ken Reid

Tysons Corner

The writer covered healthcare in Washington as a journalist and editor for 35 years and is a former County Supervisor and Leesburg Town Councilmember