An Architect of MA Speaks Out – In an op-ed published by The Hill on Sunday, former Republican Rep. Jim Greenwood of Pennsylvania — who helped write the Medicare Modernization Act that created Medicare Advantage — said plainly: “The program no longer lives up to [its] promise. I never imagined that Medicare Advantage would become a vehicle for such waste and abuse. It’s time to fix it.”
Read Jim Greenwood’s own words here.
Republicans Turn Against Medicare Advantage: A Growing Conservative Revolt
Republican leaders are increasingly criticizing Medicare Advantage (MA), marking a significant shift from traditional bipartisan support for the privatized Medicare program that now covers more than half of all beneficiaries.
Leading Conservative Voices
Former Republican Representative Jim Greenwood of Pennsylvania, who helped create the Medicare Modernization Act establishing Medicare Advantage, publicly declared that “the program no longer lives up to [its] promise.” Greenwood acknowledged that what was intended to drive innovation through private competition has been overtaken by “a handful of massive insurers who are gaming the rules for profit.”
Two Republican physicians in Congress, Representatives Greg Murphy of North Carolina and John Joyce of Pennsylvania, co-chairs of the GOP Doctors’ Caucus, wrote that “profit-driven insurance companies have destroyed [Medicare Advantage’s] model.” They specifically criticized insurers for using prior authorization to delay or deny necessary care and for “upcoding” – exaggerating patient illness severity to collect more taxpayer dollars.
Financial Impact
Medicare Advantage now costs taxpayers 22% more per beneficiary than traditional Medicare, according to the Medicare Payment Advisory Commission (MedPAC), resulting in $83 billion in overpayments to private insurers last year alone. This represents a dramatic departure from the program’s original cost-saving promise.
Industry Accountability
Conservative advocacy leader Phil Kerpen warned that Medicare Advantage is “becoming increasingly costly and unstable,” pointing to the Department of Justice’s criminal investigation into UnitedHealth as evidence of systemic problems1. He called for stronger disclosure rules, better plan comparison tools, and serious action against prior authorization abuse.
Political Implications
This Republican criticism represents a crack in the insurance industry’s protective wall of bipartisan political support, potentially opening the door for meaningful Medicare Advantage reforms that the insurance lobby has successfully fought for years.
What can you do? – Join in the fight to create universal health care for everyone. Some helpful links:
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