IBM Medicare Advantage NYT report March 10, 2023

 Once again, there is a report about employers shifting retirees to Medicare Advantage plans.  The New York Times published this online yesterday and specifically talks about IBM in the article:

https://www.nytimes.com/2023/03/10/business/medicare-advantage-retirement-nyc.html

You need to be a subscriber to read the full article.  It will be in tomorrow's print edition.   There wasn't anything "new" in the article.  Just another acknowledgement that this is happening. 

It is particularly disheartening to read how NYC retirees appear to be the next group of retirees affected by this scheme even though they have what seemed to be an ironclad union contract.  It is also disheartening that, once again, the reporter writes how retiree health insurance benefits are provided because of the good graces of employers.  NO media outlet will acknowledge these benefits were consistently considered as a form of compensation.  

I particularly remember when the unions were negotiating with NYC for salary increases in the 1970's when the city was almost bankrupt but the strike was settled when the city counteroffered with enhanced retiree benefits. I particularly remember it because, at the time, reporters wrote about how the city and the union were "kicking the can down the road" by freezing salary increases but promising retiree benefit enhancements and how the cost of these benefits would overwhelm future administrations.  Neither the union nor NYC acknowledge that history, and now they scream about the cost of retiree benefits being out-of-hand. 

In IBM's case, when IBM promised retiree benefits, for a long time the executive team actually set aside funding for those benefits.  However, as the benefits trust value increased, and the executive team changed players, the demand for ever higher executive compensation needed to be satisfied. Those trust funds were "raided" to satisfy the demand.  It's in "Retirement Heist", by Ellen Schultz.  I referenced that book in an earlier post.

Meanwhile, the travesty of Medicare Advantage depleting Medicare trust funds by pushing more and more seniors into the plans while continuing to maliciously deny policyholders adequate healthcare continues.  The current administration is trying to rein in some of the Medicare trust fund abuse by Medicare Advantage plans (this is described in the NYT article) but it is modest.  Even so, the political opposition scream it is an attack on Medicare.  If they had Pinocchio noses, this lie would give them ten foot long noses. 

Centers for Medicare and Medicaid Services also claim they are putting pressure on MA plans to tap down the denials, but, if anything, it is getting worse. CMS rarely puts pressure on MA insurance providers, no matter who is in the White House. Maybe it's because most CMS leaders end up working for the insurance industry when they leave public service?  Why is that even legal?

Yesterday I counseled someone whose parent was another victim of an MA denial of coverage.  As usual, the MA plan denied additional inpatient treatment at a Skilled Nursing Facility and forced the facility to discharge the patient.  They never advised there could be a second opinion provided by the parent's doctor as part of appealing the discharge. Why would the MA plan do that?  The patient was sucking too much money out of their claim payment bucket so they had to be discharged.  So, the person tried to find "another place" for the parent to go, because going home was not an option given the condition of the parent. And that, my friends, is why Medicare Advantage plans are horrible.