topic Re: HR 3467 Auto enrollment Medigap in Social Security

HR 3467 Auto enrollment Medigap

WebWiseWoman — Mon, 21 Jul 2025 20:10:15 GMT

Something we all need to read and understand:

"To amend title XVIII to reform the Medicare Advantage program."

Re: HR 3467 Auto enrollment Medigap

GailL1 — Tue, 22 Jul 2025 01:25:28 GMT

This legislation is NOT about auto enrollment in a a MEDIGAP as your title says - maybe correct that - change it to what the proposed legislation is really about - Medicare Advantage plans.

This will NEVER fly - it actually makes little sense - not to anybody. Not to the Medicare Advantage insurers, not to the beneficiaries, not to Medicare - we have to make choices based on our health needs or wants as to which Medicare plan we choose - network adequacy, medications covered, amount of out of pocket cost.

Auto enrollment, even with the opt-out choice, is not only nuts but it does not help the beneficiary get what they needs - which means they have to have a choice in the pick for whatever their reason.

Giving Medicare Advantage plans some responsibility with hospice care isn’t a bad idea - with specific rules set in place by CMS but again, I am not sure that it would really do anything except we would be paying them more for this benefit - plus it would give them a chance to then go into this business model. So the final rules written after the proposal is passed by CMS on the proposal would be what would be making the difference here.

Legislative action to control MA insurers from up-coding a beneficiary based on some rather questionable tactics might be OK but I don’t think we need legislative action to control this - just firmer rules made by CMS - and if we do need legislative action on this to fix it - then let it be a clean proposal not mixed with anything else to muddy up the direct action needed.

We can follow this but it doesn’t seem like a good proposal plus it hasn’t gone anywhere and has no cosponsors to this point in time. Even more conservative legislators or anybody else are not sold on it. In fact, it actually makes little sense in the total concept of things needing fixing in MA plans.

FORBES 07/08/2025 - Proposed Law Would Mandate Automatic Enrollment Into Medicare Advantage

Re: HR 3467 Auto enrollment Medigap

WebWiseWoman — Tue, 22 Jul 2025 05:01:42 GMT

Learned person, did you read the act I linked to?

Re: HR 3467 Auto enrollment Medigap

GailL1 — Tue, 22 Jul 2025 13:50:13 GMT

Yep, sure did - in fact, I had read it about a month or more ago.

Did you?

I even read the sponsors talk on floor about it on 06/03/2025

https://www.congress.gov/congressional-record/volume-171/issue-94/house-section/article/H2407-6

I have also read different views on it - like the FORBES articles I linked.

I stand by my initial post to you on the items that are covered in the legislation.

@WebWiseWoman wrote . . . . Something we all need to read and understand:

What’s your understanding?

Re: HR 3467 Auto enrollment Medigap

GailL1 — Tue, 22 Jul 2025 14:00:12 GMT

Here is another one that has also been introduced on Medicare Advantage Reform concerning this same matter that this proposed legislation is trying to address in some way.

Congress.gov - S.1105 Introduced in Senate (03/25/2025) No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act or the No UPCODE Act

AARP has done an article on it.

AARp.org 07/16/2025 - AARP Endorses Senate Legislation to Stop Medicare Advantage Plans’ Excess Billing