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What Healthcare Reform Means for: Medicare Programs

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By Sabrina Shankman and Olga Pierce, ProPublica

Using results from a questionnaire we did with American Public Media’s Public Insight Network, we’re looking at how the proposed health care reforms will actually affect people facing common health care coverage situations. This is the third in a series (Part 1, Part 2).

Medicare Advantage has been a major flash point in the health care reform debate, giving fodder to opponents of reform who say that Medicare would be cut to pay for the proposals. Our analysis of the impact of reforms on one very satisfied Medicare Advantage member finds the changes would be a loss for many seniors, but a win for taxpayers.

About Medicare Advantage: The elderly can participate either in traditional Medicare, which is administered by the government, or in Medicare Advantage, which subsidizes managed care plans administered by private insurance companies.

The private plans offer many perks – low or zero cost-sharing, comprehensive prescription drug coverage, even gym memberships. But they also have a downside: As in other managed care plans, prior authorization is needed for many services, and members are limited to certain doctors and hospitals.

The relatively new Medicare Advantage is more expensive for taxpayers, however...

Visit ProPublica.org to read the full report and to find out what the reform plans will mean for a retired Michigan man with a $75,000 income who is very happy with his Medicare Advantage plan.

Sabrina Shankman and Olga Pierce are reporters for ProPublica, America's largest investigative newsroom.