Pocan Introduces Package of Bills to Reform Medicare Advantage, Strengthen Traditional Medicare

WASHINGTON, D.C. – Today, U.S. Representatives Mark Pocan (WI-02), along with 12 other members, introduced a package of eight bills that apply guardrails to Medicare Advantage (MA) programs while strengthening traditional Medicare.

“Only Medicare is Medicare. It is one of the most popular and important services our government provides,” Rep. Pocan said. “But for too long, private healthcare companies taking advantage of Medicare’s brand and popularity have tricked and wronged seniors. This package of commonsense, pro-patient reforms will bring greater accountability, transparency, and affordability to Medicare Advantage, while strengthening traditional Medicare and protecting patient choice. This package represents a strong step forward to protect seniors, save taxpayer dollars, and restore integrity to the Medicare program.”

The eight bills are below and can be divided into three subcategories:

Delays and Denials of Care

• Denials Don’t Pay Act: Disincentivizes MA companies from delaying and denying lifesaving care through dangerous prior authorization requirements. (one-pager)
• Right to Appeal Patient Insurance Denials (RAPID) Act: Ensures that patients receive the necessary care they are entitled to by automatically appealing any denial of care. (one-pager)
• Disclose Your Denials Act: Requires MA plans to audibly and visually disclose their delay and denial rates when advertising, increasing transparency in the MA program, and allowing patients to be better informed. (one-pager)

MA Companies Overcharging Taxpayers

• Medicare Advantage Fraud Accountability Act: Bars companies from participating in the Medicare Advantage (MA) program if they have been convicted of defrauding the government. (one-pager)
• Keep Medicare Costs Down Act: Requires MA companies to charge the government per beneficiary as much as, or less than, traditional Medicare, aiming to reduce unnecessary and wasteful government spending. (one-pager)
• Seniors’ Choice and Clarity Act: Streamlines the process and improves clarity and choice for Medicare beneficiaries by limiting the number of plans that Medicare Advantage (MA) companies can offer to three a year, reinstating a 2019 CMS rule. (one-pager)

Strengthening Traditional Medicare

• Protecting Medicare Choice Act: Prohibits Medicare Advantage from being redesignated as the default option for seniors, as proposed in Project 2025. (one-pager)
• Find My Doctor Act: CMS must create a national, user-friendly website where people can search for doctors by plan, empowering Medicare beneficiaries to make informed decisions by searching whether their doctors participate in a plan before enrolling. (one-pager)

“Big Insurance has long pitched Medicare Advantage as a key tool to lowering health care costs and delivering better care, but like so much of their rhetoric, this is nothing but bold-faced lies. The truth is, Medicare Advantage is neither Medicare nor an advantage. And it certainly doesn’t exist to lower costs. It exists to help Big Insurance make sky-high profits and enrich shareholders. It is long past time Congress stepped in and protected patients. The legislative package Congressman Pocan is introducing is the most comprehensive plan ever introduced to rein in Medicare Advantage and protect patients. Congress should pass these bills without delay.” – Wendell Potter, President, The Center for Health and Democracy.

“Medicare Advantage insurers profit from withholding medically necessary care, and can withhold care with near impunity. So, people enrolling in corporate MA plans are forced to gamble with their health and with their lives. They can’t avoid the bad actors. It’s time Congress protected older Americans and people with disabilities from bad actor Medicare Advantage insurers, as Congressman Pocan’s MA Bill package would do.” – Diane Archer, President and Founder, JustCare.

“Corporate-run plans masquerading as Medicare are delaying and denying the care that people need, all while robbing taxpayers of trillions. Congressman Pocan’s package of reforms is desperately needed to hold these corporate plans accountable and strengthen Traditional Medicare. We urge Congress to swiftly pass them into law.” – Alex Lawson, Executive Director of Social Security Works.

Full Package Cosponsors Include: Andre Carson (IN-07), Steve Cohen (TN-09), Rosa DeLauro (CT-03), Lloyd Doggett (TX-37), Pramila Jayapal (WA-07), Ro Khanna (CA-17), Eleanor Holmes Norton (DC), Alexandria Ocasio-Cortez (NY-14), Jan Schakowsky (IL-09), Mark Takano (CA-39), Shri Thanedar (MI-13), Rashida Tlaib (MI-12)

Endorsing Organizations: Center for Health and Democracy, Just Care USA, Labor Campaign for Single Payer, Physicians for a National Health Program (PNHP), Public Citizen, Social Security Works

NOTE: This press release was submitted to Urban Milwaukee and was not written by an Urban Milwaukee writer. While it is believed to be reliable, Urban Milwaukee does not guarantee its accuracy or completeness.