Mailbox pic The federal government is wasting billions of taxpayer dollars — by pre-paying private Medicare Advantage insurers for care that’s ultimately provided and paid for by the Veterans Health Administration.
It’s an astonishing waste of resources. As a former secretary of the Department of Veterans Affairs, I believe the money the government pays to private insurers to not pay for care could instead be redirected to offer more services to veterans or used to reduce our ballooning national debt.
More than 9 million veterans are enrolled in healthcare through VHA, which provides care at 1,400 hospitals and outpatient clinics designed to meet the unique needs of former service members.
However, VHA isn’t the only source of health coverage available to veterans. Those over 65 years or those with permanent disabilities typically also enroll in Medicare.
When folks sign up for Medicare, they have two primary options. They can enroll in "traditional Medicare," — where the federal government directly reimburses doctors and hospitals for care already provided to the beneficiary. Or they can enroll in a Medicare Advantage plan sponsored by private insurance companies. In Medicare Advantage, the government pays an upfront lump sum to private insurers, who then pay for all the same services that traditional Medicare covers. Medicare Advantage plans are increasingly popular since they often offer vision, dental and hearing benefits in addition to standard hospital and outpatient care.
About 1.3 million veterans with VHA health coverage are enrolled in a Medicare Advantage plan.
Here is where the problem lies.
Essentially, the government pays Medicare Advantage insurers a fixed monthly amount based on the average cost of providing care to the typical beneficiary — but it doesn’t factor in that veteran beneficiaries obtain at least some of their care, and in many cases, all of their care, through the VHA.
However, VHA facilities don’t bill Medicare Advantage insurers for the care provided. In fact, they aren’t allowed to do so by law.So, in effect, taxpayers pay for care twice. They pay for the operation and upkeep of VHA facilities that provide the treatment. And they also pay full fare for veterans’ Medicare Advantage coverage […]
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