American Commitment Launches Medicare Advantage Reform Campaign
“To save Medicare Advantage, we must reform it by making it more affordable and focused on benefiting patients’ unique needs rather than serving as a cash cow for a small handful of giant health services cartels.”
Media Contact: Michael DeSantis
Washington, D.C. — May 15, 2025 — Today, Renewing the Promise of Medicare Advantage (RPMA), a new initiative of American Commitment, launched a national advocacy campaign urging the Trump Administration and Congress to act on critical reforms to the nation’s Medicare Advantage program. Specifically, the campaign aims to help restore Medicare Advantage to its intended purpose: to serve as an innovative alternative to traditional Medicare that provides more customized solutions to meet older Americans’ individual and unique healthcare needs. To do so, RPMA will be advocating for a set of reforms to return the program to a model based on accountability, transparency, increased access to care, and market competitiveness.
Initially established in 1997, today’s Medicare Advantage program is now dominated by a small set of giant insurance and health services corporations with vertically integrated networks whose business practices have come under intense scrutiny related to billions in Medicare overcharges, coding and excess diagnosis abuses, steering patients to subsidiary companies while underpaying external providers and independent pharmacies, increased access denials and prior authorization requests, PBM drug pricing controversies and more. Meanwhile, many liberal politicians and stakeholders have continued to oppose the program on the grounds that any private sector involvement in Medicare, regardless of additional benefits and services, should be discontinued.
“The once highly successful Medicare Advantage program is now at a precarious crossroads,” said Phil Kerpen, president of American Commitment. “On one side, you have a near monopoly held by large vertically integrated insurance corporations, under whom Medicare Advantage costs continue to skyrocket and access to quality care is diminishing by the day. And, on the other, liberal politicians and bureaucrats who want a return to the traditional 1960s era government-run, one-size-fits-all Medicare program serving as seniors’ only available option in order to control and redirect revenues, often for unrelated spending. Neither of these is sustainable or desirable, nor in the best interest of older Americans and taxpayers. The only and best option is systemic reform.”
A set of key policy solutions being advocated for by RPMA, the Make Medicare Advantage Great Again Agenda, can be found here. A sample of key reforms includes:
Require annual external audit of overpayments to Medicare Advantage plans and set new penalty fees.
Ban the use of AI-driven treatment denials without adequate human medical review.
Require insurer reviews of prior authorizations within 72 hours for routine cases and 24 for urgent ones.
Penalize insurers that intentionally or consistently underpay or delay payments to providers.
Eliminate insurer-PBM exemptions from federal anti-kickback corruption laws related to drug pricing rebates.
Require opt-in approval prior to insurers steering patients to subsidiaries or financially-tied enterprises.
Prohibit benefit design plans from restricting access to high-cost specialty care (e.g., oncology, cardiology).
“To save Medicare Advantage, we must reform it by making it more affordable and focused on benefiting patients’ unique needs rather than serving as a cash cow for a small handful of giant health services cartels. Likewise, we cannot allow big government politicians to eliminate it to go back to the days of using Medicare as a piggy bank to fund unrelated spending,” concluded Kerpen.
Click here to learn more about American Commitment and the Renewing the Promise of Medicare Advantage initiative.
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American Commitment is dedicated to restoring and protecting our nation’s commitment to free markets, economic growth, constitutionally limited government, property rights, and individual freedom. American Commitment engages in critical public policy fights over the size and intrusiveness of government through direct advocacy, strategic policy analysis, and grassroots mobilization. Visit us online at www.AmericanCommitment.org.