Readers Weigh Downsides of Medicare Advantage and Stick Up for Mary Lou Retton

Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names.

In response to Sarah Jane Tribble’s report about growing enrollment in Medicare Advantage plans — and the growing concerns — a senior policy adviser at the Robert Wood Johnson Foundation weighed in on X, formerly known as Twitter:

Managed care backlash in full swing as more consumers become aware of the tradeoffs involved choosing M.A. https://t.co/7EAMZJ9YJk

— Katherine Hempstead (@khemp64) January 8, 2024

— Katherine Hempstead, Princeton, New Jersey

Medicare Advantage: To Whose Advantage?

Sarah Jane Tribble did an excellent job reporting on Medicare Advantage plans and the major limitations within them that leave people basically screwed (“Older Americans Say They Feel Trapped in Medicare Advantage Plans,” Jan. 5).

Don’t forget presidential hopeful Nikki Haley at one of the Republican debates stated that Medicare Advantage plans are what the majority of seniors want and should be expanded.

That next morning, I immediately called the South Carolina Democratic Party and offered that they should be standing on their desks demonizing her because they know full well that low-income, underserved Black people in South Carolina rural ZIP codes wouldn’t be eligible for Advantage plans where care is linked to ZIP code.

Shame on all parties and candidates who never mention single-payer universal health care (with the exception of Green Party candidates).

Good news story, Ms. Tribble.

— Steve Scuderi, Chicago

A health services researcher in the Department of Health Policy at Vanderbilt University also praised the article on social media:

This piece is REALLY great (thanks, @sjtribble!). We are working on a grant related to this topic now (thanks, @LLSusa!) and cannot emphasize enough how important this issue is for people aging into Medicare. https://t.co/lQqFsnUfp9

— Stacie Dusetzina (@DusetzinaS) January 5, 2024

— Stacie Dusetzina, Nashville, Tennessee

The founder and president of Healthcare Navigation, a consultancy, added advice for health insurance shoppers on X:

Beneficiaries who originally enroll in traditional Medicare are guaranteed to qualify for a Medigap policy without pricing based on their medical history.Find out more here: https://t.co/agG9VH8Hxo pic.twitter.com/pmnq9eDYAQ

— Maura Carley (@MauraCarley) January 20, 2024

— Maura Carley, Darien, Connecticut

Don’t Blame Patients for Unaffordable Health Care

This op-ed (not article) by KFF Health News reporter Julie Appleby shames the former Olympic athlete for her financial distress and for being unable to manage her finances and health — while ill, injured, or chronically disabled (“Mary Lou Retton’s Explanation of Health Insurance Takes Some Somersaults,” Jan. 12).

The writing implies that an American consumer or citizen can be a very “successful person in your other life” but “not understand American health care” and that financial distress could have been prevented if only Mary Lou Retton had been more assertive, informed, and intelligent.

Appleby states that “Retton excelled in landing difficult moves as a gymnast, but she may have missed the bar when it came to buying insurance coverage.”

This notion — especially among health journalists and newsrooms covering the health care model in the U.S. — that commercial health insurance guarantees access to health care, or that the Affordable Care Act is affordable and guarantees access — is a false one. ACA plans are largely managed by private commercial health insurance companies. The industry business model is “Denial of Care.” That is how insurers deliver returns on investment to shareholders year after year, quarter after quarter, and profit from illness, injury, disability, and death. This model as of today is still legal. And, with PxDx software and artificial intelligence, companies are now denying medical care claims at a rate of 100 per 1.2 seconds.

To suggest paying for commercial health insurance promises medical care is editorially irresponsible. To suggest a citizen was not intelligent enough to navigate the barbaric and cruel commercial health insurance industry’s non-system of health care is reprehensible and repugnant. The only one who “missed the bar” was Appleby and her misinformed editors.

KFF Health News has been partnering with NPR and CBS for nearly seven years on the “Bill of the Month” series. During that time, physician suicide has reached record highs, medical worker strikes have hit record highs, medical bill bankruptcies have reached record highs, medical residents across the country are unionizing to protect patients’ rights and patient safety, and yet, all the while, commercial health insurance industry profits have reached record highs. And their financial product divisions continue to invest in portfolios that have nothing to do with health care.

By every measurement and metric, over the past 40 years, the commercial health insurance industry has caused preventable harm and death — intentionally, for profit. And still, Appleby suggests it’s the fault of patients that they cannot afford medical care? What, specifically, does Appleby suggest patients like Retton “do better?”

It’s time to begin reporting responsibly and accurately about statewide single-payer resolutions and legislation across the United States and the national (improved) Medicare for All Act of 2023-24 at the federal level.

Commercial health insurance is not health care.

— Kimberly J. Soenen, executive director of Some People and managing editor of The Fine Print, Grand Marais, Minnesota

This article drew swift attention on social media. Here’s a sampling of readers’ posts on X, reacting both to the KFF Health News and NPR versions:

Retton did not have insurance because premiums were too high. She has insurance now; so do millions of other Texans. That’s the story here, not that she didn’t precisely explain the rating dynamics of a non-compliant environment.https://t.co/EnzjyACn2v https://t.co/SBFSzVNe4Q

— Greg Fann (Pro-compliance Health Actuary) (@greg_fann) January 14, 2024

— Greg Fann, Temecula, California

I’m glad NPR highlighted this. Don’t know if Retton is ignorant or MAGA. Shame on ⁦@TODAYshow⁩ and ⁦@hodakotb⁩ for not using this to inform their audience that preexisting conditions aren’t an issue with the #ACA. Premiums can be $0. https://t.co/Rkl4WVG5wO

— Jody Johnson (@jodywayzata) January 13, 2024

— Jody Johnson, Dallas

I know too well the marketplace health scam that leaves so many of us without insurance. I have a fixed income of $29,000. With a bronze-level plan, that means a $10,000 deductible, and $473 per month for premiums. Are you calling this affordable? The fact I am paying $10,000 before my insurance kicks in, plus monthly premiums, it’s $15,000 out-of-pocket — a pocket I don’t have unless I am homeless. This is the scam.

— Brenda Frantz, Hinesville, Georgia

Yep. Mary Lou Retton’s explanation for why she didn’t have health insurance failed to pass the sniff test: https://t.co/AieiuAzD7n via @kffhealthnews

— Victoria Colliver (@vcolliver) January 12, 2024

— Victoria Colliver, Oakland, California

Orthopedic surgeries??So gymnastics is unhealthy?https://t.co/ki3qRbF7O2

— Lance Cross (@Tea4gunsSC2) January 14, 2024

— Lance Cross, Carta Valley, Texas