Medicare Insurance Agents Give Biden-Harris D+ Grade on Handling of Medicare

Ahead of the 2023 Annual Enrollment Period (AEP) and the highly-charged 2022 midterm election, TrustMedicare.com surveyed a national representation Medicare agents and brokers to capture their real-world perspectives on a number of issues, including Biden-Harris Administration’s handling of Medicare thus far; impacts of inflation on customers; and generally outlook Medicare.

Drug Price Negotiation: Medicare Agents Believe the Biden Administration’s Efforts as Political Theater with a Misleading Timeline

Based on survey responses and follow-up discussions with agents, Medicare shopping and enrollment discussions generally key in on the customer’s prescription drug needs. More so than ever, agents are seeing customers struggle with the increasingly high out-of-pocket drug costs, at a time when everyday inflation is squeezing fixed-income households.

Although political pundits and many insurance agents herald the Medicare provisions within the Inflation Reduction Act of 2022 as a significant disruption to US drug pricing regulations, the timeline of actual negotiation on high-cost drugs covered by Medicare is still more than three years away. Signed by President Biden on August 16, 2022, the number of negotiated-eligible drugs as selected drugs is outlined in the following chronological order:

– 10 Part D drugs in 2026 (3 years away);
– 15 Part D drugs in 2027 (4 years away);
– 15 Part B and Part D drugs in 2028 (5 years away); and
– 20 Part B and Part D drugs in 2029, and annually thereafter.

Medicare agents share a common skepticism to the number of Medicare beneficiaries who will actually see lower drug costs given the myriad of unknown and hypothetical factors, including: a.) the actual drugs Medicare will target for the initial negotiations; b.) the number of Medicare beneficiaries who will actually use those drugs; and c.) the price reductions (and savings to Medicare beneficiaries) that will actually be achieved through the negotiation process.

“Congress and Biden should have allowed more drugs to be negotiated, and on a much faster timeline than they have planned.” Oregon-based Medicare broker of 12 years.

“The current Medicare system is facing significant flaws, politicians are out of touch and fail to recognize that seniors need help now, not in five years from now.” Louisiana-based Medicare agent of 25 years.

New CMS Compliance Regulations Impose Overwhelming Burdens Medicare Agents and Medicare Brokers

Medicare agents frustrated with new changes to the CMS marketing guidelines (CMS-4192-F) which require all Medicare insurance agents to record and digitally store calls that are part of the chain of enrollment in a Medicare Advantage plan or Medicare Prescription Drug Benefit (Part D) plan. CMS requires Medicare agents to read a 38-word TPMO disclosure, verbatim, within the first 60-seconds of calls. This immediately compromises the insurance agent’s perceived value to customers. The required TPMO disclosure introduces the suggestion to visit a government website (Medicare.gov) instead working the the experienced Medicare agent on the phone.

CMS’s Mandatory TPMO Disclosure: “We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.”

According to the CMS, the Medicare marketing changes are in response to the growth of misleading Medicare TV commercials, other marketing messages by Third Party Marketing Organizations (TPMO’s). There has been a modest increase in Medicare consumer complaints to CMS over the past year.

CMS reports, 39,617 complaints in 2021, in which, not all are entirely marketing related. In that same period, CMS reports that over 29 million Medicare beneficiaries received Medicare benefits through Medicare Advantage, including plans that offer Medicare Part D coverage, and an additional 23 million individuals received Part D coverage through standalone Part D plans.

“CMS, insurance carriers, and especially agents, know the problem has been with TV commercials from the likes of Joe Namath and the “DYN-O-MITE Guy” (Jimmie Walker) oversimplifying the benefits of Medicare Advantage plans, and driving misled callers to massive call center boiler-room agencies hustling Medicare Advantage. In a classic government response, draconian measures are placed on everyone – but — the actual bad actors. The measures are oppressive, because now we have to pay for call recording and storage technology, because there’s a complaint rate of 1 in every 1,300 beneficiaries!” Georgia-based Medicare broker of 20 years.

“This is far more detrimental to Medicare beneficiaries than it is to those who prompted this ill-thought-out and hastily implemented rule. CMS’ call recording requirement extending to independent agents working with their existing clients and referred prospects is unnecessarily burdensome. Punish those who need it but not those who, as always, look out for what’s in our clients’ best interests. It was a rushed implementation at the busiest time of year (Annual Enrollment Period).” Ohio-based Health and Medicare Agent of 17 Years.

About the AEP Medicare Insurance Agent Survey

The survey was conducted in the fall of 2022, online among a nationally representative sample of 176 licensed Medicare insurance agents and brokers. The margin of sampling error is plus or minus 6 percentage points for the full sample.

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