Larsen: Privatizing Medicare will not make Washington seniors healthier

Editor’s Note: In recent months, few matters of public policy have attracted the broad and sustained attention of the public in the pages of CDN, and in our community, as the emergence of Direct Contracting Entities (DCE’s) and their impact on Medicare patients. Since a CDN guest commentary by Elisabeth Marshall in this space on Feb. 3 alerted readers to the practice, the Medicare implications via local providers such as PeaceHealth have been broadly debated in our letters section and elsewhere. This week, U.S. Rep. Rick Larsen, acknowledging that debate, offers his viewpoint:

Medicare is a cornerstone of the U.S. health care system, serving more than 1.3 million seniors and individuals with disabilities in Washington state. Medicare enables seniors and other beneficiaries to stay healthy and get healthier.

The Affordable Care Act created the U.S. Center for Medicare and Medicaid Innovation (CMMI) to test ways to better deliver Medicare and encourage healthy lifestyles for seniors. One of these CMMI models — the Global and Professional Direct Contracting Model — contracts with private companies, or Direct Contracting Entities (DCEs), to manage care for seniors enrolled in traditional Medicare within their provider networks.

I oppose Medicare privatization and am concerned about the potential impact of the DCE model on Washingtonians’ health care. Some Medicare beneficiaries do prefer a managed care approach, and since the 1990s, beneficiaries have been able to participate in Medicare Advantage for this type of care. Nearly 500,000 Washingtonians have chosen to enroll in Medicare Advantage, and I have continued to hold the Centers for Medicare and Medicaid Services (CMS) accountable to ensure its beneficiaries receive high-quality care. 

I am hearing from dozens of concerned constituents that the DCE model may impact their quality of choice in medical coverage and undermine traditional fee-for-service Medicare, and I agree. I wrote directly to the administrator for CMS, which oversees CMMI, to express my constituents’ concerns and my opposition to the DCE model. The DCE model rests on the fallacy that traditional fee-for-service Medicare cannot be used to encourage healthy seniors and assumes managed care is needed.

In response to these concerns, CMS announced the DCE model will transition to the new Accountable Care Organization (ACO) Realizing Equity, Access and Community Health (REACH) model at the beginning of 2023. The ACO REACH model makes critical changes to increase transparency, refocus on health equity and limit the ability to raise health care costs. 

Despite these changes, I remain concerned about Washingtonians’ ability to receive high-quality health care through the ACO REACH model. CMS must go back to the drawing board with the ACO REACH model and put patients’ health first by strengthening traditional fee-for-service Medicare. 

Seniors and individuals with disabilities rely on Medicare to receive quality, affordable health care. I will continue working to preserve and strengthen traditional Medicare and ensure Medicare beneficiaries in Western Washington can exercise personal control over their health care.

Rick Larsen (D-Everett) represents Washington’s Second Congressional District, which includes parts of Snohomish, Skagit and Whatcom counties and all of Island and San Juan counties. Bellingham office: 360-733-4500.