"A big change to traditional Medicare is coming" Letter to the editor Maggie Veve

 I am writing about a change to traditional Medicare I am concerned about.

Millions of us seniors and Medicare beneficiaries are quietly being enrolled into a pilot program called “Realizing Equity Access in Community Health (REACH),” run by the U.S. Department of Health and Human Services, which contracts with third-party middlemen. This is occurring without our full knowledge or consent. If left unchecked, the REACH program could radically transform traditional Medicare within a few years, without input from us and without any Congressional oversight.

Developed by the previous administration and moving forward in the administration, the Medicare REACH program allows commercial insurers and other for-profit companies to “manage” care for seniors enrolled in Traditional (fee-for-service) Medicare. Instead of paying doctors and hospitals directly for seniors’ care, Medicare gives these middlemen a monthly payment to cover a defined portion of each senior’s medical expenses. REACH investor entities are then allowed to keep what they don’t pay for in health services, a dangerous financial incentive to restrict and ration seniors’ care. While Traditional Medicare requires 98 percent of its budget to be spent on patient care, REACH requires only 60 percent, thereby allowing up to 40 percent of their budget for their own profit and overhead.  Dr. Susan Rogers, a retired internal medicine doctor and president of the 24,000-member Physicians for a National Health Program said, “this establishes a dangerous incentive to ration and restrict seniors’ care; if left unchecked, REACH will hand Traditional Medicare to Wall Street investors, without input from seniors, doctors, or even Congress.”

When I learned about this program, I called fellow Medicare recipients and they had not heard about this. One who checked if it affected them already told me their doctor was now part of this “network.” That seemed harmless enough but then learned that she would not be able to choose other doctors out of the network, like I can with Traditional Medicare.  After reading more, I called our Congressman in January and learned that at that point in time, the staff hadn’t heard about it. I have since contacted our US Senators and the Biden administration and haven’t received any indication that they know about the REACH program concerns. Consequently, I am turning to the public to learn about this program.  Do some research (see the Physicians for a National Health Program/pnhp.org) and talk with your neighbor.  At my end I, with fellow seniors from Ulster Activists and Indivisible Ulster are providing a forum to learn about REACH at Elting Memorial Library in New Paltz on Sunday, March 20 at 2 p.m. Join us to learn more about this program and what you can do to maintain your Traditional Medicare.

Publishing history:

Hudson Valley One 3/16/22