Congressional Committee Says Seniors Paid Higher Premiums Due To Alleged Medicare Overpayments

A congressional committee’s investigators released a report on Tuesday that found the average ​American senior’s Medicare premiums last year were about 10% higher due to ‌alleged overpayments to private Medicare Advantage plans.

Medicare Part B premiums that most seniors pay were partly pushed up by controversial health-insurer practices such as adding diagnoses to trigger higher payments, ​according to the Joint Economic Committee, a bipartisan group of lawmakers ​that advises Congress on financial matters.

Medicare is a U.S. government program ⁠for individuals aged 65 and older or those with disabilities. The government reimburses ​private health plans, called Medicare Advantage, a set amount for each patient but ​pays more if patients are sicker.

Medicare Part B provides coverage for outpatient services including doctor visits, diagnostic tests and physician-administered drugs.

The committee found that in 2025 the federal government paid health ​insurers who offer Medicare Advantage plans up to $84 billion more than it would ​have cost to cover the same beneficiaries under its own government-run Medicare plans.

It estimates Medicare ‌overpayments ⁠increased Part B premiums by $212 for enrollees in 2025, totaling $13.4 billion in higher premiums.

These higher Part B premiums negatively impact seniors as they are deducted directly from their social security checks.

By 2035, per-person premiums are projected to double from $2,440 to ​about $5,000, the report found, ​making the plans ⁠less affordable to seniors.

The Committee calculated the overpayments based on findings by the congressional Medicare Payment Advisory Commission, or MedPAC.

“Numerous ​experts continue to warn that making policy based on MedPAC’s ​fundamentally flawed ⁠data, methodology and extrapolations could harm 35 million Medicare beneficiaries who choose MA for more affordable, high-quality health care coverage and who will renew their coverage in ⁠October of ​2026,” said a spokesperson for AHIP, an ​association representing U.S. health insurers.

Government investigators have been probing how health insurers’ billing practices have contributed to ​Medicare Advantage costs.

 

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