Contact: Sarah Abel

Phone: 202-225-5506


Rep. Ron Kind Introduces Bipartisan Bill to Expand Access to Quality, Affordable Medicare Advantage Plans for Older Wisconsinites

La Crosse, WI – Today, Rep. Ron Kind (D-WI) introduced the bipartisan Medicare Advantage Quality Payment Relief Act. This legislation will reward high-performing Medicare Advantage health plans while lowering premiums for Wisconsin seniors. The bill was introduced with Reps. Mike Doyle (D-PA), Mike Kelly (R-PA), and Brett Guthrie (R-KY).

“Older Wisconsinites deserve the very best care and coverage we can provide,” said Rep. Ron Kind. “That’s why I’m proud to work with my colleagues on both sides of the aisle to introduce commonsense legislation that would lower premiums and ensure Medicare Advantage beneficiaries have expanded access to quality health plan options.”

In order to improve quality for seniors enrolled in Medicare Advantage plans, Congress created a quality incentive payment program designed to reward high-performing plans for providing high-quality care. Unfortunately, the Department of Health and Human Services (HHS) has subjected quality bonus payments to a payment “benchmark cap.” This glitch in HHS’s interpretation of the benchmark cap cuts off the full quality incentive payments to the highest performing 4- and 5-star health plans. In 2021, high-performing plans will miss out on over $230 million in quality bonus payments, which are required to be returned to enrollees in the form of lower premiums or enhanced benefits.

More than 140,000 Wisconsin seniors enrolled in Medicare Advantage are losing out on reduced premiums and supplemental benefits due to the cap. On a county-by-county level, western and northern Wisconsin are disproportionally impacted by this issue. Security Health Plan, part of the Marshfield Clinic Health System in Wisconsin, could reduce their Medicare Advantage premium by $15 per month for Wisconsin beneficiaries if the bill were enacted.

The bipartisan Medicare Advantage Quality Payment Relief Act is supported by many impacted organizations and patient advocacy groups, including Marshfield Clinic Health System in Wisconsin:

“The Benchmark Cap is unfair to seniors across Wisconsin, and across the United States,” stated Krista Hoglund, Chief Actuary and Chief Financial Officer and incoming Interim CEO of Security Health Plan, part of the Marshfield Clinic Health System. “Because of the glitch in current legislation, seniors are facing higher costs for their healthcare.  Solving this problem will halt high performing health plans like Security Health Plan and others across the country from facing arbitrary financial penalties.  This will mean better benefits and lower costs for seniors enrolled in Medicare Advantage.  We appreciate Rep. Kind’s leadership in drafting and introducing the Medicare Advantage Quality Payment Relief Act.  His common sense approach is what we need to address this ongoing problem.  We look forward to working with him and his colleagues to move this forward through Congress.”

Wisconsinites with questions about their Medicare plan can call Rep. Ron Kind’s office toll-free: 1-888-442-8040, or visit kind.house.gov.

Read the bipartisan bill here.

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