By Rev. Dr. Al Hathaway, President, African Ancestry Neuroscience Research Initiative
The events of the past several years have highlighted disparities in health outcomes among different populations. This showed true during the height of the Covid-19 pandemic and the number of cases and the vaccination rates within these populations. Organizations like the National Institute of Health are working to address racial disparities by committing to improving minority health and removing the barriers to advancing health disparities research. The National Institute on Minority Health and Health Disparities is dedicated to researching and developing solutions to address racial health disparities across the country.
Recently, the Center for Medicare and Medicaid Innovation rejected a proposal put forth by the State of Maryland’s Health Services Cost Review Commission to strengthen Maryland’s Medicare Advantage market that would help Maryland’s most vulnerable populations, specifically, minorities and the economically disadvantaged. The Center for Medicare and Medicaid Innovation was in a particularly unique space to make considerable change to tackle the health disparity challenges our state is facing. This decision comes as a great disappointment, in a time where our residents need access to healthcare the most.
For the past two years, the pandemic forced those across the country, as well as in Maryland, to acknowledge just how hard those from underserved communities are hit when it comes to healthcare. It is imperative that we move forward in a way that protects these residents and offers them access to insurance policies to ensure that our most high-risk Medicare beneficiaries have the resources needed to stay healthy.
As the Medicare Advantage plan currently stands, Marylanders, particularly those that come from diverse backgrounds, are impacted by the plan disproportionately when compared to others. Nationally, the national penetration rate for the Medicare Advantage plan is 42%. However, only 14% of Marylanders eligible for both Medicare and Medicaid are enrolled in a Medicare Advantage plan. Within that population, 43% are Black and 4% are Hispanic. Those who are eligible for both programs tend to need access to healthcare more often due to medical conditions that ensue higher costs and enroll in Medicare Advantage plans. In Maryland, beneficiaries have fewer Medicare Advantage options than neighboring states, and plan options provide less supplemental benefits with higher copays and deductibles.
What’s alarming is that while Medicare Advantage enrollment continues to grow, Medicare Advantage plans have dropped in Maryland, leaving those who need benefits the most with little option when it comes to coverage. The remaining plans in Maryland, unlike our neighbors, are unable to offer supplemental benefits for dental, vision, and transportation.
In our state, we have a unique Total Cost of Care (TCOC) Model, that has created some obstacles for operating a Medicare Advantage Plan. These plans do not have the option to negotiate lower prices where fee-for-spending services are high like in other states, because of the restrictions that the TCOC model places on price negotiation. Unfortunately, the patients are those who are impacted the most due to the restrictions.
While it is understood that the Center for Medicare and Medicaid Innovation is willing to communicate in the future on repairing the issues that Maryland has when it comes to Medicare Advantage, our low-income and racial and ethnic minorities who are being disproportionately impacted by these issues cannot afford to wait. As more time passes, there is no guarantee that more Medicare Advantage Plans will not leave, leaving even fewer options for Marylanders that need coverage.
It is imperative that we move forward in a way that protects these residents and offers them access to insurance policies to ensure that our most high-risk Medicare beneficiaries have the resources needed to stay healthy. In a time where technology is allowing for healthcare to become more accessible, it is important for our leaders to make sure all Marylanders are in a position to take advantage of the incredible healthcare offered to them in our state.