Niagara Leader

Congresswoman Claudia Tenney (NY-24), along with Congressman Paul Tonko (NY-20), Congresswoman Elise Stefanik (NY-21), Congressman Joseph Morelle (NY-25), Congressman Nick Langworthy (NY-23), Congressman Brandon Williams (NY-22), and Congressman Marc Molinaro (NY-19), has introduced bipartisan legislation aimed at protecting benefits and access to care for seniors enrolled in Medicare Advantage plans in Upstate New York.

Last year, the Centers for Medicare and Medicaid Services (CMS) made an adjustment to the wage index for Upstate hospitals, treating geographically rural and rural reclassified hospitals equally. This change resulted in wage index increases of 20-40% across Upstate New York. While this adjustment provided significant relief for hospitals previously underpaid by the fee-for-service program, it inadvertently placed substantial financial pressure on regional Medicare Advantage (MA) plans, which are predominantly non-profit organizations. CMS did not account for these new costs in their benchmark rates for 2024, leading to financial challenges that jeopardize the ability of MA plans to provide affordable, quality coverage to their beneficiaries. Without intervention, health plans may be forced to cut benefits and increase premiums for seniors.

The proposed legislation would address these reductions in access and benefits by granting CMS the ability to adjust their benchmark amounts to account for local areas with wage indices that grew by 20 percent or more. This measure aims to ensure that regional, non-profit MA plans remain viable and safeguard enrollees' benefits and access to quality care.

“Our community's seniors deserve continued access to affordable, high-quality healthcare,” said Congresswoman Tenney. “By adjusting the benchmark rates to reflect the increased costs faced by our regional plans, we can protect our seniors from losing essential coverage and experiencing higher premiums. This bill will ensure that Medicare Advantage plans continue to provide the robust benefits that so many members of our community rely on.”

“Ensuring our seniors have access to the most affordable health plans and are able to maintain their popular Medicare Advantage benefits is one of my top priorities which is why I am proud to co-lead this legislation to address the wage index reclassification,” said Congresswoman Stefanik.

“Many Upstate New Yorkers rely on not-for-profit Medicare Advantage plans,” said Congressman Molinaro. “I’m proud to support Rep. Tenney’s bill to give CMS the authority to ensure seniors have access to the benefits they earned and are fully cared for.”

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