Welcome to POLITICO’s West Wing Playbook, your guide to the people and power centers in the Biden administration. With help from Allie Bice. Send tips | Subscribe here| Email Eli | Email Lauren President JOE BIDEN dropped the word “Medicare” 12 times in his State of the Union remarks Tuesday night, and riled Republicans in the process. Indeed, his success in baiting them into responding to — and denying — his claim they want cuts to the program proved to be one of the speech’s most memorable moments, with pundits calling it a political “rope a dope.” But as Biden prepares to travel Thursday to Tampa for an event focused on, you guessed it, Medicare, Republicans aren’t content to cede the entire field to him. GOP lawmakers are trying to refocus attention on the administration’s proposed possible cuts to Medicare Advantage, the privatized alternative to the original Medicare program that now enrolls 30 million seniors, nearly half of all Medicare recipients. During the State of the Union, Sen. STEVE DAINES (R-Mont.) tweeted that Biden, not Republicans, was the one “proposing Medicare Advantage cuts.” Similarly, Rep. BRIAN MAST (R-Fla.) blasted Biden for “a gross political lie. He’s the one who just cut billions from Medicare Advantage.” Rep. KEVIN HERN (R-Okla.) and Sen. TOM COTTON (R-Ark.) had started the attack line on Monday, when both responded to a Biden tweet about Republicans wanting to cut entitlements. Cotton stated it’s the president “who is proposing to cut Medicare Advantage, a program used by almost 4 in 10 Arkansas seniors.” Democrats have seen this movie before. And many dismiss it as part of the annual lobbying blitz by Medicare Advantage providers — one funded by the country’s big healthcare conglomerates — to set more advantageous rates. This year’s effort also happens to offer Republicans a way to go after Biden over another issue: the debt limit. “There’s a sense among Democrats on the Hill that this may be being stirred up for Republican advantage in the debt limit fight,” one Democratic Senate aide told West Wing Playbook. Although Speaker KEVIN MCCARTHY (R-Calif.) insists entitlement cuts are “off the table” as part of a debt ceiling deal, his party is still looking for ways to defuse the White House’s charge that his party will try to cut just that. The calculations from the Centers for Medicare and Medicaid Services, part of the proposal made public last week, show that Medicare Advantage plans will ultimately see a small bump of 1.03 percent – mostly due to a proposed 2.09 percent increase in what the government pays providers for service. But the industry believes that when other factors are included in the final analysis, it will have to swallow what’s effectively a cut. “Auditing plans and recouping funds puts money back in the Medicare trust funds when big insurance companies get caught taking advantage of the Medicare program,” a spokesperson for the Department of Health and Human Services said. “This is about good governance and holding our senior’s health care to the standard they deserve; indications otherwise are incorrect.” The Better Medicare Alliance, bankrolled largely by HMOs that account for a huge chunk of the private Medicare Advantage market, sent a memo to lawmakers Tuesday claiming that the proposed “cuts” would affect 30 million seniors. While actuaries are still crunching the numbers, Medicare Advantage insurers could ultimately see a net cut of around 2.3 percent — a $3 billion hit to the industry — as a result of proposed updates to coding systems used to explain the health condition of enrollees. “We’re continuing to fully analyze the implications of the proposal, but we do see that these are going to lead to massive cuts,” said MARY BETH DONAHUE, the president and CEO of the Better Medicare Alliance. “Medicare Advantage is Medicare. Those are 30 million seniors who will ultimately see higher premiums and a negative impact on their benefits.” Administration officials expressed confidence in their projections and dismissed those claims as cherry-picked numbers by an industry-backed group trying to protect profits. But the industry notes that the 139-page notice outlining changes includes far more than the projected rate increase – and that a net reduction is likely once the final calculations are factored in. Lawmakers are used to this type of campaign. Many of them also send a letter to the administration every year affirming their support for Medicare Advantage, given its popularity in so many states. This year’s notice, sent just last week and signed by a bipartisan group of 57 senators, was spearheaded by Sen. CATHERINE CORTEZ MASTO (D-N.M.). The industry had success in weakening the knees of lawmakers in the run-up to the 2014 midterms, when President BARACK OBAMA reversed proposed cuts to Medicare Advantage in response to pleas from several dozen Democrats worried about their election prospects. Although 15 Democrats signed this year’s letter expressing support for Medicare Advantage broadly, many noted that it was sent the day before the administration released its proposal and should not be read as a reflection of opposition or concern. “If there are changes to the program, they cannot jeopardize Nevadans’ health care access,” Cortez Masto told West Wing Playbook, noting that 50 percent of her state’s senior and disabled population rely on the program. “I’m confident the White House understands this, given their proposal, and look forward to working together to make sure Medicare Advantage can continue to meet patients’ health care needs.” MESSAGE US — Are you CHIQUITA BROOKS-LASURE, the CMMS administrator? We want to hear from you. And we’ll keep you anonymous! Email us at westwingtips@politico.com. Did someone forward this email to you? Subscribe here!
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