Jason Lopez, President of the Austin AFL-CIO Labor Council, reports that on November 16, 2022, the council unanimously adopted a resolution calling for the protection of Traditional Medicare by stopping and dismantling ACO REACH. The resolution was drafted by Chris Cruz, a delegate from the Texas Alliance for Retired Americans (TARA).
ACO REACH is the new name for the pilot program, Direct Contracting Entities (DCEs), that was established by the Trump Administration. The Biden Administration renamed the program ACO REACH, but ACO REACH keeps the harmful features of the DCEs.
Both DCEs and ACO REACH place private equity, venture capital, and insurance companies as middlemen into Traditional Medicare, allowing those companies to manage the care of seniors while keeping up to 40% of the Medicare money as overhead and profit.
Under both the DCEs and ACO REACH, seniors who chose Traditional Medicare can be placed, without their consent, into these for-profit plans. Such plans provide an incentive to deny care since unused funds are kept by the private company. Both DCEs and ACO REACH threaten the Medicare Trust Fund as private companies are placed between seniors and their care.
The DCE program will be replaced by ACO REACH beginning in January 2023.
Further information on the campaign to end ACO REACH can be found at National Single Payer, Puget Sound Advocates for Retirement Action, Physicians for a National Health Program, and Protect Medicare.
Other union resolutions on ACO REACH are here:
The Austin AFL-CIO Labor Council resolution is below. Please send a copy of resolutions passed to nursenpo@aol.com.
Distributed by:
Kay Tillow, Coordinator
All Unions Committee for Single Payer Health Care
P. O. Box 17595
Louisville, KY 40217
(502) 636 1551
Email: nursenpo@aol.com
http://unionsforsinglepayer.org
https://www.facebook.com/unionsforsinglepayer
11/20/2022
_________________
Resolution to Stop a New Medicare Program supported by the Trump
Administration called Medicare ACO-REACH
WHEREAS when seniors and retirees become eligible to apply for Medicare, the majority of
them choose Traditional Medicare (the original program where Medicare pays the participating
doctor directly) versus the Medicare Advantage Program, a “third party for-profit middleman
insurance company” that is paid monthly by Medicare to manage patient’s care and authorizes
payment to the patient’s doctor; and
WHEREAS the former Trump administration supported a new pilot Medicare program that
was created by a separate section of CMS called CMMSI (Center for Medicare & Medicaid Services Innovation), and the new Medicare program which is named ACO-REACH (Accountable Care Organization-Realizing Equity, Access, and Community Health) claims to be a new Medicare value-based payment demonstration model, but it is actually a “third party for-profit insurance company” program that will rapidly drain away the Medicare Trust; and
WHEREAS this new program is set to be launched on January 1, 2023, with no current
Congressional oversight; and
WHEREAS according to Physicians for a National Health Program, ACO-REACH allows
doctors and their offices to convert a patients’ Traditional Medicare choice into ACO-REACH
coverage without first informing their patients about the change nor getting their patients’ written
permission; and
WHEREAS Doctors and their offices will have a financial incentive to convert to ACO-
REACH coverage as they will also be allowed to keep up to 40% of their revenue that they don’t
spend on healthcare services as overhead resulting in a “windfall profit” versus Traditional Medicare Programs that are only allowed to keep the balance of 2% of their revenue after paying for overhead; and
WHEREAS Doctors and their offices will have an additional financial incentive as ACO-
REACH will pay money to treat their patients with more complicated diagnoses by allowing doctors to “up code” additional diagnoses. Up-coding is a practice that has led to fraud by exaggerating or including related, but unnecessary, diagnoses, leading to higher costs; and
WHEREAS if the Biden/Harris Administration does not STOP the deployment of Medicare
ACO-REACH by HHS/CMS now, it potentially could make things worse since the Congressional Budget Office has already projected the insolvency of the Medicare Hospital Trust in 2026 that could affect 52.6 million seniors whose care is provided by the Trust, NOW
THEREFORE
BE IT RESOLVED that Austin AFL-CIO Central Labor Council opposes CMMSI’s
Medicare ACO-REACH Program and asks the Biden/Harris Administration to immediately STOP and dismantle the ACO-REACH Program, and instead, immediately protect and preserve Traditional Medicare plus adding coverage for Hearing, Vision and Dental Care.