Compendium of Policy Proposals for Medicare Advantage and Part D

Background

Private plans are an integral part of Medicare. In 2024, out of nearly 68 million Medicare beneficiaries, about half (34 million) are enrolled in Medicare Advantage (MA) plans and another 23 million are enrolled in stand-alone Part D drug plans.^[1] In 2022, nearly three-fifths of total Medicare spending was paid to private plans though the MA and Part D programs.^[2] With so many beneficiaries relying on private plans and such a large share of Medicare resources at stake, it is vitally important to ensure that these programs deliver affordable, quality care to enrollees and do so in a way that is financially sustainable for taxpayers.

This website is designed to provide illustrative examples of the range of policy options for the MA and Part D programs. The compendium is current as of October 2024. The compendium is not designed to be an exhaustive list, but it will be revised quarterly to add, remove, and update policy proposals as more information becomes available.

Inclusion and Exclusion Criteria

Numerous individuals and organizations have put forth policy proposals that would make changes to Medicare Advantage or Part D. For purposes of this compendium, proposals are included if they met various criteria. Proposals are included if:

• They are put forth by sources such as Members of Congress, congressional support agencies, executive branch agencies, think tanks, health policy academics, and advocacy groups.
• They were published generally within the past five years, although some earlier proposals are included if they are standing recommendations of government agencies such as the Medicare Payment Advisory Commission or a budget option of the Congressional Budget Office.
• They are laid out with sufficient specificity that their effects on beneficiaries or Medicare program spending have been or could be estimated. The ability to estimate costs or impacts may require a proposal’s authors to specify some additional parameters, but the core elements should be clear in the proposal.
• In the view of each proposal’s authors, the policy proposal is designed to make program changes that should help Medicare beneficiaries, improve Medicare data collection, foster transparency to inform beneficiary decision making, or generate savings to the Medicare program and taxpayers.

A small number of proposals were excluded because they were already in the process of being carried out through executive branch rulemaking, called only for stronger enforcement of existing policies, or were very narrow in scope rather than reflecting broader policy concerns.

Disclaimer

Inclusion of a policy proposal in this compendium does not imply support or opposition by Georgetown University’s Medicare Policy Initiative (MPI) or the Commonwealth Fund and Arnold Ventures as the sponsors of this project.