Medicare Advantage ‘Dark Money’ Group Attempts To Win Higher Payments for Insurance Companies

Judging by more than 16,400 comments recently posted on a federal government website, you’d think there’s a wave of older Americans demanding that federal officials increase payments for their Medicare Advantage health insurance plans.

Yet about 82 percent of the comments are identical to a letter that appeared on the website of a secretive advocacy group called Medicare Advantage Majority, according to a KFF Health News analysis of the data.

The “dark money” group doesn’t reveal its backers or much else — other than to say that it is “dedicated to protecting and strengthening Medicare Advantage” and is “supported by hundreds of thousands of grassroots advocates across the country.”

“Our campaign provides information and offers tools that concerned Americans can use to reach decision-makers,” spokesman Darren Grubb said in an email. The group has spent more than $3.1 million on hundreds of Facebook ads since September 2024, according to the Facebook Ad Library, a database of the social media company’s online ads.

There’s no doubt that health insurers are unhappy with a January proposal from the Centers for Medicare & Medicaid Services, or CMS, to keep Medicare Advantage reimbursement rates essentially flat in 2027 — far less than they expected from the Trump administration.

Medicare Advantage plans differ from traditional Medicare because private insurance companies administer them. Insurance plans have about 35 million members, or more than half of those eligible for Medicare. The plans offer things like vision and drug coverage, but Medicare Advantage insurers limit which hospitals and doctors patients can use and require pre-approval for various procedures.

CMS is expected to announce a final decision early next month on the rate proposal. The agency solicited public comment on the proposal from Jan. 26 to Feb. 25 to give interested parties and the public an opportunity to express their views.

Medicare Advantage Majority, which says the rate proposal amounts to a “cutback” in services and warns of dire consequences for seniors if it passes, accounted for at least 13,522 of the 16,422 comments posted as of March 12.

The proposed pricing plan “endangers my access to care,” the group’s model letter to policymakers reads in part. “If Washington’s investment in Medicare Advantage remains virtually flat year over year, I could lose the benefits I rely on every day, including affordable prescriptions, capped out-of-pocket costs, and access to trusted doctors and specialists.

“Medicare Advantage is not optional for me. The cost protections alone have saved me thousands of dollars and made my health care manageable. Without this program, I would face higher costs, fewer providers, and fewer benefits at a time when I can least afford them,” the letter states.

Critics warn that these types of campaigns can create a misleading impression of popular support, particularly when it is unclear who is funding them.

“It puts a different spin on a massive wave of comments to know that all of them are led by a specific organization,” said Michael Beckel, director of money in politics reform for Issue One, a group that seeks to limit the influence of money on government policy and legislation.

“There is no way for the public to know which wealthy donors or special interests are funding dark money groups like this,” he said. “This means there is no control over who actually takes the lead.”

Some health care policy experts, who have long argued that the government overpays Medicare Advantage plans by tens of billions of dollars each year, believe that industry groups or their surrogates routinely overestimate the possible negative impacts of pricing decisions they don’t like.

“The plans always say the sky is falling,” said Matthew Fiedler, a health policy expert at the Brookings Institution. “The industry has a lot of money at stake. They’re trying to put pressure on policymakers any way they can.”

At the same time, even critics admit that some of the millions of people enrolled in Medicare Advantage plans could face cuts in services if insurance companies aren’t satisfied with government payments.

“It’s legitimate for people to be concerned,” said Julie Carter, a federal policy adviser at the Medicare Rights Center, a group that advocates on behalf of seniors and people with disabilities.

His group claims that Medicare Advantage plans have never achieved expected savings and have instead been overpaid for years, at least in part because of “profit-maximizing actions.” She said health plans “are supposed to save money, not take more.”

People struggling to pay their health care bills may have little use for the political debate in Washington.

“Without this program, I really couldn’t afford medical services, to be honest,” said EsterAlicia Rose, 75, who works at the front desk of a hotel in Pagosa Springs, Colorado. She said she signed the Medicare Advantage Majority form letter to reach policymakers.

So did Kathy Lovely-Marshall, 66, a retired nurse who lives in Brookville, Ohio. She said she receives “many benefits” from her plan, such as dental care, glasses and prescriptions.

“All of those things are a big plus as far as I’m concerned,” she said. “I’m very happy with the plan I have.”

But Corenia Branham, 90, a widow and cancer survivor who lives in Alum Creek, West Virginia, said she wants nothing to do with Medicare Advantage plans run by private health insurance companies. She said she did not deliver any of the four form letters under her name, which were posted online by CMS on Feb. 23 and signed “Miss Corenia Branham Branham.” It is unclear why his last name is signed twice.

Branham said she doesn’t have Medicare Advantage and doubts she can rely on it for needed care.

“I wouldn’t recommend it to anyone,” she said. “I certainly don’t want anything to do with it.”

Grubb, the Medicare Advantage Majority spokesman, disputed that narrative. He said Branham responded to an ad on Facebook. On Feb. 6, she “completed the form with her information and chose to send her comments to CMS as well as her representatives in Congress and the White House,” he said.

Other Medicare Advantage advocacy groups have ramped up their advertising campaigns as the rate decision looms.

The Better Medicare Alliance, whose “allies” include a range of health insurers, health care providers and consumers, is urging seniors to “tell Washington to stand up for Medicare benefits.”

“We mobilized beneficiaries to write letters and make phone calls, and we ran digital ads on streaming platforms,” said spokesperson Susan Reilly.

Reilly said that this year, about 3 million seniors “were forced to find new coverage” because plans either halted operations or moved out of certain areas.

She also said Medicare Advantage plans have “cut back” benefits such as providing transportation to medical appointments, nutritional support, and dental and vision coverage, while over the past two years beneficiaries have faced an average $900 increase in maximum out-of-pocket amounts.

“We view this as particularly serious,” Reilly said. “It’s not just one bad year; it’s the cumulative effect of years of underfunding and political disruption by the previous administration that has left the program increasingly vulnerable.”

As of March 12, CMS said it had received 46,884 comments but had only posted 16,422 online.

CMS spokeswoman Catherine Howden said the agency would make more comments public “as soon as possible.”

“The agency is focused on reviewing the content of submissions in a timely manner and does not speculate on the volume, sentiment, or potential impact of comments while the comment period is open/under review,” it said in a statement.