National Policy Institute Releases Report on the Value of Medicare Advantage Employer Group Waiver Plans Within Public Sector

WASHINGTON, May 9, 2024 /PRNewswire/ -- As Employer Group Waiver Plans (EGWPs) become an increasingly popular choice among employers providing health care coverage to their retirees through Medicare Advantage (MA), the National Institute for Public Employee Health Care Policy (the Institute) today released a report underscoring the significant role MA-EGWPs play in retiree benefits for public sector purchasers, including those who provide health coverage to teachers, firefighters, and law enforcement.

Over half of all eligible Medicare beneficiaries are now enrolled in Medicare Advantage, and between 2018 and 2022, total MA-EGWP enrollment increased by nearly 27%, from 4.1 to 5.2 million.ⁱ  As health care costs continue to climb, public sector purchasers increasingly turn to MA-EGWPs to maintain or enhance coverage for beneficiaries while reducing immediate costs and long-term liabilities.

Marta Green, Executive Director and Former Chief of Health Plan Research and Administration at the California Public Employees' Retirement System said, "MA-EGWPs provide employers with a coverage tool that delivers lower costs, flexible benefits, and protects retiree health and financial security. As policymakers continue to refine plans to address the long-term affordability and funding of Medicare, there is a pressing need for further research to comprehend the current role of MA-EGWPs and the potential ramifications of proposed policy changes."

The report explores the various benefits and adaptability of MA-EGWPs, including robust coverage and supplemental benefits for seniors, greater payment stability for plan sponsors, and advancements in health equity and social risk factors. While this foundational paper provides a comprehensive overview of the Medicare Advantage and EGWP landscape, the anticipated follow-on report from the Institute will delve further into EGWPs within the public sector, highlighting member experiences with their EGWPs and the impact on beneficiaries. 

National Institute for Public Employee Health Care Policy

The National Institute for Public Employee Health Care Policy (the Institute) is a non-profit, nonpartisan, national policy institute focused on public policy areas impacting health care plans available to public sector employees, retirees, and their beneficiaries. The Institute conducts research, develops authored papers and issue briefs, and hosts events to raise awareness and educate the Washington, D.C. policy community. Visit our website at healthcarepolicy-institute.org/.

ⁱ Analysis using enrollment data released by the Centers for Medicare & Medicaid Services. The analysis uses enrollment files released in February of each year, from 2018 through 2022, reflecting enrollment effective in January of each respective year.

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SOURCE National Institute for Public Employee Health Care Policy