Industry associations blast MedPAC view of Medicare agents

Two professional associations representing health agents and brokers have come out against the Medicare Payment Advisory Commission’s view of those who enroll consumers in coverage.

After its 2025 Public Meeting held earlier this month, MedPAC released a report claiming that health agents receive financial incentives to steer enrollees toward Medicare Advantage plans instead of traditional Medicare and Medigap coverage. MedPAC also cited a 2022 Commonwealth Fund survey showing that 1 in 3 Medicare beneficiaries used an agent or a broker to choose a plan, regardless of which type of coverage was selected.

“MedPAC commissioners showed their limited understanding of the Medicare Annual Enrollment Process and disparaged the role of agents and brokers,” said Jessica Brooks-Woods, CEO of the National Association of Benefits and Insurance Professionals, in a statement.

"Medicare is complicated, and beneficiaries need expert guidance to find coverage that meets their unique needs," said NABIP CEO Jessica Brooks-Woods. "Licensed independent agents have dedicated their careers to helping seniors navigate their options, ensuring they fully understand their benefits and make informed choices about their healthcare coverage."

Agents relied upon in light of 'looming' cuts

“Despite MedPAC’s flawed assertions, more than 30% of the 61.2 million Medicare beneficiaries rely on independent agents to guide them through their coverage options and advocate on their behalf,” added Brooks-Woods. “MedPAC commissioners seem to assume that seniors would be comfortable navigating complex healthcare decisions through a 1-800 number from their health plan or a government agency. However, with significant budget cuts looming at HHS and CMS, staffing shortages will likely make it even harder for beneficiaries to get timely assistance. At the same time, limited funding for grants means undertrained volunteer groups will be unable to fill the gap, leaving seniors with fewer resources and greater confusion.

"Independent agents are not beholden to shareholders or government grants. We are committed to protecting seniors from misinformation and ensuring they have access to unbiased, expert guidance. We welcome the opportunity to work with MedPAC on real solutions that protect the beneficiary and eliminate predatory marketing and confusing regulatory processes."

Key issues

NABIP said MedPAC failed to recognize several key issues, including:

• Strict agent disclosures – Agents are required by the Centers for Medicare and Medicaid Services to provide disclaimers clearly explaining the number of plans they represent, ensuring transparency in the sales process.

• Affordability drives enrollment choices – Many beneficiaries simply cannot afford Medigap due to rising costs, not because agents push them toward Medicare Advantage for commissions.

• Part D instability – Potential changes to the premium stabilization program could cause drastic rate hikes, making it even harder for seniors to afford non-MA options.

• Deceptive marketing – Third-party marketing organizations mislead seniors with ads promising extravagant benefits such as $2,800 flex cards, leading them to make misinformed plan choices. Licensed independent agents and brokers are not the same as TPMOs.

• Bad actors must be addressed – NABIP and its members fully support efforts to eliminate deceptive marketing practices and will meet with policymakers to implement real solutions.
• Medigap and MA marketing are regulated differently – The rules governing Medigap and MA marketing are not the same. Treating them as if they are comparable is misleading and inaccurate.

HAFA: MedPAC’s perspective harms older Americans

Health Agents for America president and CEO Ronnell Nolan issued a similar statement blasting MedPAC’s view of agents and brokers.

“MedPAC’s recommendations fail to recognize the critical role agents play in assisting Medicare beneficiaries, and their stance threatens to undermine consumer choice, access to expert guidance, and the very structure of Medicare enrollment,” Nolan said in a statement.

HAFA said MedPAC’s perspective on agents and brokers harms older Americans in the following ways:

• Unfounded claims of bias – MedPAC falsely assumes that agents and brokers act against consumers' best interests due to compensation structures. In reality, licensed professionals are bound by strict regulations and always prioritize their clients’ needs.
• Ignoring CMS’s failures – Instead of addressing systemic fraud and oversight failures within the Centers for Medicare and Medicaid Services, MedPAC has chosen to scapegoat agents who are on the frontlines assisting seniors.
• Driving seniors to call centers and government bureaucracy – By undermining the role of agents and brokers, MedPAC is pushing seniors toward confusing, impersonal systems that fail to provide the same level of care and attention.

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Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].