On the Margins -- Mar 23: Klomp floats automatic Medicare Advantage enro...
On the Margins
Your daily health economics & actuarial brief
Monday, March 23, 2026
What's happening today
| ■ | CMS Medicare chief Chris Klomp floated automatic Medicare Advantage enrollment as a policy option for eligible seniors. |
| ■ | PCMA asked DOL to scrap its PBM transparency rule after Congress passed broader PBM reform legislation. |
| ■ | Alignment Healthcare presented its idiosyncratic take on Medicare Advantage. |
Key Stories
Klomp floats automatic Medicare Advantage enrollment as policy option
STAT reported on March 20 that CMS Medicare director Chris Klomp is considering automatic Medicare Advantage enrollment. The concept mirrors H.R. 3467, a House bill to auto-enroll Part A and B beneficiaries into the lowest-premium MA plan. That bill would start in 2028 and give auto-enrolled beneficiaries a chance to opt out. With just over 35 million already in MA on February 1, 2026, a default switch could route passive enrollment to low-premium carriers and pressure Medigap.
PCMA Wants DOL PBM Rule Scrapped After Congress Passed Reforms
On March 20, PCMA asked the Labor Department to withdraw its January 29 PBM fee-disclosure proposal. The trade group said Congress's February 3 appropriations law already imposed overlapping PBM reforms, making the rule duplicative. DOL had already extended comments to April 15 so stakeholders could address how the proposal should align with the new ERISA amendments. For plan sponsors, the near-term cost lever is administrative: duplicate disclosure regimes raise compliance expense before they change spread pricing or rebate flow.
Alignment Healthcare's idiosyncratic take on Medicare Advantage
Alignment Healthcare's idiosyncratic take on Medicare Advantage.
Significant Digit
MedPAC says higher payments to Medicare Advantage plans now raise Part B premiums even for seniors who stay in traditional Medicare.
MedPAC estimates Part B premiums will be about $11 billion higher in 2026 because Medicare pays MA plans more than it would have spent for similar beneficiaries in fee-for-service Medicare--about $175 per beneficiary for the year, or $14.61 per month. That means traditional Medicare enrollees are helping finance MA extras whether they asked for the arrangement or not. Cute little cross-subsidy.
Other Relevant Headlines
Payer Operations
| Subsidy expiry is driving ACA cost spikes, especially before Medicare age | Fierce Healthcare |
| Moody's: Insurers' 2026 outlook is negative as cost pressures continue to batter industry | Fierce Healthcare |
| Most Medicare Beneficiaries Affected by Plan Terminations in 2025 Have Robust Medicare Advantage Options in 2026 | KFF |
Policy & Regulation
| Maryland fines Cigna $80K, demands halt to automatic downcoding | Becker's Payer |
| CMS final rule aims to axe the fax machine, phase out paper mailing | Fierce Healthcare |
| Democratic senators detail plans to take on Big Insurance | Fierce Healthcare |
Provider Economics
| Provider consolidation slammed in latest House affordability hearing | Healthcare Dive |
| Hospitals' financial performance off to a shaky start in 2026: report | Healthcare Dive |
Pharmacy & Drug Pricing
| Recent Trends in Medicaid Outpatient Prescription Drugs and Spending | KFF |
| Medicare chief says TrumpRx is meant to be narrow in scope | STAT |
ICYMI (Recent Key Stories)
- Providence puts its health plan on the block, or close to it -- Providence is exploring options for its health plan, including a potential sale or similar deal. (2026-03-20)
- NIH tells House appropriators it will spend its full-year budget -- NIH told House appropriators it expects to use its entire budget allocation for the fiscal year. (2026-03-19)
- HIMSS26 spotlights CMS AI navigation push and payer data-trust risk -- At HIMSS26, discussion centered on CMS's AI efforts and concerns over payer data reliability and trust. (2026-03-18)
- CMS targets 2H 2026 rollout of centralized No Surprises IDR Gateway -- CMS plans to launch a centralized portal for No Surprises Act payment disputes in late 2026. (2026-03-17)
- MedPAC pegs Medicare Advantage overpayments at $76B, turning up heat -- MedPAC estimated Medicare Advantage overpayments at $76 billion, intensifying scrutiny of the program. (2026-03-16)