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Q: President Obama has repeatedly mentioned reducing “unwarranted” subsidies to private insurance companies under Medicare. Does this mean that the Medicare Advantage plans will disappear or become less common?

PAUL EKLOF, Petaluma

A: While reductions in Medicare Advantage payments are being discussed as part of the health care reform debate, it is too early to know how any such changes, if passed, would affect Medicare beneficiaries. We won’t know the impact of any payment reductions to Medicare plans until Congress agrees on the magnitude, mechanisms and timeline for implementation.

Some proposals currently under consideration could result in increased premiums and/or cost sharing for Medicare beneficiaries. We hope that any changes will be moderate and phased in over time. This balanced approach would help mitigate the adverse financial impact on seniors.

Related proposals in Congress would limit the reduction in payments to plans that demonstrate a higher quality of care. We encourage Congress to move in that direction. Paying high-performing Medicare Advantage plans a quality bonus could reduce the adverse financial impact on seniors in these plans and also encourage all plans to focus even more on improving the quality of care delivered to Medicare beneficiaries, which will benefit seniors enrolled in those plans and the country as a whole.

- Tony Barrueta, vice president, Kaiser Foundation Health Plan & Hospitals

This article appeared on page F – 4 of the San Francisco Chronicle

As the nation wrestles with the complex issue of health care reform, The Chronicle is asking readers to submit their questions so we all can understand what reform means. If you have a question, please e-mail forum@sfchronicle.com.