Press Releases
July 24, 2018


Washington, DC – Better Medicare Alliance (BMA), the leading advocacy coalition for Medicare Advantage sent a letter signed by 13 ally organizations to members of Congress in support of bipartisan legislation to advance the process to remedy the problem of the so-called “benchmark cap” in Medicare Advantage.

In Medicare Advantage, the Star Ratings System rewards high-quality plans with a 4-Star rating or higher (on a 5-Star scale) with a bonus payment that must directly benefit beneficiaries by reducing beneficiary cost sharing or adding benefits such as dental or vision coverage. However, the benchmark cap policy prevents 4-Star or higher plans in certain counties from receiving the bonus payment they have earned. Millions of beneficiaries in these counties are denied supplemental benefits enabled by the quality incentives.

The letter acknowledged Congressmen Mike Kelly (R-PA) and Ron Kind (D-WI) for cosponsoring the Improving Seniors Access to Quality Benefits Act (HR 4952) that would direct the Secretary of Health and Human Services to conduct a study on the benchmark cap issue and submit a report to Congress.

“Failing to address the benchmark cap issue impacts over 5.8 million Medicare Advantage beneficiaries who are unfairly penalized and do not receive the additional benefits as enrollees in a high-quality Medicare Advantage plan in capped counties across the country. Lifting the benchmark cap would ensure that beneficiaries receive the additional benefits in the value-driven, high-quality care in Medicare Advantage,” said Allyson Y. Schwartz, BMA President and CEO.

Lifting the benchmark cap on Medicare Advantage is an important goal for BMA. Last year, BMA mobilized allies to send letters to CMS leadership and state delegations on the issue of the benchmark cap. Through BMA’s online advocacy portal, senior advocates wrote letters, made phone calls, and utilized social media platforms to urge policymakers to ensure access to the full value of high-quality Medicare Advantage plans.

Visit BMA’s Lift the Cap campaign page here to learn more and read real patient stories on the impact of the benchmark cap and the value of Medicare Advantage.


U.S. House of Representatives is expected to vote on HR 4952 in today’s evening votes.


  • AMGA
  • American Telemedicine Association
  • Association for Behavioral Health and Wellness
  • Better Medicare Alliance
  • Consumer Action
  • Council for Affordable Health Coverage
  • Healthcare Leadership Council
  • Meals on Wheels America
  • National Association of Nutrition and Aging Services Programs (NANASP)
  • National Coalition on Health Care
  • National Hispanic Council on Aging
  • National Minority Quality Forum
  • SNP Alliance


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