Advocacy & Policy for Professionals
This section of our website provides our latest activity in national and state advocacy and public policy work on behalf of Medicare beneficiaries in California. Do you have a Medicare related coverage or beneficiary care access issue that you believe needs closer scrutiny? Send e-mail to or call 916-231-5110.
Advocacy & Policy Staff
See staff biographies and photos on our Staff page.
Training & Policy Specialist
tel: 831-438-6677 | fax: 831-438-2441
Elaine Wong Eakin, Executive Director
tel: 510-885-1995 I fax: 510-927-2599
- CHA Advocates for Increased Consumer Protections in MA and Part D Plans for 2017
- March 10, 2016 CHA submitted comments on the Advance Notice and Call Letter for CY 2017. These comments include recommendations for: increased beneficiary access to providers, clarity in provider directory publications, and greater education for plan providers on the balance billing prohibition for dual eligibles.
- CHA Advocates for Long Term Care Insurance Rate Increase Protections for Policy Holders
- August 27, 2015 CHA submitted a letter to the Minnesota Department of Commerce that advocates and provides recommendations for clear and meaningful options for consumers when faced with rate increases they can't afford.
- CHA Comments on Medicaid Managed Care Proposed Rule
- Aug 17, 2015 CHA submitted comments on the Centers for Medicare and Medicaid's proposed rule on Medicaid managed Care. Some recommendations include adopting a minimum of 60 choice period for beneficiaries to make a choice in switching from fee-for-service care to managed care, requiring prior testing of notices before sending, and mandating notices include inserts in multiple languages to alert beneficiaries of their right to interpreter services.
- CHA Supports Task Force to Create a Statewide Long-Term Care Program
- July 6, 2015 CHA submits another letter in support of AB 332 to create task force for developing a statewide long-term care program. In the coming years, almost a quarter of California’s population will be comprised of people 60 and older. Planning, providing and paying for long-term care is critical to the social and economic health of all populations.
- CHA Calls for Task Force to Create a Statewide Program to Provide Long Term Care
- Apr 6, 2015 CHA submitted this letter of support for AB 332 which would establish a task force to begin exploring the feasibility of a statewide program to provide and pay for long term care, and subsequently to recommend options to the Governor and the legislature.
- CHA Supports AB 763 to Raise the Aged & Disabled Program Income Level to 138% of the FPL
- Apr 6, 2015 California Health Advocates submitted this letter of support for AB 763, which would raise Medi-Cal's Aged and Disabled program income level of to 138% of the federal poverty level, the same as the income ceiling for MAGI Medi-Cal, California’s adoption of expanded Medicaid provided by the Affordable Care Act.
- CHA Supports SB 426 Requiring Deferred Annuity Death Benefits to be Equal to Annuity Value
- Mar 25, 2015 CHA submitted this letter of support for SB 426 which would require the death benefit of a deferred annuity sold to an individual 65 years of age or older to be at least equal to the annuity value at the time death occurs.
- CHA Calls for Annual Notification to Beneficiaries with "Banked" Long Term Care Benefits
- Mar 25, 2015 CHA submitted this letter of support for SB 575 which would require annual notification of long term care insurance benefits that were "banked" as a result of increased or unaffordable premiums.
- CHA Calls for Limit on Medi-Cal's Estate Recovery
- Mar 19, 2015 California Health Advocates wrote this letter in support of SB 33 to limit Medi-Cal estate recovery to what is federally required. This would help protect the homes and health of some of our state's most vulnerable families.
- CHA Advocates for Making the Part D Exceptions and Appeals Processes More Accessible for Beneficiaries
- Mar 6, 2015 CHA and other advocates submitted this letter to the Centers for Medicare and Medicaid Services in support of making the Part D appeals process more accessible for beneficiaries, including improving the clarity of denial notices and streamlining the appeals process.
- CHA Calls for Government Notifications to Inform People Nearing 65 of Their Medicare Rights and Obligations
- Dec 11, 2014 CHA and other advocates submitted this letter to several government agencies requesting them to inform people nearing 65 of their rights and obligations surrounding Medicare enrollment, including their options to enroll, when they can delay enrollment and consequences of not enrolling (such as life time late enrollment penalties).
- CHA Responds to Proposed Health Plan Innovation Initiatives for Supplemental Insurance
- Nov 3, 2014 A pilot program proposed by the Centers for Medicaid and Medicare Innovation to help Medicare beneficiaries better manage their daily chronic care needs and utilize existing community services and supports could be very beneficial for certain beneficiaries. Yet, this is not an appropriate task for Medigap carriers, as discussed in the submitted comments.
- CHA Supports AB 2025 to Raise the Aged & Disabled Program Income Level to 138% of the FPL
- Mar 18, 2014 Letter submitted by CHA in support of AB 2025 which would raise the Aged & Disabled Medi-Cal program (A&D Program) to 138% of the federal poverty level, creating consistent income eligibility for different Medi-Cal programs and parity for seniors and disabled Medi-Cal beneficiaries.
- CHA Supports AB 1553 to Prohibit Gender-Based Pricing for Long-Term Care Policies
- Feb 20, 2014 CHA submitted this letter in support of bill AB 1553, which would prohibit increased premiums for women buying long-term care insurance based solely on their gender.
- Medicare Eligibility Letters Requested for People Approaching 65 in Individual Qualified Health Plans
- Nov 8, 2013 Concerned that individuals in Qualified Health Plans could unwittingly miss their initial Medicare enrollment period when turning 65 and thus later incur a penalty when enrolling in Medicare, CHA requests that states require health plans to notify an insured of their impending Medicare eligibility prior to their 65th birthday.
- CHA Advocates for Waiving 3-Day Inpatient Hospital Stay Requirement for Skilled Nursing Facility Coverage
- May 17, 2013 These comments address the proposed rule for hospitals to bill Medicare Part B when a claim for an inpatient hospital stay has been denied because it was deemed not medically reasonable and necessary.
- CHA Supports Medi-Cal Expansion and Simplification of Eligibility Rules
- Feb 19, 2013 Letter submitted by CHA.
- CHA Advocates for Important Information Included on All Consumer Notices of Long-Term Care Premium Increases
- Feb 24, 2012 Letter submitted by CHA and other advocates to the National Association of Insurance Commissioners (NAIC) Senior Issues Task Force.
- Congress Proposes Cuts to Medicare and Medigap Coverage
- July 22, 2011 CHA is very concerned that these proposals could shift billions of dollars in out-of-pocket costs to seniors and people with disabilities.
- Medicare Costs and People with Supplemental Coverage
- March 23, 2011 Reviews the NAIC's task of developing nominal cost sharing for Medigap plans C and F effective in 2015 as outlined in federal law. Carefully considers the history of cost sharing in Medigap plans the potential impact such cost sharing may have on Medicare beneficiaries needing necessary medical care.
- CMS’ Notice of Proposed Rule-making with Medicare Advantage and Part D Plan Sponsors
- DECEMBER 8, 2009 Comments submitted by CHA, drafted jointly with various advocacy organizations. Advocates using regulations versus guidelines, having access to all CMS guidance materials, and strengthening beneficiary protections, including marketing and language access provisions.
- Draft Medicare Marketing Guidelines: Comment/Response Form
- June 2009 In general, we are disappointed that CMS has failed to follow the spirit, and in some cases, the letter, of the law in interpreting marketing guidelines and consumer protections found in MIPPA. We urge CMS to conduct a thorough overhaul of these guidelines and strengthen consumer protections and oversight of both plan sponsors and agents/brokers.
- Comments on CMS' Medicare Prescription Drug Benefit Manual
- September 4, 2009 Comments submitted by CHA, drafted jointly with various advocacy organizations. Comments on Chapter 4, covering creditable coverage and late enrollment penalties; and Chapter 18, covering Part D enrollee grievances.
- Comments on CMS' Beneficiary Protections Chapter in Medicare Managed Care Manual
- July 30, 2009 Comments submitted by CHA, drafted jointly with various advocacy organizations. Recommends new and strengthened beneficiary protections for Medicare Managed Care plans.
- CMS' 2010 Call Letter to Medicare Advantage & Part D Plans
- March 6, 2009 Comments submitted by CHA, drafted jointly with various advocacy organizations. Includes recommendations on CMS' guidelines for plan marketing materials, plan benefit requirements, and beneficiary protections.
- CMS' Proposed Rules on New Compensation Limits for Agents Selling Medicare Part C & D Plans
- DECEMBER 15, 2008 Comments submitted by CHA, drafted jointly with various advocacy organizations. Comments reveal how proposed compensation rules encourage agents to focus enrollment efforts on people new to Medicare, or those in Original fee-for-service Medicare. Several recommendations included.
- CMS' proposed regulations concerning various Medicare Advantage and Part D issues (PDF)
- July 15, 2008 COMMENTS submitted by CHA, drafted jointly with various advocacy organizations. Some specifics addressed include: establishing eligibility, enrollment and care coordination in special needs plans (SNPs); eliminating default auto-enrollment into Part D plans of dual eligible individuals with retiree health benefits; making revisions to ensure beneficiaries don't pay inflated prices for prescriptions; clarifying best available evidence (BAE) and other polices related to the low-income subsidy; establishing protections when premiums are not withdrawn from Social Security benefits as requested; and codifying provisions of marketing guidelines.
- CMS' proposed regulations concerning Part D appeals process (PDF)
- May 16, 2008 COMMENTS submitted by CHA, drafted jointly with various advocacy organizations.
- CMS's Medicare Advantage/PDP Enrollment Guidance (Excel)
- May 12, 2008 COMMENTS submitted to CMS by CHA, drafted jointly with other consumer advocacy organizations.
- Response to America's Health Insurance Plans' (AHIP) proposals addressing ongoing marketing abuses with MA product sales (PDF)
- March 12, 2008 LETTER to Senate Finance Committee making specific recommendations, such as: increasing cooperation between state and federal regulators; prohibiting door-to-door marketing; limiting cold calling; having clear plan type designations; and prohibiting plans from offering agents varied commissions and bonuses for sales of different plan types. Submitted jointly by CHA, Center for Medicare Advocacy and Medicare Rights Center.
- CMS' proposed regulations concerning LIS and Reassignment (PDF)
- March 3, 2008
- CMS's 2009 Call Letter to Medicare Advantage and Part D plans (Excel)
- January 30, 2008
- Medicare Advantage/Prescription Drug Plan Enrollment Guidance
- May 2007 COMMENTS
- Continuing Abuses Concerning the Marketing of Medicare Plans
- April 2007
- Involuntary Disenrollments of Sierra Rx Part D Plan Enrollees
- March 2007
- CMS’ Interpretation of Limited Open Enrollment Period (L-OEP)
- February 2007
- Comments on CMS’ Revised Draft PDP Enrollment/Disenrollment Guidance (Dated 6/30/06)
- July 2006
- Updated Summary: Community Living Assistance Services & Supports (CLASS) Act Passed with Health Reform Legislation
- REVISED JULY 29, 2010 The Patient Protection and Affordable Care Act signed into law on March 23, 2010 establishes a national voluntary long-term care insurance program for actively employed individuals and is part of the legislative legacy of Senator Ted Kennedy. Summary outlines the Act's provisions, including its benefits, premiums, and advisory structure.
- The Price is Right: the Selling of Medicare - New Marketing Rules Fail to Cure Problems in the Medicare Marketplace (PDF)
- DECEMBER 31, 2008 This issue brief: 1) reviews the past 2 years of changes in Medicare marketplace regulations; 2) explores unresolved systemic issues that prevent adequate marketing oversight; 3) analyzes selected new marketing rules, including their shortcomings; and 4) provides recommendations to better protect beneficiaries from ongoing marketing abuses.
- Dual Eligibles & Medicare Advantage Plans: Do New Rules Make Them a Better Fit? (PDF)
- December 15, 2008 Part 1 explores the topic of dual eligibles in MA plans in general and whether recent legislative and regulatory changes make MA plans, as a whole, a more viable option for dual eligibles; Part 2 explores these changes as they specifically apply to MA Special Needs Plans (SNPs) for dual eligibles.
- There’s a Hole in the Bucket: New “Gap” Product Being Sold to Fill-in Medicare Advantage Deficiencies
- November 2007 Despite the insurance industry’s and CMS’ insistence that Medicare Advantage plans are a good value for all beneficiaries, significant “gaps” created by the cost-sharing imposed by Medicare Advantage plans have led to the emergence of a new insurance product aimed at “filling” those gaps.
- Informed Choice: The Case for Standardizing and Simplifying Medicare Private Health Plans
- September 2007 People with Medicare would be better able to make informed decisions about their coverage options and be more likely to receive protection against high out-of-pocket spending on health care if Medicare private health plans — so-called Medicare Advantage plans — were limited to finite number of standardized benefit packages.
- The Reluctant Regulator: Centers for Medicare and Medicaid Services’ Response to Marketing Misconduct by Medicare Advantage Plans
- July 2007 An analysis of problems relating to the marketing of private Medicare plans by evaluating the effectiveness of CMS’s response to reports of marketing misconduct, assessing the potential benefits of increased state oversight and enforcement and proposing additional policy recommendations that address the root causes of marketing misconduct.
- After the Goldrush: The Marketing of Medicare Advantage and Part D Plans (PDF)
- January 2007 Regulatory Oversight of Insurance Companies and Agents Inadequate to Protect Medicare Beneficiaries
- October 2006 Fixing the Part D Plan Call Centers Before the Next Enrollment Period Starts on November 15, 2006
- February 2006 Deluged with marketing materials, frustrated by inaccurate and conflicting information, people with Medicare and professionals that counsel them, struggle to find consistent and accurate information for this important choice.
- Consumers Face Inadequate Protections Concerning Medicare Part D Enrollment and/or Disenrollment Problems
- November 2005 This issue brief explores key decisions concerning the drug benefit for consumers and describes how the drug benefit’s complexity and administration through private plans will cause enrollment and disenrollment problems that could leave persons without drug coverage or with inadequate drug coverage and high out-of-pocket expenses.
Legislative and Congressional Testimony
- CHA Testifies on Behalf of Beneficiaries "Trapped in the Gap" at White House Conference on Aging
- September 29, 2014 Elaine Wong Eakin of California Health Advocates provided oral and written testimony at the White House Conference on Aging. She illuminates the challenges many low and middle income beneficiaries “trapped in the gap” face, explains why proposals to increase Medicare cost-sharing on beneficiaries could be harmful, and advocates for innovative and affordable solutions for long-term care services. See written testimony (PDF).
- CHA Testifies on the Need for Long-Term Care Services & Recommends Innovative, Comprehensive Solutions
- August 1, 2013 Bonnie Burns of California Health Advocates provided oral and written testimony to the Commission on Long-Term Care. She speaks to the urgent, growing need of long-term care services, our current broken system of care, the limits of long-term care insurance, and provides several recommendations for creating a new system. Some recommendations include: looking at what's working in other countries; drawing ideas from the deceased CLASS Act and the Federal long-term care insurance program; standardizing each element of LTC insurance policies for ease of comparison; and making personal care a mandatory benefit of each state's Medicaid program. See written testimony (PDF).
- Proposals for Changed Medicare Benefit & Cost-sharing Structures Could Harm Beneficiaries
- June 26, 2013 California Health Advocates, the Center for Medicare Advocacy and the Medicare Rights Center submitted written testimony to the Subcommittee on Health of the U.S. House of Representatives Committee on Energy and Commerce. Their testimony addresses proposed changes to Medicare's benefit and cost-sharing structures. Advocates point out the harm these changes could cause and outline other methods to reduce costs and address systemic rises in health care. See written testimony (PDF).
- Proposed Increased Cost-Sharing in Medicare is a No Win Solution
- May 21, 2013 California Health Advocates, the Center for Medicare Advocacy and the Medicare Rights Center submitted written testimony to the Subcommittee on Health of the U.S. House of Representatives Committee on Ways and Means opposing proposed policies to change Medicare cost-sharing, including increasing the Medicare Part B deductible; introducing home health copayments; and expanding the number of people to pay higher income-related Part B and Part D premiums. Instead, various methods for reducing costs while protecting Medicare's most vulnerable populations are proposed as viable solutions. See written testimony (PDF).
- Medicare Redesign Proposals Pose Significant Risks to Beneficiaries
- FEB 26, 2013 California Health Advocates, the Center for Medicare Advocacy, Inc. and the Medicare Rights Center submitted testimony to the U.S. House Committee on Ways & Means, urging lawmakers to reject Medicare redesign proposals that burden beneficiaries with added health care costs. The joint statement presses policymakers to adopt cost saving proposals that eliminate wasteful spending on pharmaceutical drugs and private plans and to encourage value-driven payment systems. See written testimony (PDF).
- Gambling on Consumer Ignorance: Comprehensive Consumer Protections and Regulatory Scrutiny Are Required to Protect Purchasers of Long-Term Care Insurance Products
- June 3, 2009 Testimony before the Senate Special Committee on Aging. Statement of CHA’s Bonnie Burns addressing the need for greater consumer protections, standardization of policies and marketing practices and regulation of LTC insurance products. Includes specific recommendations. See also the archived hearing and other written testimonies.
- CHA testifies on 1-800 Medicare before Senate Special Committee on Aging
- September 11, 2008 Tatiana Fassieux, CHA Board Chair and HICAP Manager, testifies on 1-800 Medicare performance, complaints, and suggestions for improvement. See also the hearing and other written testimonies. Also view ABC News Good Morning America's video clip, Medicare's Busy Signal.
- Promises Made, Promises Denied: Consumers of Long-Term Care Insurance (LTCI) Experience Denied Claims and Premium Increases
- JULY 24, 2008 Testimony before the House Energy & Commerce Committee, Subcommittee on Oversight and Investigations. Statement of CHA’s Bonnie Burns addressing consumer issues with LTCI, additional needed protections and LTCI product and marketing standards. See also the archived hearing and written testimonies.
- Medicare Advantage Costs, Benefits and Oversight: the Beneficiary Experience
- February 28, 2008 Testimony before the Subcommittee on Health of the House Committee on Ways and Means. Statement of CHA’s David A. Lipschutz.
- Testimony before the NAIC Senior Issues Task Force - Medicare Private Plans Subgroup
- September 2007 Public Hearing on Regulation of Medicare Private Plans. Statement of CHA’s David A. Lipschutz and Bonnie Burns. Recommending greater regulatory oversight by CMS, restoration of state regulatory oversight, and strengthened consumer protections that include standardization and simplification of plans providing coverage of Medicare benefits.
- Predatory Sales Practices in Medicare Advantage
- June 2007 Testimony Before the Subcommittee on Oversight and Investigations of the House Committee on Energy and Commerce. Statement of CHA’s David A. Lipschutz addressing predatory sales practices in Medicare Advantage plans.
- Medicare Advantage Private Fee-for-service Plans: The Beneficiary Perspective
- May 2007 Testimony Before the Subcommittee on Health of the House Committee on Ways and Means. Statement of CHA’s David A. Lipschutz addressing Medicare Advantage plans and abusive marketing practices.
- Joint Informational Hearing: “Medicare Prescription Drug Coverage: Challenges of Implementation and Status of State Assistance Efforts”
- February 2006 Testimony of David Lipschutz, Staff Attorney; and Testimony of Marta Erismann, Community Outreach Coordinator.
Radio interview on "Long-Term Care Insurance"
June 8, 2008: CHA’s Bonnie Burns is interviewed in the 2nd quarter of the program. Download MP3 Podcast (19MB).
Low-Income Health Advocate Alerts On Medicare Part D
Updated August 17, 2015