Private insurers are padding their pockets with billions in alleged overpayments from Medicare Advantage, and hardworking American seniors are footing the bill through higher Part B premiums, according to a congressional report obtained by the Wall Street Journal.
The report, issued by the bipartisan Joint Economic Committee, shows that controversial practices, such as adding extra diagnoses to trigger larger government reimbursements, drove up Medicare Part B premiums by $13.4 billion in 2025 alone.
That amounts to roughly 10% higher costs, or more than $200 extra annually, for the average senior on a fixed Social Security income. The impact extends beyond enrollees in Medicare Advantage plans. Traditional Medicare beneficiaries are also paying higher premiums to help subsidize the private plans’ gains.
Rep. David Schweikert (R-AZ), who chairs the committee, said in a statement to the Journal, “Extra spending on Medicare Advantage is not just coming out of the federal government’s budget, a portion of this comes out of you.”
Politicians scream at each other over scraps while Medicare Advantage spits out $84B in overpayments in a single year.
That’s almost $1T in misaligned incentives we could fix in one reconciliation bill that pays for real health, not for coding seniors as sicker. pic.twitter.com/aG0RHSf5Bt
— Rep. David Schweikert (@RepDavid) February 16, 2026
The Journal reports:
Medicare Advantage, which has long enjoyed support from Republicans, has faced growing bipartisan scrutiny. Among the biggest players in the business are UnitedHealth Group, Humana and Elevance Health.
Lawmakers and government investigators have been probing how insurers’ billing practices have contributed to Medicare Advantage costs. A congressional watchdog found Medicare Advantage costs the federal government more than traditional Medicare, partly because of insurers’ billing practices. The insurers are paid more to cover enrollees who have more health conditions, and they can boost their reimbursement by recording more diagnoses.
Medicare Part B, which covers doctor visits, lab tests, and outpatient services, had standard premiums around $185 per month in 2025, deducted directly from Social Security checks. Due to these alleged overpayments, however, everyone pays more for the same benefits.
Speaking to the Journal on Friday, Medicare agency administrator Mehmet Oz said that while he doesn’t believe Medicare Advantage insurers are as overpaid as has been reported, he did concede that, “we should change the rules.”
