THIS TIME ON CODE WACK!
How does Medicare Advantage – also known as privatized Medicare – fail seniors … especially seniors of color? Why do many seniors find they actually have no other choice than an Advantage plan? What’s the consequence of that lack of choice? And how do Medicare Advantage insurance plans actually deepen racial and income disparities?
To find out, we spoke with Dr. Belinda McIntosh – an Atlanta-based psychiatrist with more than 20 years of experience, a board member of Physicians for a National Health Program, and co-author of a new PNHP report titled “No Real Choices: How Medicare Advantage Fails Seniors of Color.”
This is the first episode in a two-part series.
Check out the Transcript and Show Notes for more!
And please keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.
SHOW NOTES
WE DISCUSS
Welcome to Code WACK! Tell us about yourself and how you got involved with PNHP and the issue of equity in health care.
“I’m a psychiatrist. I trained at Emory and I’ve lived in Atlanta since I came to do my medical training here. And I work at a very large urban hospital right in the center of the city…. In my day-to-day work, I’m confronting the issues around health equity every single day.
“I was working with, you know, people who have depression and anxiety. They’re young adults trying to adjust to a different kind of life …
“… between the ages of 18 and 25 are sort of the highest risk times for people who are gonna develop a serious and chronic mental health problem. That’s when it tends to occur. And so often if I had a student who got really sick with, let’s say they had symptoms of schizophrenia or severe bipolar disorder, and they had to withdraw from school for the semester, potentially longer, sometimes.
“I realized that the students that were covered under this wonderful comprehensive student health plan that our university offered, suddenly we’re gonna lose access to their healthcare at exactly the moment that they needed it the most. And I would say that that’s when I really became deeply concerned about our healthcare system.”
“I realized, this is the story of our health system. Almost all of our health insurance is tied to employment. And just when people get really sick and can no longer work, they lose access to their benefits.” – Dr. Belinda McIntosh
What do you think is the most important takeaway of your paper, “No Real Choices: How Medicare Advantage Fails Seniors of Color?
“I’d say the big take home message is that diversity and access are not the same as equity. That is what the insurance industry has been trying to tell legislators and the public about why Medicare Advantage is a ‘good’ program. You know, our organization [PNHP] and other folks have blown the whistle on Medicare Advantage programs.
“There are massive amounts of overpayments and, and there are all sorts of fraud and waste going on in Medicare Advantage. And how they’ve been countering that in recent years is saying, ‘But hey, our plans enroll so many seniors of color, we are actually advancing health equity.’
“And it’s simply not true. And this report pushes back on that very sharply by saying, just because you have more people from minority groups signing up for Medicare Advantage now, which is true, Black seniors and other folks of color are signing up for Medicare Advantage over traditional Medicare at a much faster rate than white American seniors are. But the trouble is that they’re mostly ending up with lower quality plans.
“And so just because you have more Black people in the plan doesn’t mean that the plan is more equitable if the plans are not equal. And we see this play out in various ways in terms of access to care, cost related barriers to care and health outcomes.” – Dr. Belinda McIntosh
Tell us about The Gap Trap. What is it and how does it affect seniors, especially seniors of color
“… The Gap Trap is basically related to how traditional Medicare works. So when seniors turn 65 and they get to sign up for Medicare, now they have the option of signing up for Medicare and they have the option of signing up for a Medicare Advantage plan.
“The problem with traditional Medicare is that … traditional Medicare doesn’t have a cap on out-of-pocket expenses and it doesn’t cover supplemental benefits. And so seniors who sign up for traditional Medicare are often also signing up for Medigap, which is another plan, a separate plan called Medicare Part G, which covers a lot of the things that traditional Medicare doesn’t and allows people to have a cap on their out-of-pocket expenses.
“Now, if you have very low income and you can’t afford the premiums of the Medigap plan, you don’t really have a choice to sign up for traditional Medicare. And here come the Medicare Advantage plans advertising their lower premiums and their out-of-pocket maximum to constrain your healthcare costs and their supplemental benefits like dental and vision and hearing. And when you are a fairly healthy 65-year-old and you’re being wooed by a plan that has supplemental benefits and even a gym membership, a lot of people will sign up for these plans.
“And so we call it The Gap Trap because it’s a false choice. People who have lower income aren’t choosing Medicare Advantage over traditional Medicare. They simply can’t afford the premiums of the Medigap plan. ” – Dr. Belinda McIntosh
Helpful Links
Physicians for a National Health Program
No Real Choices: How Medicare Advantage Fails Seniors of Color, PNHP
Understanding Medicare Plan G Supplemental Coverage, HealthLine
Understanding Medigap Underwriting, HealthLine
5 Hidden Disadvantages of Medicare Advantage Plans, Medicare.org
Senate Report Exposes Medicare Advantage Gaming, Medicare Rights Center
Turning 26: Health Insurance Chaos, KFF
Episode Transcript
Read the full episode transcript.
Guest Biography: Belinda McIntosh, MD
Dr. Belinda McIntosh received her medical degree from Emory University School of Medicine and has been in practice for more than 20 years specializing in Psychiatry in Atlanta GA.
Her clinical and research interests are in psychotic disorders and community mental health. In 2021, she shepherded a resolution through the Atlanta City Council in support of Medicare for All.
Dr. McIntosh is a Board member of Physicians for a National Health Program (PNHP). She is a co-author on a 2025 report published by PNHP entitled, “No Real Choices: How Medicare Advantage Fails Seniors of Color.”
Host Biography: Brenda Gazzar
Brenda Gazzar, the host and co-producer of Code WACK!, has produced over 300 weekly podcast episodes topping 400,000 downloads. A skilled interviewer and storyteller, Brenda brings nuance, curiosity, and clarity to every conversation.
Brenda has worked as a multilingual and award-winning reporter with more than two decades experience in California and the Middle East.
Her work has been published by Reuters, Ms. Magazine, USA Today, Los Angeles Daily News, the Orange County Register, The Wrap, The Jerusalem Post, Cairo Times and numerous other publications. She speaks Spanish, Hebrew, and moderate Arabic and is the recipient of national, state and regional awards.
Brenda also enjoys being a life coach, helping people align with their purpose so they feel fulfilled while achieving their boldest dreams.
Brenda’s work is grounded in a belief that systemic change and personal growth go hand in hand — and she’s here for both.
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Keywords:
Medicare Advantage, Medicare for All, privatized Medicare, health equity, seniors health, healthcare disparities, racial disparities in healthcare, seniors of color, healthcare access, healthcare inequality, medical debt, prior authorization, narrow provider networks, Medigap, Medicare Part G, The Gap Trap, healthcare policy, health insurance reform, single payer healthcare, Physicians for a National Health Program, PNHP report, healthcare justice, aging and healthcare, seniors rights, public health, structural racism in healthcare, healthcare costs, Code WACK! podcast
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