Medicare bro
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To Whom It May Concern,
As a licensed Medicare agent and independent business owner, I'm writing to express grave concern over a growing and largely overlooked crisis: the rapid erosion of commissions paid to agents for servicing Medicare Advantage (MA) and Part D (PDP) plans.
While commission structures are not guaranteed by regulation, they have long been the foundational mechanism by which millions of seniors have received free, personalized, and ethical guidance in navigating the increasingly complex Medicare system.
What is unfolding now, however, is far more than a change in carrier policy—it is a systemic unraveling that will ripple across agents, consumers, the healthcare system, and the broader U.S. economy.
The Core Issue
In recent months, several of the largest insurance carriers—including UnitedHealthcare, Centene (WellCare), Aetna, Cigna, and Elevance—have moved to cut or eliminate commissions for various Medicare Advantage and Part D products.
This trend is accelerating, with some carriers implementing these cuts mid-year, mid-contract, and with minimal public disclosure.
While their motivation may be to manage rising costs or streamline internal sales, the real impact is on the ground—where thousands of independent agents and small businesses are now facing existential threats.
Who Will Be Affected — and How
Independent Licensed Agents (50,000–70,000+)
FMOs employ tens of thousands in marketing, training, back-office support, and compliance.
Agents are the last human link in an increasingly automated and depersonalized healthcare system. They are not just salespeople. They are educators, advocates, crisis managers, and trusted community members.
Removing or gutting their pay—while outsourcing their role to tech and offshore systems—may save short-term dollars but will cost the system far more in the long run.
What Needs to Happen
We respectfully urge CMS and legislative leaders to:
Please do not let the pursuit of corporate efficiency erase the human heart of Medicare.
The seniors we serve—and the economy we live in—cannot afford that
As a licensed Medicare agent and independent business owner, I'm writing to express grave concern over a growing and largely overlooked crisis: the rapid erosion of commissions paid to agents for servicing Medicare Advantage (MA) and Part D (PDP) plans.
While commission structures are not guaranteed by regulation, they have long been the foundational mechanism by which millions of seniors have received free, personalized, and ethical guidance in navigating the increasingly complex Medicare system.
What is unfolding now, however, is far more than a change in carrier policy—it is a systemic unraveling that will ripple across agents, consumers, the healthcare system, and the broader U.S. economy.
The Core Issue
In recent months, several of the largest insurance carriers—including UnitedHealthcare, Centene (WellCare), Aetna, Cigna, and Elevance—have moved to cut or eliminate commissions for various Medicare Advantage and Part D products.
This trend is accelerating, with some carriers implementing these cuts mid-year, mid-contract, and with minimal public disclosure.
While their motivation may be to manage rising costs or streamline internal sales, the real impact is on the ground—where thousands of independent agents and small businesses are now facing existential threats.
Who Will Be Affected — and How
Independent Licensed Agents (50,000–70,000+)
- Most are self-employed, earning 100% of their income from Medicare commissions.
- These professionals provide unpaid plan research, enrollment assistance, and long-term client support—all funded by those commissions.
- With commissions cut, agents will be forced to leave the industry, leaving seniors with fewer trusted resources.
- The result: unemployment, loss of small businesses, and a deep blow to the backbone of localized Medicare support.
FMOs employ tens of thousands in marketing, training, back-office support, and compliance.
- With no commissions to override, these organizations will collapse or consolidate, eliminating jobs, relationships, and the agent training pipeline.
- Millions of seniors rely on independent agents to explain options, compare plans, and help during life transitions (retirement, diagnosis, relocation, widowhood).
- Removing agents from the equation pushes seniors to:
- Overwhelmed government lines (1-800-MEDICARE)
- Undertrained overseas or AI-driven call centers
- Misaligned plans that increase long-term costs
- Without agents, expect a spike in confusion, misenrollment, medical debt, and even underutilization of covered services.
- Agents live and work in local communities. When their income disappears, it affects:
- Local tax revenue
- Real estate and housing demand
- Church and charitable giving
- Small business support and vendor networks
- This is especially acute in rural areas, where agents are often the only in-person Medicare resource.
- Public sector strain: If independent agents are removed, seniors will overwhelm government resources.
- Healthcare costs will rise: Seniors improperly matched with plans (or uninsured entirely) cost more in ER visits and uncoordinated care.
- Carrier accountability will diminish: With fewer independent advisors, plan choice becomes carrier-dominated—reducing transparency and consumer empowerment.
- Data centralization and predatory practices may rise as direct-to-consumer models grow with little human oversight.
Agents are the last human link in an increasingly automated and depersonalized healthcare system. They are not just salespeople. They are educators, advocates, crisis managers, and trusted community members.
Removing or gutting their pay—while outsourcing their role to tech and offshore systems—may save short-term dollars but will cost the system far more in the long run.
What Needs to HappenWe respectfully urge CMS and legislative leaders to:
- Mandate baseline compensation for Medicare Advantage and PDP enrollments to protect consumer access to licensed assistance.
- Limit carrier ability to eliminate commissions on essential plans while still marketing them to the public.
- Launch a full impact study on how commission cuts affect seniors, agents, and Medicare system costs.
- Include licensed agent representation in future CMS policy and marketing rule changes.
Please do not let the pursuit of corporate efficiency erase the human heart of Medicare.
The seniors we serve—and the economy we live in—cannot afford that
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