Alan,

I think the problem with the "no more than 95%" model wasn't just that insurers couldn't make money. It was that insurers' couldn't make money with a plan that seniors actually wanted to join.

The typical MA HMO plan (80% of MA plans) does in fact cost 97% of what Medicare does, if (yes, I know it's a big "if") you take out the rebates and incentives.

By the way, while I don't get into it in the story, I might offer an even more vigorous defense of MA. The bottom line is that it is more expensive than ordinary Medicare. But the way that the standard Medicare program controls costs winds up punishing seniors who are unable to afford even fairly small co-payments and deductibles. That to me seems like bad policy, to a point where I would call it morally callous.

Mark