Joint Economic Committee flags rising insurance broker costs in U.S. Medicare Advantage market

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Medicare Advantage broker costs

Highlights

Joint Economic Committee reports annual broker spending across Medicare Advantage, Part D, and ACA markets now exceeds $25 billion, with Medicare Advantage as the largest segment.
Medicare Advantage insurers spend an average of $234 per member annually on brokers in 2023, surpassing combined expenditures on multiple supplemental benefits and equaling about one-third of total reported supplemental benefit spending.
Higher broker payments correlate with increased overpayments from coding intensity—especially among the 10 largest Medicare Advantage insurers—raising concerns about efficiency and program integrity ahead of the June 24 hearing.

Brief details broker spending growth

As reported by the Joint Economic Committee, the new brief, titled Right Plans or Wrong Incentives? How Broker Payments May Raise Federal Spending, says annual broker spending across Medicare Advantage, Part D, and Affordable Care Act regulated individual, small-group, and large-group markets now exceeds $25 billion, with Medicare Advantage making up the largest share.

The committee says health insurance markets such as Medicare Advantage and the Affordable Care Act are complex, which leads many consumers to depend on brokers when choosing plans. It says that while brokers can support plan selection, insurer-paid commissions may create incentives that do not always align with consumers' interests and may contribute to inefficient plan choices and higher system costs.

Chairman David Schweikert says broker spending is rising sharply in Medicare Advantage and the Affordable Care Act and questions whether that growth is producing meaningful value or simply increasing federal costs. He says current incentives may also be contributing to inflated costs and improper enrollments, creating risks for taxpayers as well as beneficiaries.

Medicare Advantage spending and policy implications

The brief says Medicare Advantage insurers spend an average of $234 per member per year on brokers in 2023. According to the committee, that amount exceeds combined spending on vision, hearing, dental, transportation, fitness benefits, meals, routine foot care, personal emergency response systems, acupuncture, chiropractic care, health education, and smoking-cessation counseling, and equals about one-third of total reported supplemental benefit spending.

The committee also says higher broker spending is associated with higher overpayments from coding intensity, particularly among the 10 largest Medicare Advantage insurers, suggesting scale may influence that relationship. It adds that broker spending in Affordable Care Act marketplace plans rises sharply after 2020 alongside enrollment growth and expanded premium subsidies, prompting questions over whether higher commissions reflect better consumer assistance or subsidized growth in a market with documented program integrity concerns.

Schweikert is also holding a hearing on Wednesday, June 24, titled Protecting Patients and Taxpayers: Combating Healthcare Fraud and Leakage to Strengthen Program Integrity. The hearing is expected to address explicit fraud as well as broader leakage in healthcare programs, including Medicare Advantage overpayments, and the broker payment findings are also expected to be part of the discussion.

In our earlier article on the 2026 National Health Care Fraud Takedown, we covered how federal and state authorities expanded enforcement across dozens of jurisdictions to target alleged schemes involving false claims, opioid abuse, and patient harm. The crackdown included hundreds of defendants, record Medicaid-related charges, and significant asset seizures, underscoring heightened scrutiny of billing practices and broader program integrity across the healthcare system.

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