Uncertainties of design and implementation make it impossible to predict whether beneficiaries will enjoy they level of freedom of choice of doctor that they now have under traditional Medicare. It is possible that traditional Medicare will be out of reach for many beneficiaries. The plan calls for choice for low-income consumers, but there are many uncertainties about how this will translate into choice of provider and choice of plan for beneficiaries. Does not expand Medicare coverage to anyone under age 65. Does not modernize Medicare coverage to include prescription drugs or a framework for long-term care.
Administrative costs associated with sufficient risk adjustment are likely to be very high.
Does not necessarily save Medicare money, while turning over control to the private sector. Fails to establish a standard benefit package needed for fair marketplace competition. Raises the possibility of serious erosion in Medicare benefits for beneficiaries who might choose a plan with skimpy benefits because they simply can not afford the higher cost plans.