Ranking member of the Senate Finance Committee Senator Ron Wyden (D-OR), released “Pushing Medicare Advantage on Seniors: Unraveling the Complex Network of Marketing Middlemen,” a 40-page investigation into Medicare Advantage (MA) marketing practices, with a focus on the behaviors of MA plan middleman called third-party marketing organizations (TPMOs).

The report highlights that commissions for these middlemen (a.k.a. agents and brokers) have nearly tripled over seven years and that these commissions drive which MA plans these middlemen offer to an older adult.

Commissions–or the halting of commissions–also curb enrollment into certain plans.

During the MA open enrollment period for the 2025 plan year, there were several news reports of MA plans ceasing to pay commissions to slow or stop enrollments into certain plans. Plans were concerned about their profit margins which were narrowing and didn’t want to grow their enrollment further. In these cases, these middlemen often stop offering those plans as options to beneficiaries because they won’t get paid. In other words, it isn’t the fact that brokers/agents are paid commissions but instead that plans use these commissions to influence beneficiary enrollment into certain plans not giving them information on all their options.

Sen. Wyden’s report includes several recommendations for how to correct current practices and ensure beneficiaries are provided with complete information about the MA options that are best for their circumstances.  One of those recommendations underscores the importance of funding unbiased sources of information, such as State Health Insurance Assistance Programs (SHIPs), for which LeadingAge has also advocated.