Illustration: Rebecca Zisser/Axios

Today is the final day when seniors and people with disabilities can sign up for Medicare plans for 2019, and consumer groups are concerned the Trump administration is steering people into privately run Medicare Advantage plans while giving short shrift to their limitations.

Between the lines: Medicare Advantage has been growing like gangbusters for years, and has garnered bipartisan support. But the Center for Medicare Advocacy says the Trump administration is tilting the scales by broadcasting information that "is incomplete and continues to promote certain options over others."

The big picture: The government has talked up the benefits of Medicare Advantage plans in emails to prospective enrollees during the past several weeks, the New York Times recently reported. Enrollment is approaching 22 million people, and there are reasons for its popularity.

  • Many MA plans offer $0 premiums and extra perks that don't exist in standard Medicare, like vision and hearing coverage and gym memberships. MA plans also cap enrollees' out-of-pocket expenses.
  • Traditional Medicare, by contrast, has higher out-of-pocket costs that usually require people to buy supplemental medical policies, called Medigap plans, as well as separate drug plans.

Yes, but: Federal marketing materials rarely mention MA's tradeoffs.

  • MA plans limit which doctors and hospitals people can see, and they require prior approval for certain procedures. Provider directories also are loaded with errors.
  • MA plans spend less on care, yet continue to cost taxpayers more than traditional Medicare. Coding is a major problem.
  • People who enroll in MA often can't buy a Medigap plan if they later decide to switch to traditional Medicare. And others, especially retirees leaving their jobs, may not even realize their employers are enrolling them in Medicare Advantage.

Where it stands: The Affordable Care Act slashed payments to MA insurers, but other Obama administration policies bolstered the industry. And now the Trump administration is helping it even more.

  • Obama officials built the chassis for today's bonus system, which has been lucrative for plans (and likely wasteful, according to federal auditors).
  • A bipartisan 2015 law that adjusted Medicare payments to doctors killed the most popular Medigap plans, starting in 2020 — a move experts say could indirectly drive more people to MA.
  • HHS championed MA in a new policy document this week, on the heels of positive marketing.

What we're hearing: Wall Street is beyond bullish on the major MA insurers like UnitedHealth Group and Humana. Supporters of MA like the idea of treating Medicare more like a marketplace, where people have to shop for a plan every year, but experts are worried about how it will affect the average enrollee.

"We know people don't" actively engage in health insurance shopping, said Tricia Neuman, a Medicare expert at the Kaiser Family Foundation who recently wrote about MA. "It's just too hard."

Go deeper:

Go deeper

Updated 11 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 8 p.m. ET: 18,185,015 — Total deaths: 691,303 — Total recoveries — 10,836,439Map.
  2. U.S.: Total confirmed cases as of 8 p.m. ET: 4,711,323 — Total deaths: 155,366 — Total recoveries: 1,513,446 — Total tests: 57,543,852Map.
  3. Politics: White House will require staff to undergo randomized coronavirus testing — Pelosi says Birx "enabled" Trump on misinformation.
  4. Sports: 13 members of St. Louis Cardinals test positive, prompting MLB to cancel Tigers series — Former FDA chief says MLB outbreaks should be warning sign for schools.
  5. 1 🎥 thing: "Tenet" may be the first major film to get a global pandemic release.

In photos: Thousands evacuated as Southern California fire grows

A plane makes a retardant drop on a ridge at the Apple Fire north of Banning in Riverside County, which "doubled in size" Saturday, per KTLA. Robert Gauthier / Los Angeles Times via Getty Images

A massive wildfire that prompted mandatory evacuations in Southern California over the weekend burned 26,450 acres and was 5% contained by Monday afternoon, the California Department of Forestry and Fire Protection said.

The big picture: As California remains an epicenter of the coronavirus pandemic in the U.S., some 15 separate fires are raging across the state. About 7,800 people were under evacuation orders from the Apple Fire, about 75 miles east of Los Angeles, as hundreds of firefighters battled the blaze. CalFire said Monday that a malfunction involving a "diesel-fueled vehicle emitting burning carbon from the exhaust system" started the Apple Fire.

Twitter faces FTC fine of up to $250 million over alleged privacy violations

Photo: Rafael Henrique/SOPA Images/LightRocket

The Federal Trade Commission has accused Twitter of using phone numbers and emails from its users to make targeted ads between 2013 and 2019, Twitter said in an SEC filing published Monday.

Why it matters: Twitter estimates that the FTC's draft complaint, which was sent a few days after its Q2 earnings report, could cost the company between $150 million and $250 million. The complaint is unrelated to the recent Twitter hack involving a bitcoin scam.