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"If Oz is confirmed as the CMS administrator, attacks on traditional Medicare are likely to move into overdrive," said one advocate, calling to strengthen the program, "not weaken it through further privatization."
The watchdog group Public Citizen on Tuesday released a research brief about the hundreds of millions of dollars Medicare Advantage companies have spent on lobbying ahead of a U.S. Senate confirmation hearing for Dr. Mehmet Oz.
Oz, a heart surgeon and former television host, is President Donald Trump's nominee to run the Centers for Medicare and Medicaid (CMS)—an agency in the U.S. Department of Health and Human Services, which is led by conspiracy theorist Robert F. Kennedy Jr.
Health experts and others have sounded the alarm about Oz since Trump announceded his nomination in November, with many opponents highlighting the doctor's investments in companies with direct CMS interests and his push to expand Medicare Advantage when he unsuccessfully ran as a Republican to represent Pennsylvania in the U.S. Senate in 2022.
Medicare Advantage is a type of CMS-approved health insurance plan from a private company that seniors can choose for medical coverage instead of government-administered Medicare. Critics often call it a "profit-seeking healthcare scam."
Public Citizen's brief points out that last year, "more than half of all seniors eligible for Medicare were enrolled" in these private plans that "cost taxpayers hundreds of billions of dollars and deliver inferior care compared to traditional Medicare."
"Since their inception in 2003, Medicare Advantage plans are estimated to have cost taxpayers more than $600 billion in overpayments," the document notes. "These overpayments are expected to grow to $1 trillion over the next decade."
"Just seven companies account for 84% of all Medicare Advantage enrollment," the brief continues. "While lobbying disclosures do not reveal how much is spent on a single issue, disclosures reveal that these seven companies spent more than $330 million combined lobbying on all issues over the last five years, according to data from OpenSecrets."
Those companies are UnitedHealthcare, Humana, Blue Cross Blue Shield, CVS Health, Kaiser, Centene, and Cigna.
Public Citizen found that in 2024, they collectively had 328 lobbyists targeting the federal government, with nearly 70% of them specifically working on Medicare Advantage. Blue Cross had the most lobbyists focused on such plans (99), followed by Humana (33) and UnitedHealth Group (27).
"If Oz is confirmed as the CMS administrator, attacks on traditional Medicare are likely to move into overdrive," Eagan Kemp, a healthcare policy advocate at Public Citizen, warned in a Tuesday statement. "We should strengthen Medicare by improving it and expanding access to it, not weaken it through further privatization."
The Senate Committee on Finance is set to consider Oz on Friday morning. Since Trump returned to the White House in January, the GOP-controlled chamber hasn't blocked any of his nominees.
"I'm tired of insurance companies putting profit over people," said one activist at a Chicago rally.
Pushing back against insurers' annual denial of nearly a quarter-billion healthcare claims or pre-authorization requests, activists rallied in more than a dozen U.S. cities on Wednesday to demand "an end to private health insurance industry greed so people can get the care they need when they need it."
The Care Over Cost Campaign—a national grassroots initiative launched by the advocacy group People's Action—held rallies in cities including Baltimore, Maryland; Chicago, Illinois; Denver, Colorado; Detroit Michigan; Portland, Maine; and Hartford, Connecticut, known as the "insurance capital of the world." The campaign called on the industry lobby group America's Health Insurance Plans (AHIP) to "direct its members to put people over profit."
Activists implored AHIP and private health insurance corporations including Blue Cross Blue Shield (BCBS), UnitedHealthcare, Cigna, Humana, and Aetna "focus on ending the epidemic of care denials."
"CEOs at private health insurance companies profit off our pain and deny our healthcare. That's why people are rising up across the country to expose the lie that private health insurers are there for us when we need them," People's Action Healthcare for All campaign director Aija Nemer-Aanerud said in a statement.
"We all deserve the care we need when we need it, and it's time for greedy corporations like BCBS, Aetna, Cigna, and UnitedHealthcare to pay up and stop denying care," Nemer-Aanerud added.
According to Care Over Cost, private insurers deny more than 248 million claims and pre-authorization requests each year.
The campaign's demands include "sharing claims denial data, holding public meetings, ceasing lobbying, and working with policymakers and public authorities to transform the system to people over profit."
In Chicago, activists from groups including the People's Lobby, ONE Northside, and Jane Addams Senior Caucus held a "die-in" demonstration outside the downtown office of BlueCross BlueShield in support of what the organizers said are "the 700,000 Americans whose lives are impacted or lost due to lack of access to medical care from denied medical claims each day."
Activist Michael Grice, who lives with a disability, told rally attendees that "it took me over four years to get the wheelchair I'm sitting in now."
"I'm tired of insurance companies putting profit over people," Grice said. "They always do it for people with disabilities and senior citizens. I'm fed up with this garbage."
Illinois state Sen. Mike Simmons (D-7) addressed the Chicago rally, asserting that "it's not too much to ask in a developed democracy that people live long, healthy, prosperous lives."
"Those 700,00 denied claims—that's someone who needs insulin, someone who has an untreated liver condition," Simmons said. "That's somebody's aunt, somebody's mom."
Hartford rally attendee Kristen Whitney Daniels toldCT Insider: "This is an untenable situation. And it's only getting worse and worse every year, getting less and less covered."
"The frustrations are gonna boil over eventually," she added. "And [insurers] can either be part of the solution and working with patients to find ways to help patients have health, or they can be a part of the problem."
Responding to the protests, Alex Kepnes, executive director of communications for Aetna, toldCT Insider that the company wants to be "part of the solution."
"We believe that every American should have access to affordable, high-quality health coverage," Kepnes said. "The basic premise of making healthcare more affordable and simpler is at the core of CVS Health's transformation."
CVH Health, which owns Aetna, reported revenue of over $300 billion last year, with profits topping $4 billion—even as the company plans to lay off 500 Connecticut employees.
Daniels, who has Type 1 diabetes and other healthcare needs, said her insurance company, UnitedHealth, is part of the problem, making it extremely difficult to get the insulin she needs. She also said the company stopped covering one medication she needs a year after it was approved for coverage.
"I am tired of insurance companies getting rich off treating patients and disabled folks, like myself, as if we are expendable."
"The problem is this medication has worked so well for the last two years," Daniels said. "So I know how well it works. And then I want it and then I've been off of it for the last few months. And it's been horrible. It's like relearning to be diabetic again."
"I am tired of insurance companies getting rich off treating patients and disabled folks, like myself, as if we are expendable. I am not alone," she added. "That's why I am fighting and I will keep on fighting these claims and for affordable insurance that everyone has access to."
Phil Brewer, an emergency physician representing the single-payer healthcare advocacy group Physicians for a National Health Program (PNHP) at the Hartford rally, told CT Insider that "requiring pre-authorization used to be rare."
"Now it's routine," he added. "It also used to be that a human being actually reviewed the request, but now most requests are 'reviewed' by algorithm-driven AI programs."
At the Portland rally, Ronan Aubrey—whose family has a history of cancer—said they were surprised to receive a bill for a diagnostic ultrasound they thought would be covered by their insurance.
"Because my procedure was recommended by a doctor, I had assumed it would be fully covered. I was wrong," Aubrey told the Maine Beacon. "My insurer only covered a small part of the scan and procedure because I hadn't yet met my $3,500 deductible for the year."
"When an insurer tells us that medical care we need isn't covered, what are we going to do?" Aubrey asked. "My insurer shouldn't be deciding whether I should be getting a medical procedure—my doctor should."
"These health insurance CEOs have been so successful not because they have improved the health and well-being of Americans, but rather because they have sustained financial returns for Wall Street investors."
The United States' healthcare system is the worst in the developed world, delivering the highest death rates for treatable conditions, the highest infant and maternal mortality rates, and the lowest life expectancy at birth.
But a system that is failing patients, often in catastrophic ways, has been a massive boon for the executives who run the few private companies that dominate the nation's healthcare sector.
Last year, the CEOs of CVS Health, UnitedHealth Group, Cigna, Elevance Health, Centene, Humana, and Molina Healthcare—the top seven publicly traded health insurance giants in the U.S.—brought in a combined $335 million in compensation, STAT recently reported.
The outlet emphasized that "high-flying stock prices again fueled a vast majority of the gains," which mark a new record. Joseph Zubretsky, the CEO of Molina Healthcare—a company whose revenue comes entirely from taxpayer-funded programs such as Medicaid—took home a staggering $181 million in 2022.
As former Cigna executive Wendell Potter noted Tuesday, "these health insurance CEOs have been so successful not because they have improved the health and well-being of Americans, but rather because they have sustained financial returns for Wall Street investors."
"Not much has changed in how insurer CEOs are compensated since I left Cigna in 2008. Except they're making way more," wrote Potter, who is now the executive director of the Center for Health and Democracy.
In a new analysis of the latest CEO pay figures, Potter observed that "had it not been for their companies' share buybacks"—which help boost the price of their stock by reducing the number of shares outstanding—"they wouldn't have banked nearly that much money."
"My analysis of how much the companies have used our premiums and tax dollars to buy back shares of their own stock showed that combined they spent $141 billion on share repurchases between 2007 and 2022," Potter wrote. "Keep in mind that that is $141 billion that otherwise could have been used to reduce our premiums and deductibles–and keep an untold number of American families out of bankruptcy and away from GoFundMe–but was used instead to increase the wealth of their shareholders and top executives."
\u201c(1/6) LATEST: CEOs from the 7 big health insurance companies pulled in $335 million in just 2022 alone.\n\nHow did they do it?\n\nBy imposing high out-out-pockets requirements and premiums; stock share repurchases; and by gaming the Medicare and drug supply chain.\u201d— Wendell Potter (@Wendell Potter) 1686067073
Potter argued that the CEOs' exorbitant pay packages are "especially alarming when you consider that they are getting more and more of it from us as taxpayers" as tens of millions of Americans go without insurance, struggle to afford their prescription medicines, and drown in medical debt.
In an analysis released earlier this year, Potter estimated that government programs are the source of around 90% of the health plan revenues of Molina, Humana, and Centene.
Centene CEO Sarah London brought in more than $13 million in total compensation last year, and Humana chief Bruce Broussard took home more than $17 million. Both companies are major providers of Medicare Advantage—a privately run, publicly funded, and fraud-ridden program that is a growing source of insurance company revenues.
"Keep all of this in mind the next time you go to the pharmacy counter and are told that even with insurance you'll have to pay a king's ransom for your meds because your insurer—through its pharmacy benefit manager (PBM)—has once again jacked up your out-of-pocket requirement," Potter wrote. "Or the next time you notice how much has been deducted from your paycheck for your health insurance–and Uncle Sam."
Fresh outrage over the pay of insurance industry CEOs, which surged during the coronavirus pandemic as millions lost health coverage and got sick, comes amid a renewed Medicare for All push in Congress.
Last month, Sen. Bernie Sanders (I-Vt.), Rep. Pramila Jayapal (D-Wash.), and others reintroduced Medicare for All legislation in both chambers, with more co-sponsors than ever before—though the bill has no chance of passing the divided Congress.
The legislation would virtually eliminate private health insurance and provide comprehensive care to all for free at the point of service, a transformative change that would likely save tens of thousands of lives and hundreds of billions of dollars each year.
"In America, your health and your longevity should not be dependent on your bank account or your stock portfolio," said Sanders. "After all the lives that we lost to this terrible pandemic, it is clearer now, perhaps more than it has ever been before, that we must act to end the international embarrassment of the United States being the only major country on earth to not guarantee healthcare to all."