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medicare advantage
Trump Reportedly Picks Medicare Advantage Lobbyist for Top Health Budget Role
Don Dempsey would join Centers for Medicare and Medicaid Services nominee Mehmet Oz and other supporters of privatized Medicare Advantage plans in the new administration.
Jan 23, 2025
U.S. President Donald Trump is reportedly set to appoint a lobbyist for the for-profit health insurance industry for a top White House budget job, a move likely to heighten concerns about the new administration's expected push to bolster Medicare Advantage plans that deny necessary care and dramatically overbill the federal government.
The Financial Timesreported Wednesday that Trump is "poised to appoint" Don Dempsey as associate director of the Office of Management and Budget's health programs. The appointment would give Dempsey "sweeping power over the $1.8 trillion U.S. healthcare budget and responsibilities of the 13 divisions and agencies," the newspaper noted.
Dempsey is currently the vice president of policy and research at the Better Medicare Alliance, a lobbying organization that describes itself as "the nation's leading research and advocacy organization supporting Medicare Advantage." FT observed that the group is "funded by insurance companies including UnitedHealth Group and Humana"—the two largest Medicare Advantage insurers in the United States.
Trump's reported choice represents another potential boon for Medicare Advantage, a program run by private insurers and funded by the federal government. As STATreported last month, "Medicare Advantage insurers thrived under the first Trump administration, and it's expected to happen again now that Trump is returning to the White House and Republicans are taking control of Congress."
The president has nominated Mehmet Oz, who has previously expressed support for a plan dubbed "Medicare Advantage for All," to lead the Centers for Medicare and Medicaid Services (CMS), a move that one watchdog warned would kick Medicare privatization efforts "into overdrive."
Since his inauguration earlier this week, Trump has taken a number of steps that have alarmed healthcare advocates, including rescinding Biden-era executive orders aimed at lowering prescription drug prices and strengthening Medicaid and the Affordable Care Act.
"On one hand, what we see coming from the executive orders by Trump is important because it shows us the direction they are going with policy changes," Sarah Lueck, vice president for health policy at the Center on Budget and Policy Priorities, toldKFF Health News. "But the other track is that on the Hill, there are active conversations about what goes into budget legislation. They are considering some pretty huge cuts to Medicaid."
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Hey Elon and Vivek! Here's What a Real 'Department of Government Efficiency' Would Do
A new report identifies what a DOGE "based on evidence, not ideology, would include—from slashing drug prices to ending privatized Medicare to reducing the wasteful Pentagon budget."
Jan 15, 2025
While the U.S. Senate on Wednesday held confirmation hearings for several of President-elect Donald Trump's Cabinet nominees, the watchdog Public Citizen sounded the alarm about a new commission and its billionaire leaders, who don't require congressional oversight but could significantly impact federal agencies, regulations, and spending.
Despite being called the Department of Government Efficiency, DOGE is not a government department. It is a presidential advisory commission that Trump announced after his November win. He has asked billionaires Elon Musk and Vivek Ramaswamy to co-lead it.
Public Citizen co-presidents Lisa Gilbert and Robert Weissman on Monday wrote to Trump's transition team, asking to join DOGE. While their group has concerns about the commission's "structure and mission," including potential conflicts of interest regarding Musk and Ramaswamy's financials, the watchdog leaders made the case that they could serve "as voices for the interests of consumers and the public who are the beneficiaries of federal regulatory and spending programs."
"There is nothing 'efficient' about hitting a pre-determined target for spending cuts, least of all one that is infeasible."
The pair highlighted that their appointment "would be an important step towards compliance with the Federal Advisory Committee Act," and outlined some ideas they have "to slash drug prices, end privatized Medicare, reduce the wasteful Pentagon budget."
Weissman expanded on the group's recommendations in a Wednesday report titled DOGE Delusions: A Real-World Plan to Reject Elon Musk and Vivek Ramaswamy's Misguided Agenda, Crack Down on Corporate Handouts, Tax the Rich, and Invest for the Future.
"Every sign from DOGE suggests that it aims to use 'efficiency' as a cover to shrink government, benefit corporations by cutting regulations, and advance a predetermined ideological agenda," Weissman said in a Wednesday statement. "This report identifies what an efficiency agenda based on evidence, not ideology, would include—from slashing drug prices to ending privatized Medicare to reducing the wasteful Pentagon budget."
The report's introduction notes that Trump and Musk's suggestions that DOGE would cut $2 trillion in yearly spending, even though "many commentators have pointed out the effective impossibility of cutting $2 trillion annually from the federal budget, given that all federal discretionary spending—including the Pentagon budget and veterans' benefits—totals less than $2 trillion."
Musk even
admitted last week that $2 trillion is unlikely, after which experts said his lower target of $1 trillion is still "too large."
"Few would argue with the purported goal of 'government efficiency,' but there is nothing 'efficient' about hitting a pre-determined target for spending cuts, least of all one that is infeasible," Weissman wrote. "Nor is there anything 'efficient' about ideologically driven notions of shrinking government or corporate profit-driven plans to roll back regulatory protections."
"Additionally, 'efficiency' is not a primary value," he continued. "Whatever the government does, it should strive to do efficiently (mindful of other considerations), but the real question is what the government should be doing in the first place."
The 35-page report features sections on ending Big Pharma's price gouging, shutting down privatized Medicare, cutting Pentagon waste and curbing contractor greed, taxing the rich and corporations, taxing high earners and the wealthy, eliminating oil and gas subsidies, regulating efficiency, the costs of not regulating, investing in the care economy, and investing to avert a climate catastrophe.
Many of the proposals overtly conflict with the priorities of the incoming Trump administration and the new Republican-controlled Congress, which are expected to swiftly and aggressively pursue tax cuts for wealthy individuals and corporations, expansion of Medicare Advantage, and the Big Oil-backed president-elect's campaign pledge to "drill, baby, drill" for climate-heating fossil fuels.
The GOP has promoted additional fossil fuel extraction despite the costly and devastating impacts of the climate emergency, as seen with 27 U.S. disasters with losses exceeding $1 billion in 2024—the hottest year on record—and in Los Angeles, California, which is currently enduring what could be "the costliest wildfire disaster in American history."
The Public Citizen report points out that the monetary costs of climate inaction "will severely reduce the size of the global economy. Depending on how quickly we move and how severe we let climate chaos become, the insurance giant Swiss Re suggests the annual dollar costs could be 11% to 14% of total global economic output by 2050—amounting to around $23 trillion annually—and around 7% of North American economic output. These costs will compound and grow even worse over time."
The watchdog estimates that one of its related proposals—ending handouts to fossil fuel companies—would save about $20 billion annually. Ending privatized Medicare would save $100 billion each year, and modest cuts to the Pentagon budget would save $100 billion yearly. More serious defense cuts could save $200 billion, the same figure for measures to reduce prescription drug prices. The biggest savings from the group's recommendations would come from fair tax reforms, at $500 billion annually.
"If DOGE is interested in saving taxpayers and consumers money and making sound investments that will generate a positive return to the government and society," the report concludes, "there is a clear set of evidence-based measures for it to pursue."
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Americans Are Angry About Their Health Insurance—With Good Reason
As a physician, I have seen patients suffer and die in order to pad the bottom lines of corporate health insurers—and in recent years I have seen this problem getting much worse.
Jan 01, 2025
How should we react when a man is shot to death on the street on his way to work? Our humanity tells us that we should be shocked and horrified—and feel that something is deeply wrong with such a brazen act of murder. Ideally, we would do what we could to help sooth the survivors, condemn the violence, and bring the perpetrator to justice.
So why did hundreds of thousands of people have the exact opposite reaction when UnitedHealthcare CEO Brian Thompson was executed in New York City last month? Because Americans are furious with health insurance corporations—and they have every right to be.
In the immediate aftermath of the shooting, many Americans took to social media not to mourn, but to celebrate. Caustic posts about prior authorization and denied medical claims were common. Sympathetic statements were met with rancor—and in the case of UnitedHealth Group’s own statement, over 70,000 “laugh reactions” before the company made that tally private. Even verbose political figures like Elon Musk and President-elect Donald Trump declined to comment for days. This shooting touched a raw nerve.
The health insurance industry doesn’t have a communications problem, it has a profiteering problem—and no amount of marketing will convince people who have already been burned.
As a physician who’s treated countless victims of gun violence, and who’s life’s work is to care for all of my patients, I found this response to be deeply unnerving. But I also can’t waive it away with simple explanations like online radicalization or trolling. Something much deeper is at play.
For decades, health insurance corporations like United have been growing more powerful and more profitable. How do they generate these profits? By taking in as much money as possible in premiums and paying out as little as possible in medical claims. Over time, they have tried everything from requiring “prior authorization” of care, to excluding high-quality providers from their networks, to imposing a Byzantine series of charges including ever-growing copays, coinsurance, and deductibles. When all else fails, many insurers simply deny claims.
Behind each of these practices are millions of Americans who are made to suffer. I hear these stories routinely in my practice, and they never become easier to stomach. I have seen patients with aggressive cancer who avoided seeing a doctor for months because they feared bankruptcy; patients with chronic conditions like diabetes who are denied treatments that would improve their quality of life; and gunshot victims whose fight to recover and gain a semblance of normalcy is complicated by their health plans saying no, no, and no again.
I have seen patients suffer and die in order to pad the bottom lines of corporate health insurers—and in recent years I have seen this problem getting much worse.
These are the stories that Americans are sharing in this fraught moment. We have to ask ourselves: Are we listening? And what are we going to do about it?
Insurers like UnitedHealthcare will have their own responses. Their PR teams will no doubt work overtime to marginalize aggrieved voices and to highlight what they consider to be the “value” of their health plans. Expect to see glossy commercials and towering billboards touting the “peace of mind” that Americans should enjoy knowing that their medical needs are “covered.” But the health insurance industry doesn’t have a communications problem, it has a profiteering problem—and no amount of marketing will convince people who have already been burned.
Behind the scenes, corporate insurers will no doubt lobby for the preferential treatment they have come to expect. Our newly elected Congress may acquiesce, or they may decide that the industry needs to be regulated—a strategy that has failed to live up to its promise.
Republicans and Democrats have made separate attempts to combine federal requirements with federal largesse in order to make corporate health insurers play nice. But both the Affordable Care Act and the Medicare Advantage program have only succeeded in ballooning the profits of firms like United—without improving Americans’ health or sparing their wallets.
It’s also clear that violence is not the answer, both on a purely human level and because corporate insurers will simply not be moved. UnitedHealthcare will have a new CEO in short order, and it will be that person’s responsibility to boost profits and make shareholders wealthier. Responding to patients’ cries will not serve these ends, so it is not in the cards.
What would help is a proven reform proposal that is long overdue: a single-payer national health program. Such a system would provide universal coverage and comprehensive benefits—with zero out-of-pocket costs. It could be easily implemented given the gargantuan sums we spend on healthcare in this country, and it would be a boon for those who are suffering, and for those who are fearful.
Americans are crying out in pain—and are recognizing that they are not alone in their pain. We should listen to these cries and we should finally, after decades of delay, do something about it.
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