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Project 2025 Threatens Full Privatization of Medicare—A Death Sentence for Millions
Despite the overwhelming evidence showing that privatized Medicare does not serve our seniors’ best interests and wastes money, Project 2025 wants to take over all of Medicare by automatically enrolling seniors in corporate insurance plans without their full consent.
Oct 19, 2024
Once you’ve been told you have cancer, waiting is the last thing you want to do. As a practicing Gynecologic Oncologist, I know patients with so-called “Medicare Advantage” plans will be waiting—waiting to find a specialist like me within their network, waiting to get pre-authorization for the tests they need so we can discuss their diagnosis and possible treatments and, ultimately, waiting to get approval for their surgery and treatments.
Unfortunately, Project 2025 would make this already difficult process even worse. By fully privatizing Medicare, this Heritage Foundation plan would shift even more power into the hands of corporate insurers, who prioritize profits over patient care. The result would be even narrower provider networks, more restrictive approvals for tests and treatments, and a system designed to delay or deny care to those who need it most. For patients, that means critical time lost—time that may mean more pain, more symptoms, and a decreased chance of being cured.
Under Project 2025, the burden of navigating these hurdles would fall not just on patients, but on physicians and health care workers who are already stretched thin. Physicians for a National Health Program estimates that doctors and their teams would spend up to 43 million hours annually dealing with prior authorizations alone. This clinically meaningless administrative burden steals time that should be spent caring for patients, wastes resources that we can’t afford to lose, and is a source of burnout and moral distress for healthcare professionals.
Corporate insurance plans are designed to make profits, not take care of patients.
I feel helpless to overcome the negative impact that delays in care have on patients’ chances of being cured. But delayed care is often the best-case scenario for seniors in “Advantage” plans, because there is a high potential that the best cancer center in their area is outside of their narrow network and that treatments will be denied.
Research shows seniors with corporate “Advantage” plans have lower access to the high-volume hospitals that most successfully care for uncommon cancers. For example, people with stomach, pancreatic, and liver cancer requiring surgery were shown to have a higher likelihood of dying when compared to seniors with real Medicare.
Despite the overwhelming evidence showing that privatized Medicare does not serve our seniors’ best interests and wastes money, Project 2025 wants to take over all of Medicare by automatically enrolling seniors in corporate insurance plans without their full consent.
This will be catastrophic for people on Medicare, who will face increasing financial burdens and decreased access to care. An estimated 24 million seniors in corporate “Advantage” plans would face limited provider networks that exclude up to 70% of the doctors in their regions. And more than 15 million people would be considered underinsured due to the reduced benefits available under privatized plans. Without the choice of sticking with real Medicare, our seniors would all be threatened by the health impacts of delayed and denied care.
Instead of funneling money into the hands of corporate insurers, we should be cracking down on overcharging and using those savings to strengthen Medicare.
Corporate insurance plans are designed to make profits, not take care of patients, and so they use shady techniques such as upcoding, which boost payment rates by making patients seem sicker than they are. In 2024, so-called “Advantage” plans overcharged the American people by as much as 140 billion dollars—and provided less care with worse health outcomes. If this system of skimming funds were extended to all seniors, the Medicare trust fund would immediately begin deficit spending, leading to insolvency within five years. It would cost $1.5 trillion more than real Medicare over 10 years.
Congress must take a stand to protect American seniors and the Medicare Trust Fund by rejecting Project 2025’s dangerous push to privatize Medicare.
Instead of funneling money into the hands of corporate insurers, we should be cracking down on overcharging and using those savings to strengthen Medicare. For example, a cap on out-of-pocket spending is crucial to ensure seniors receive the financial protection they deserve. We should also invest in much-needed dental, vision, and hearing coverage for everybody on Medicare.
It’s time to give all seniors access to the best care possible and stop wasting our healthcare dollars on corporate profits.
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To Win ‘Medicare for All,’ First Reclaim Medicare From Profiteers
If we want to build on the promise of Medicare, then we’re going to have to grapple directly with the power of corporate health insurance: That starts with taking on the so-called “Medicare Advantage” program.
Jul 30, 2024
Fifty-nine years ago today, President Lyndon Johnson signed Medicare into law—a high-water mark in the fight for universal healthcare that had started decades before and that continues to this day.
Ever since Medicare became law, it has been a shining example of what is possible in U.S. healthcare: a truly public, truly universal program that has saved countless lives and prevented untold financial ruin among America’s seniors. But alongside this success, corporate health interests have also grown immeasurably more powerful. Insurers like UnitedHealthcare and Blue Cross Blue Shield have erected cruel barriers to care and are laughing all the way to the bank.
If we want to build on the promise of Medicare—and win the best possible version of Medicare for All—then we’re going to have to grapple directly with the power of corporate health insurance. That starts with taking on the so-called “Medicare Advantage” program.
The Strategic Importance of Medicare Advantage
Single-payer advocates understand that there can’t be “Medicare for All” if there is no “Medicare.” And no, Medicare Advantage (MA) doesn’t count as Medicare. The health insurance corporations that run these plans have a business imperative to prioritize profits above all else; this is anathema to any public health program.
Physicians for a National Health Program (PNHP) has compiled overwhelming evidence that MA insurers are harming patients, physicians, and hospitals by delaying and denying care—harms that are virtually unseen in Traditional Medicare. Nor is this cruelty even a trade-off for lowering the cost of healthcare. In fact, these corporations are paid far more than what is spent for similar patients in Traditional Medicare—up to $140 billion per year, or as much as 35% above the funding levels of Traditional Medicare.
There is no road to Medicare for All that ignores this existential threat.
Where we see middlemen standing between patients and the care they need, we should remove them. Where we see limited provider networks, we should expand them. Where we see piles of pre-authorization paperwork, we should shred them.
Thankfully, support for eliminating overpayments to MA extends far beyond those who are already committed to single payer. This fight builds our movement by mobilizing a wide range of people who understand, or can be educated about, the damage insurance companies are doing to patients. When we find common ground, we should walk together.
For that reason, PNHP is exposing MA overpayments and demanding a more fiscally responsible approach from policymakers. We are working closely with several organizations to change the national conversation and provide a badly needed counterweight to the lobbying might of big insurance.
When MA was created, way back in 2003, corporate insurers promised to reduce the cost of healthcare by improving care coordination and health outcomes. A healthier population, they claimed, would be less expensive. We should demand that MA corporations live up to these lofty promises without billions of dollars in overpayments.
We’d like to see them try.
Improved Medicare… for ALL
Winning back $140 billion in annual overpayments begs a tantalizing question: How can we use those funds to improve Medicare for all seniors?
Instead of the paltry benefits that MA plans offer, those funds would help us add robust hearing, vision, and dental benefits; totally eliminate Medicare Part B premiums; and fold in the Medicare Part D prescription drug benefit. Imagine the relief a senior on Medicare Advantage would feel when enrolling in a plan that actually covers the full range of dental care, while also freeing themselves from the narrow provider networks and prior authorization requirements imposed by MA plans.
Most critically, we need to establish a low out-of-pocket maximum for Medicare. Insurance corporations lure seniors and people with disabilities into the MA trap by selling lower up-front costs while hiding substantial barriers to care. It’s a classic bait and switch. Eliminating the need to purchase Medigap would level the playing field and allow everybody to remain in Traditional Medicare.
Let’s work to build a movement of seniors, physicians, students, people with disabilities, and everybody else who cares about Medicare.
Well, not everybody—but that’s our ultimate goal. PNHP advocates for a national single-payer health insurance program, and what better way to get there than through an improved version of the already popular Medicare program?
Where we see middlemen standing between patients and the care they need, we should remove them. Where we see limited provider networks, we should expand them. Where we see piles of pre-authorization paperwork, we should shred them.
We should also expand benefits to include all medically necessary care, and ultimately eliminate out-of-pocket costs that deter people from seeing a doctor. Once these improvements are in place, we will have a program that’s truly worthy of the name Medicare for All.
The advocacy work for these priorities—ending MA overpayments, improving Traditional Medicare, and realizing our vision for single payer—overlap and build on one another.
Let’s work to build a movement of seniors, physicians, students, people with disabilities, and everybody else who cares about Medicare. Together, we can take on the corporate insurers that are wreaking so much havoc in our lives and lay the groundwork for winning a single-payer program that brings everybody in and leaves nobody out.
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Sick and Tired of Industry Greed, Activists Across US Target For-Profit Health Insurers
"I'm tired of insurance companies putting profit over people," said one activist at a Chicago rally.
Oct 12, 2023
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."
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