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Doctors protest the Medicare Direct Contracting program

Doctors attend a protest at the headquarters of the Health and Human Services Department on November 30, 2021 in Washington, D.C. (Photo: Physicians for a National Health Program)

Pressure Grows on Biden to Shut Down Trump-Era Medicare Privatization Scheme

A petition calling on the president to end the Medicare Direct Contracting pilot program has now garnered more than 10,000 signatures.

Jake Johnson

Calls are mounting for President Joe Biden to terminate an under-the-radar Trump-era pilot program that—if allowed to run its course—could result in the complete privatization of traditional Medicare by the end of the decade.

"The Biden administration is moving the DCE program forward, threatening the future of Medicare as we know it."

A petition recently launched by Physicians for a National Program (PNHP) has garnered more than 10,000 signatures as doctors and other advocates work to raise public awareness of the Medicare Direct Contracting program, which the Trump administration rolled out during its final months in power.

"Under this model," the petition warns, "the Centers for Medicare and Medicaid Services (CMS) could move more than 30 million traditional Medicare beneficiaries into mostly commercial, for-profit plans called Direct Contracting Entities (DCE) without the enrollees' understanding or consent."

"In ways similar to commercial Medicare Advantage plans, DCEs have the potential to interfere with care decisions and waste taxpayer money when compared with the efficiency of traditional Medicare," the appeal continues. "The Biden administration is moving the DCE program forward, threatening the future of Medicare as we know it. We, the undersigned, demand that CMS immediately stop the DCE program to keep Medicare public and nonprofit for future generations."

Late last month, as Common Dreams reported, a group of physicians from across the U.S. traveled to the headquarters of the Health and Human Services Department in Washington, D.C. to demand that HHS Secretary Xavier Becerra halt the pilot program in its tracks.

The doctors were ultimately blocked from delivering a petition signed by around 1,500 physicians calling for an end to the privatization scheme, which inserts profit-seeking companies between traditional Medicare and healthcare providers.

"Just like corporate middlemen stand between patients and the healthcare they need, security staff stood between PNHP doctors and the policymakers who want to privatize Medicare," PNHP tweeted during the demonstration at the nation's capital.

While the doctor-led protest was followed by a brief uptick in reporting on the obscure initiative, Biden's HHS has yet to act and few members of Congress have publicly spoken out against the Direct Contracting program despite the massive implications for the future of Medicare and its tens of millions of beneficiaries.

"People don't know that it's happening," Dr. Ed Weisbart, chair of PNHP's Missouri chapter, told Common Dreams in an interview last month. "Most people in Congress don't know that it's happening. We've started having some of these conversations with congressional staff... but it's not on their radar either."

One notable exception is Rep. Pramila Jayapal (D-Wash.), chair of the Congressional Progressive Caucus. Earlier this month, Jayapal penned an op-ed with PNHP president Dr. Susan Rogers urging Biden to stop the Direct Contracting program "while we have the chance."

According to PNHP, Jayapal is collecting signatures from fellow lawmakers' for a letter pressuring Biden to shut down the pilot, which sparked legal concerns and general revulsion among career CMS staff when it was launched toward the end of former President Donald Trump's White House tenure.

"This shit is so fucking gross," one staffer wrote in a group text viewed by The Intercept.

In their op-ed for The Hill earlier this month, Jayapal and Rogers warned that the Direct Contracting program "could radically transform Medicare within a few years, without input from seniors or even a vote by Congress."

"After our experience with commercial Medicare Advantage plans," they added, "we already know that inserting a profit-seeking middleman into Medicare ends up costing taxpayers more, with fewer choices and worse outcomes for seniors."


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