medicare advantage

medicare for all

Patients & Doctors Denounce UnitedHealth On The Steps Of Wall Street As The Company's Record Profits Are Announced

Advocates Call for End of Deadly Tactic Used by For-Profit Health Insurers to Deny Treatment

Researchers found prior authorization—which allows insurers to overrule physicians and deny coverage—acts as a “corporate care veto” that drains tens of billions of dollars each year that could go toward patients.

A new report is making the case for ending a widely-hated and sometimes deadly tactic used by for-profit health insurers to deny needed care.

It's called "prior authorization," and it allows health insurance companies to override physicians and decide whether certain care is medically necessary before it is covered.

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healthcare

President Trump Announces TrumpRx From The White House

Trump Weighs Ultimate Gift to For-Profit Insurance Industry: Medicare Privatization

"They want to remove the guarantee of Medicare," one advocate said of the Trump administration's floated plan to automatically enroll seniors in Medicare Advantage.

The Trump administration is considering enacting a policy that would automatically funnel seniors into for-profit Medicare Advantage plans—which critics say would set Medicare on the path to full-scale privatization.

Chris Klomp, the Trump administration's director of Medicare and deputy administrator of the Centers for Medicare and Medicaid Services (CMS), told STAT last month that enrolling seniors in Medicare Advantage (MA) plans by default "is something that we're thinking through." MA plans are funded by the federal government and run by private insurance companies such as UnitedHealthcare and Humana, both of which have been accused of improperly denying necessary care to patients and overcharging taxpayers.

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Obamacare Won’t Work: Time for Medicare for All

Our healthcare ‘system’—with or without the Affordable Care Act—is unsustainable: we have reached the end of the line.

Those without employer sponsored insurance (or Federal insurance like Medicare or the VA) in Red states, who signed up for the Affordable Care Act (aka Obamacare), are now learning what they voted for: higher premiums for health insurance, maybe unaffordable. Meanwhile, premiums continue to rise relentlessly for employers and employees.

Our healthcare "system" is unsustainable: we have reached the end of the line.

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medicare for all

Democratic Lawmakers Speak To The Press On Medicare

'Medicare Advantage Is Not Medicare': Democrats Proposal Would Unmask For-Profit Fraudsters

"We don't allow banks to call themselves the U.S. Treasury Investment Fund," said Rep. Mark Pocan. "We don't allow anyone to call themselves USPS Plus. So why allow insurance companies to call private insurance Medicare Advantage?"

A group of Democratic lawmakers on Wednesday reintroduced legislation aimed at reining in for-profit insurance companies who use the Medicare name to market their plans.

The "Save Medicare Act," being reintroduced by US Reps. Mark Pocan (D-Wis.), Ro Khanna (D-Calif.), and Jan Schakowsky (D-Ill.), bars private insurers from using the word "Medicare" in marketing their plans, imposing "significant fines" for any insurer that doesn't comply.

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A $1.2 Trillion ‘Rip Off’: Report Spotlights Massive Scale of Medicare Advantage Fraud

"These private insurer-run plans are more expensive AND lead to worse outcomes for patients," said Rep. Pramila Jayapal. "It’s time to rein in Medicare DisAdvantage and protect traditional Medicare."

A report released earlier this month to little fanfare estimated that federal overpayments to privately run Medicare Advantage plans could total $76 billion this year—or potentially a staggering $1.2 trillion over the next decade if current trends persist.

The Medicare Payment Advisory Commission (MedPAC), an independent congressional agency that advises lawmakers on Medicare, calculates overpayments by comparing spending on Medicare Advantage (MA) plans to what the federal government would have spent if MA enrollees were on traditional fee-for-service Medicare.

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Trump's Health Plan Is Doomed to Fail—We Need Medicare for All

Unsurprisingly, Trump’s concepts of a plan don't even begin to reverse the damage he caused when he made massive cuts to Medicaid and the Affordable Care Act in order to fund tax cuts for billionaires.

President Donald Trump’s new “Great Health Care Plan” is anything but.

Unsurprisingly, Trump’s concepts of a plan fail to even begin to reverse the damage he caused when he made massive cuts to Medicaid and the Affordable Care Act in order to fund tax cuts for billionaires. Now, Trump and his Republican allies are trying to cover up the gaping wound they have created with a Band-Aid. At the same time, Americans are desperate for relief from Trumpflation, including rapidly rising healthcare costs.

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healthcare

President Trump Announces Plan To Reduce The Cost Of Prescription Drugs

Medicare Advantage, Privatized Medicaid Could Cost Americans $2 Trillion Extra Over Next Decade

"If the administration were serious about curbing waste and inefficiency, it would start by reducing the diversion of public funds to these corporate intermediaries," argues a new paper.

US President Donald Trump and his Republican allies in Congress took a sledgehammer to Medicaid over the summer, justifying the unprecedented cuts by falsely claiming the program that provides health coverage to tens of millions of low-income Americans is overrun with waste and abuse.

But a new paper published Friday in the journal Health Affairs argues that if the administration actually wanted to target waste, fraud, and abuse, it would have been much better off taking aim at Medicare Advantage (MA) and Medicaid privatization.

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Protesters hold a sign reading, "Hands off Medicare."

Just Say No to AI-Assisted Medicare Preauthorization

A new AI-driven Medicare prior-authorization pilot could dramatically weaken Medicare, just another frightening step toward privatization and profiteering.

The odds are that if you have private health insurance or someone in your family has private health insurance, you have heard the dreaded phrase “we need preauthorization” from your insurance company. What this means is that your insurance company needs to approve in advance that your treatment or prescription is covered. In theory, this should be no big deal. However, reality is something else. But as the New York Times points out:

Private insurers often require a cumbersome review process that frequently results in the denial or delay of essential treatments that are readily covered by traditional Medicare. This practice, known as prior authorization, has drawn public scrutiny, which intensified after the murder of a UnitedHealthcare executive last December.

So, reading this you might think that you are glad that you or someone in your family choose traditional Medicare (in other words not a Medicare Advantage plan), so you would be able to avoid the “prior authorization needed” drama. Well, unfortunately you would be wrong as the prior authorization is slowly coming to Medicare. In late June, the Centers for Medicare and Medicaid Services (CMS) issued a press release:

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