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medicare advantage
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.
Apr 10, 2026
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.
The default enrollment scheme was floated in the far-right Project 2025 agenda that President Donald Trump has repeatedly tried to disavow. Currently, older Americans who have received Social Security benefits for at least four months before they turn 65 are automatically enrolled in traditional Medicare, and they can choose to enroll in an MA plan as an alternative.
"Another bad idea straight from Project 2025," Rep. Mark Pocan (D-Wis.) said in response to Klomp's comments on the proposed default enrollment change. "Medicare Advantage is private, for-profit insurance that overcharges American taxpayers by billions every year and regularly denies seniors the care they need."
"Making Medicare Advantage the default option hurts patients and taxpayers," Pocan added, "but it will make insurance execs a lot of money."
"With Mehmet Oz running the agency, they can move incredibly quickly to make that happen, and they are."
Klomp said no plans have been finalized, but defenders of traditional Medicare warned that CMS—headed by Mehmet Oz, who during his 2022 US Senate run backed a plan entitled "Medicare Advantage for All"—could try to swiftly ram the change through without public input.
"With Mehmet Oz running the agency, they can move incredibly quickly to make that happen, and they are," Alex Lawson, executive director of the progressive advocacy group Social Security Works, told Common Dreams on Friday. "They will not explain it to the people, because the people hate the idea. Instead, they say 'change the default option' and other policy jargon to try and hide the fact of what they are doing, privatizing Medicare."
"They want to remove the guarantee of Medicare," warned Lawson, "and replace it with the same private insurance giants that make billions denying healthcare, especially to those who need it the most."
Experts say making Medicare Advantage plans the default enrollment option for seniors would likely decrease traditional Medicare enrollment dramatically.
Given massive overpayments to Medicare Advantage plans—potentially $1.2 trillion over the next decade, according to one independent estimate—a large increase in MA enrollment would be sure to drive up costs and monthly premiums across the board. A report released last month by the congressional Joint Economic Committee estimated that MA overpayments led to premium hikes of $212 per Medicare Part B enrollee last year.
"Since 2016, MA overpayments have added an estimated $82 billion to Part B premiums," the congressional report found. "[Traditional Medicare] beneficiaries, who are not enrolled in MA, bore roughly $6 billion of that burden."
Under one scheme floated last year by Rep. David Schweikert (R-Ariz.), eligible Medicare recipients would be automatically enrolled in the "MA plan with the lowest premium available," unless they actively decide to opt out. Once enrolled in an MA plan, individuals would be unable to switch plans for three years.
Wendell Potter, a former health insurance executive who now champions Medicare for All, warned Friday that under Schweikert's plan, "seniors would be locked in a plan that the government chose for them, that has a limited network of doctors and hospitals, that makes them pay the entire bill for services they might receive outside of that network, and that denies coverage for medically necessary care far more than traditional Medicare—for three years."
In addition to weighing the default enrollment change, the Trump administration has recently delivered smaller-scale but significant victories to MA insurers, including by boosting federal payment rates—bowing to a massive industry lobbying blitz—and easing rules around the marketing of MA plans.
David Lipschutz, co-director of law and policy at the Center for Medicare Advocacy, said Thursday that the latter move represents "a rollback of consumer protections, which gives in to pressures from the insurance industry and those who sell their products."
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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.
Mar 14, 2026
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.
Americans pay more for healthcare (about18 percent of GDP) than any other developed country, with mediocre outcomes. Yet the other countries, with better outcomes, have universal coverage.
It is time for change. Extend traditional Medicare to all Americans (gradually, over the course of several years). Medicare is familiar; it works. Private for profit-health insurance, less than a century old, makes no sense today.
Sick and injured patients have turned to medicine—to healers—since time immemorial. Health insurance is new: Blue Cross started as a community non profit organization in 1929, to cover surgery in hospitals.
Private for profit-health insurance, less than a century old, makes no sense today.
Yes, we are a capitalist country, and markets are efficient at producing many things, like commodities: groceries, shoes, cars, even some insurance, when it is straightforward and highly regulated, like auto insurance. But for-profit health insurance does not work.
The idea of insurance is to spread risk over a maximum number of subscribers, each of whom is at the same low risk of unpredictable casualty, like fire. This was essentially the situation of Americans a century ago—illness and injury were acute and unpredictable, patients either recovered or died. Everyone was at similar risk, only surgery was expensive.
Today is different: illness is not only predictable, it can be chronic, even life long. Moreover, today’s scientific care is expensive. The social determinants of health—income security, education, adequate food and shelter, social support (your zip code, not your genetic code)—plus public health, keep healthy people healthy.
Medical care is for the sick.
For-profit health insurers maximize premiums, minimize cost (provider fees), keep the difference, and most important, avoid the sick. Insurers exclude those with “pre-existing” conditions whenever allowed (not under the ACA), deny "authorization" where they can. They tailor "plans" with carefully engineered restrictions you don’t discover until you file a claim. They are not even providing insurance: the payments from the Federal government are risk adjusted, so the insurers are paid more for riskier patients (and they are now illegally upcoding). The providers are not. Making this happen entails huge administrative expense, which adds no value for patients or providers, only massive returns to investors. United Health Group is the third largest company in the Fortune 500.
Healthy people don’t know what plan is "right for them"; they hate the annual "choice." They only know what they can afford. (Sick people know what they need.) They do want to choose their doctor.
Traditional Medicare eliminates these problems for its beneficiaries: by law, everything medically necessary is covered. The Federal government determines fees for doctors and hospitals based on cost, as it did historically when markets didn’t work. Beneficiaries pay premiums based on income.
Fee-for-service works when we pay the right fees for the right services. Today, based on 1950’s medicine, Medicare pays too little for office visits, so-called ‘cognitive’ services (versus procedures) both primary and specialized, so there are too few providers, especially as Medicare rolls expand with retiring
Boomers. No office doctor can make a living from Medicare anymore. That is, however, easy to fix: pay providers more to care for the sickest people, who need the services only highly skilled, experienced physicians can provide. Pay surgeons less.
Best of all, Medicare is simple—ask your grandmother.
But where will the money come from?
Start by eliminating Medicare Advantage (MA) and Part D, while updating Medicare to cover prescription drugs, along with vision, hearing aids, etc. MA was supposed to save taxpayers money by providing care more efficiently. Instead, Medicare pays MA companies 20 percent more than traditional Medicare for comparable patients.
Then, require all employers (including those who currently don’t provide insurance) to pay premiums to Medicare based on payroll. Require employees to pay Medicare premiums based on wages. Just like Social Security (of which Medicare is technically a provision). The Federal government continues to pay a share.
Everyone pays, everyone gets the care they need and nobody is left out. People can choose any qualified provider. Providers remain private, and are paid enough to attract and sustain the clinicians we want and need.
We have tried every kind of private for profit health insurance there is: employer sponsored, government subsidized, market based, capitation, value-based, catastrophic, health savings accounts—it no longer works for employers, taxpayers, or the sick. This year premiums will go up, coverage will go down.
Americans’ health will suffer.
Americans need care, not coverage. We clinicians have dedicated our lives to providing it. Medicare has served millions of us well for 60 years. We cannot allow opportunistic capitalists to stand in the way for the rest.
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'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?"
Mar 05, 2026
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.
At issue, the lawmakers said, is that insurers are flooding the airwaves with ads for Medicare Advantage plans during open enrollment periods. The ads are deceiving Americans into thinking their plans are just variations of Medicare services offered by the federal government, they said.
"Let’s be clear: Medicare Advantage is not Medicare," said Schakowsky. "These private insurance plans use Medicare’s trusted name while too often denying medically necessary care, restricting providers, and overcharging taxpayers by billions. That is unacceptable. We have seen insurers exploit the system to boost profits at the expense of seniors."
Khanna noted that Medicare Advantage is "a private insurance program that too often boosts profits by limiting coverage," even as it "misleads seniors into thinking it's traditional Medicare."
"That's wrong," Khanna emphasized. "This legislation will stop private insurers from cashing in on the Medicare name. We should be working to protect and expand real Medicare instead."
Pocan declared that "only Medicare is Medicare," adding that Medicare Advantage plans "often leave patients without the benefits they need while overcharging the federal government for corporate profit."
"This bill makes clear what is—and what is not—Medicare," added Pocan, "and ensures this essential program will continue to serve seniors and other Americans for generations to come."
Pocan also posted a video on social media where he talked about his elderly mother being unable to see the physician that came to her assisted living home because she relied on Medicare Advantage and the doctor in question was out of network.
"She would have had to go all the way across town to get that care," Pocan explained. "The problem is, she wasn't very mobile and she never got the medical care."
We don't allow banks to call themselves the U.S. Treasury Investment Fund. We don't allow anyone to call themselves USPS Plus.
So why allow insurance companies to call private insurance Medicare Advantage?
I’m reintroducing the Save Medicare Act with @RepRoKhanna and… pic.twitter.com/c6dAXpEJqY
— Rep. Mark Pocan (@RepMarkPocan) March 4, 2026
"We don't allow banks to call themselves the U.S. Treasury Investment Fund," said Pocan. "We don't allow anyone to call themselves USPS Plus. So why allow insurance companies to call private insurance Medicare Advantage?"
Many progressive critics have for years pointed to Medicare Advantage as a legitimate example of wasteful spending by the federal government.
A report released in January by the Medicare Payment Advisory Commission (MedPAC), an independent congressional agency that advises lawmakers on Medicare, estimated that overpayments to Medicare Advantage plans could total $76 billion in 2026.
One major factor in the overpayments is that patients using Medicare Advantage plans tend to be healthier than patients on traditional Medicare, with the result being that private insurers charge the government more than is necessary to meet these patients' needs.
On Wednesday, Schakowsky said that the "crucial legislation" she joined Khanna and Pocan in introducing "will end deceptive marketing and ensure beneficiaries understand the difference between traditional Medicare and private insurance plans."
"Seniors deserve transparency, accountability, and the full benefits they have earned," she said.
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