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Luigi Mangione—Accused of Murdering UnitedHealth CEO—to Invoke Psychiatric Defense in State Trial
The legal strategy—which is not an insanity defense—would be an admission that Mangione killed UnitedHealth's Brian Thompson, but did so under mitigating circumstances.
Jun 17, 2026
Luigi Mangione, who stands accused of murdering UnitedHealth CEO Brian Thompson in 2024, will assert a psychiatric defense in his state murder trial, the New York judge presiding over the case revealed Wednesday.
The Associated Press reported that Judge Gregory Carro of the New York State Supreme Court in Manhattan said Mangione’s legal team informed him that they will argue that the 28-year-old defendant suffered from “extreme emotional disturbance" when he allegedly gunned down Thompson outside the New York Hilton Midtown Hotel just after dawn on December 4, 2024.
The defense strategy would be an admission that Mangione killed Thompson, but did so due to mitigating circumstances. The precise nature of the claimed psychiatric issue remains under seal, but it has been reported that Mangione suffered chronic back pain for years and harbored deep animosity toward the for-profit health insurance industry that dominate the US system.
Court documents indicate that Mangione's lawyers previously sought additional time to decide whether to pursue a mental health defense.
Extreme emotional disturbance is not the same as pleading guilty by reason of insanity, which would result in a convicted defendant being sent to a psychiatric facility instead of prison.
On Wednesday, Carro revealed that he had held a secret hearing on the matter earlier this month, and that the session's proceedings were sealed "to give the defense an opportunity to determine whether they were going forth" with the extreme emotional disturbance defense.
The June 3 hearing focused on the psychiatric basis for such a defense, its procedural consequences, disclosure obligations, and potential examinations.
Mangione's attorney, Karen Friedman Agnifilo, decried Carro's decision to unseal details of the secret hearing.
“The reason why we asked for the sealing is that this defense is not available federally and Mr. Mangione is being prosecuted federally and this is prejudicial to his defense to the exact same facts,” she said.
Last year, then-US Attorney General Pam Bondi said she would seek the death penalty for Mangione at his federal trial. New York state effectively abolished capital punishment in 2004.
Mangione allegedly shot Thompson, 50, as he walked to the New York Midtown Hilton for UnitedHealth Group’s annual investor conference. Police said the words “delay,” “deny,” and “depose”—a description of how insurance companies avoid paying claims—were engraved in shell casings of bullets used in the attack, which was carried out with a 3D-printed pistol. New York police also said they recovered a three-page handwritten note that expressed "some ill will toward corporate America."
Five days after the shooting, Mangione was arrested after a customer in an Altoona, Pennsylvania McDonald's recognized him and alerted authorities.
Thompson's murder exposed the depth of public rage over corporate greed and a for-profit healthcare system in which thousands of people die each year because they have no insurance, while millions more face financial hardship or bankruptcy.
Mangione is facing state charges of second-degree murder, multiple weapons violations, and possession of a fake ID. More serious charges, including first-degree murder and terrorism, have been dismissed. Mangione's New York trial is set to begin on September 8.
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NY State Judge Throws Out Terrorism Charges Against Luigi Mangione
"While the defendant was clearly expressing an animus toward UHC, and the health care industry generally," said the judge, "it does not follow that his goal was to ‘intimidate and coerce a civilian population.'"
Sep 16, 2025
A judge in New York City on Tuesday threw out a pair of charges against Luigi Mangione, the man accused of killing UnitedHealthcare CEO Brian Thompson in December of last year while he walked down a street in Manhattan.
Judge Gregory Carro did not throw out the entirety of the murder charges against Mangione, but said two of the most serious charges—murder in the first degree as a crime of terrorism and a second-degree charge related to terrorism—were not proven by the prosecution's case presented to a grand jury.
The judge indicated that just because Mangione may have been motivated by ideological opposition to the for-profit industry, that does not de facto make it terrorism under New York statute.
"While the defendant was clearly expressing an animus toward UHC, and the health care industry generally, it does not follow that his goal was to ‘intimidate and coerce a civilian population,’ and indeed, there was no evidence presented of such a goal,” Carro wrote in his decision.
In addition to state charges in New York, Mangione is also facing a federal murder case over the killing of Thompson, with the federal prosecutors seeking the death penalty. The accused has pleaded not guilty to all charges.
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'Gouging': US Health Insurance Giants Raked in Over $71 Billion in Profits Last Year
Meanwhile, 17% of Americans say they're using buy now, pay later services for medical or dental care.
Aug 06, 2025
The seven largest publicly traded U.S. health insurance companies made a collective $71.3 billion in profits last year, and their CEOs took home a total of $146.1 million in compensation, according to an analysis released Wednesday by an ex-industry executive.
Wendell Potter, a former vice president for corporate communications at Cigna who now leads the nonprofit Center for Health and Democracy, compiled the data ahead of his recent testimony before the Senate Committee on Health, Education, Labor, and Pensions.
As Potter detailed for his newsletter, Health Care un-covered, the companies—UnitedHealth, CVS/Aetna, Cigna, Elevance, Humana, Centene, and Molina—boosted their profits by more than half a billion dollars from 2023 to 2024.
(Image: Health Care un-covered)
Alongside a chart detailing the companies' 2023 and 2024 revenues and profits, Potter published one showing each CEO's compensation. He also pointed out that their collective take-home pay is "enough to cover annual premiums for thousands of American families."
(Image: Health Care un-covered)
"So, what's driving the revenue surge?" Potter wrote. "Gouging. Insurers continued to jack up premiums for their commercial customers and overcharge the government."
He highlighted how investigations have exposed rampant fraud and upcoding with private Medicare Advantage plans and noted that "Medicaid managed care is a gold mine, too."
Potter further noted that "to the dismay of shareholders, the big seven insurers have had to admit that so far in 2025, they've paid more medical claims than they had expected, which means their profits were down somewhat during the first months of the year."
The expert warned that the American public should "expect even more financial pain (and difficulty getting the care you need) as these companies do all they can to get their profit margins back to where Wall Street wants them."
His warning comes as new polling makes clear that Americans are already feeling the pain from healthcare bills. Results released Monday by the Associated Press-NORC Center for Public Affairs Research show that 17% of U.S. adults have used buy now, pay later services for medical or dental care.
Most Americans are also stressed by healthcare costs. According to the poll, 42% of adults identified that as a major stressor, and another 36% said it's a minor stressor. Other sources of stress include grocery prices, housing, savings, and wages.
Healthcare could become an ever bigger source of stress soon, as Republicans' recently signed budget reconciliation package starts to strip millions of people of their insurance coverage, thanks to the law's attacks on Medicaid and the Affordable Care Act (ACA).
"Cuts to the ACA will raise premiums for almost 23M Americans by hundreds of dollars each year," Congressman Ro Khanna (D-Calif.) said on social media Monday. "Working and middle-class families can't afford that. We need to pass Medicare for All and make sure health insurance stays affordable for all Americans."
While more than 100 Democratic members of the U.S. House of Representatives and over a dozen senators support the Medicare for All Act, led by Rep. Pramila Jayapal (D-Wash.) and Sen. Bernie Sanders (I-Vt.), the proposal remains opposed by not only Republicans—who control both chambers—but also some corporate Democrats.
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'We the People—Not the Wealthy Few': Voters Target Greed of Landlords, Insurers, and Gas Giants
"We deserve a government that uses our money to fund our care, not one that uses our money to line the pockets of corporations," said one protester.
Feb 26, 2025
After meeting with their members of Congress, working-class voters on Wednesday marched to the Washington, D.C. offices of three companies behind the nation's housing, health, and climate crises that are set to cash in on federal Republicans' planned tax giveaways.
Organized by People's Action Institute, the protest targeted Blackstone, an investment company that has become the world's largest corporate landlord; UnitedHealth, the country's biggest health insurance company; and American Gas Association, which represents more than 200 energy companies that provide services to 189 million Americans.
The participants—who hailed from 60 congressional districts across 27 states—emphasized issues including unaffordable rent rates, housing insecurity, homelessness, denied medical treatment, unpayable healthcare costs, high utility bills, health harms from fossil fuels, and corporate lobbying for tax cuts that benefit companies and billionaires rather than working people.
"We're here today because we want to make the rich pay their fair share!" declared JJ Ramirez of People's Action Institute member organization VOCAL-Texas. "Blackstone is a private equity company that has over 300,000 rental properties across the country. They gobble up these homes, raise our rents, price gouge us, and then evict us when we can't afford to live in their places. We're here today because Blackstone has conspired with other corporate bad actors so they can gobble up everything that we have."
While the protesters gathered outside Blackstone, they stressed that corporate landlords in general are an issue. Ann Kiesling of Progressive Maryland, which supported tenants at the Enclave Silver Spring apartment complex, said that "I will never forget a woman with a disability telling me about the time she had to hop up, with the help of a neighbor, 15 flights of stairs to get to her apartment because the landlords refused to fix the elevators. I will never forget the parents of a four-year-old telling me how they had to heat up water on their stove to give their kid baths because their landlord refused to fix their hot water for over a month."
"An out-of-state private equity landlord, Hampshire Properties, is raking in massive profits by charging luxury rent prices while letting the building fall apart and leaving tenants with the consequences," Kiesling continued. "And while we are here fighting for basic living conditions against mold, broken elevators, pest infestations, corporate landlords like Hampshire Properties, like Greystar, like Blackstone, are pouring our rent money into lobbyists and elected officials' campaigns instead of fixing their buildings."
Hannah Peterson, a disabled veteran, seminary student, and member of the People's Lobby in Chicago, pointed out Wednesday that "just last night, House Republicans passed their budget resolution to cut millions from Medicaid."
That resolution
sets the stage for cutting not only $880 billion from the healthcare program that serves low-income Americans, but also $230 billion from the Supplemental Nutrition Assistance Program (SNAP), commonly called food stamps. Elected Republicans, who control both chambers of Congress and the White House, want to gut safety net programs to fund an expansion of tax giveaways to the rich that GOP lawmakers passed and President Donald Trump signed in 2017.
"Republicans are already funneling our tax dollars out of programs our communities need and into pockets of private corporations and billionaires," Peterson said. "We deserve a government that uses our money to fund our care, not one that uses our money to line the pockets of corporations."
As Medicare for All advocates often highlight, although the United States has Medicaid and Medicare, which serves seniors, it is the only developed country in the world without universal healthcare. Instead, the U.S. has a for-profit system that often leaves patients unable to access or afford necessary care, including because of denials from insurance companies.
"To the folks at UnitedHealthcare... if you really care about people's health, why don't you publicly come out and oppose the cuts to Medicaid?" asked Citizen Action of New York's Amelia Bittel—who has dysautonomia, a disorder that led to a heart surgery at age 35 and requires weekly blood draws.
"In my city of Syracuse, New York, 48% of the population relies on government-funded programs to get their insurance," said Bittel. "You don't need the $1.3 billion that you stand to profit from these cuts. Your company routinely reports the highest profits. Why not give back to the patients?"
At the American Gas Association, Gloria de Graves from Citizen Action of Wisconsin explained that in the Midwestern state, "if you're not familiar, we hit negative 30°F sometimes, and that means that people can freeze to death in their homes if they do not have a way to heat their homes."
"So all I'm saying is We Energies and Xcel Energy, who I have paid plenty of money to over the years, need to stop charging us so much money so that we can afford to feed ourselves, we can afford to stay housed, and when we are fleeing domestic violence, that there is a safe, electrified, and heated home to go into so that we are warm and safe in the winter," de Graves said.
Celebrating the multisite protest on Wednesday, progressive Congresswoman Rashida Tlaib (D-Mich.) said that "I want to thank you from the bottom of my heart, because there are people in my community that can't afford to come up here."
"It is so important to understand corporate greed and how it is embedded in environmental injustices, embedded in environmental racism," she said. "They want the federal government to continue to literally fund poisoning us, while we get sick here in our country. So they're making us sick, and we're subsidizing the fact that we don't have access to healthcare that supports our families."
In a dispatch earlier this week, People's Action executive director Sulma Arias wrote that her group "refuses to give up. We believe ordinary people have the power to rise and meet this and every moment, if we act together. We believe in the fundamental dignity of every person, without exception, and we believe government exists to serve all people—We the People—not the wealthy few."
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Improved Medicare for All Can Heal This Sick Country
A system that collects money from patients and employers then profits by withholding the promised care is not a business but a fraudulent, diabolical scam.
Jan 17, 2025
It’s the beginning of the end for corporate control of health care. The tsunami of outrage against the health insurance industry in the wake of the shooting of United Healthcare CEO Brian Thompson, can propel an urgent, unyielding demand for the removal of profit from healthcare and the enactment of a universal, national single payer system. That is, if the single payer, Medicare for All, national health service movement can summon the vision and audacity to rise to the occasion.
The myth, promoted by health care think tanks and policy experts, that people in the United States are satisfied with their health insurance was exploded in the social media rage unleashed in the aftermath of the killing of the United Healthcare CEO.
Fifteen years after the passage of the Affordable Care Act (ACA), our failing health care system is exposed with all its cruel denials, debt, disease, despair and death at the hands of the investor-owned companies for whom patients are merely pawns for the extraction of profit.
Health care in the United States comes in dead last when rated against comparable countries. The U. S. is at the bottom in overall performance, health outcomes, equity, access to care, and efficiency. As the Commonwealth Fund states: “In fulfilling this fundamental obligation [the ability to keep people healthy], the U. S. continues to fail.”
Health care in the United States comes in dead last when rated against comparable countries.
People in the United States aren’t living to their full potential. Already, the U.S. is 55th in life expectancy, behind Panama, Albania, and Czechia, and will fall in its global rankings by 2050 if the country continues the same trajectory. Years of life are lost to a health care system that serves profit over the value of life.
Our maternal mortality rate would be the shame of many of the poorest nations. In 2020, U.S. maternal mortality rate was higher than in Gaza. In 2022, there were 22 maternal deaths per 100,000 live births in the U.S. This is easily double, and often triple, the mortality rate in peer nations, which can be as low as 5 per 100,000 live births. Black mortality rate is criminally worse: 49.5 per 100,000 live births.
Over one million in the U.S. died in the pandemic, a rate much higher than other nations. Over 330,000 of the pandemic deaths in the U.S. were avoidable. Those lives could have been saved had we had a healthcare system that left no one with inadequate coverage.
Cancer patients must not only fight for their lives but also for the economic survival of their families. The newest treatments with so much hope are beyond the means of those who have insurance policies but no great wealth. About 30% of cancer survivors report lasting financial hardship.
Cancer patients are nearly 5 times more likely to experience bankruptcy, and the medical burden forces many to forego care.
Those who have employer-based insurance were assumed to have the gold standard in health care. Now even the highest paid workers are subjected to premiums, deductibles, and co-pays that impede their care despite the family plans that average $32,000 per year. More have insurance that covers less than a hospital gown. Gold has turned to scrap metal.
As people struggle to pay for the premiums, deductibles, and co-pays, revenues of the seven largest health insurance companies in 2022 reached $1.25 trillion and profits soared to $69.3 billion. That’s a 287% increase in profits in just one decade, when profits were $24 billion.
The toxicity of the health care profit makers that spread unnecessary suffering and death generates the hatred that is poisoning the land.
Medicare, our best health care program, publicly funded and open to all, is now strangled in the grip of the privatized Medicare Advantage plans and the Accountable Care Organizations facilitated by the Center for Medicare and Medicaid Innovation (CMMI). Medicare Advantage now controls a majority of recipients, not because it is better, but because the law that established it and the regulators that control it have allowed it to charge less in monthly premiums—plans that are also allowed to delay and deny care yet are overpaid by billions every year. CMMI issues waivers to the private plans exempting them from fraud and abuse laws and allowing kickbacks, self-referral, and illegal benefit inducement.
Millions on fixed incomes cannot afford the alternative of traditional Medicare plus a prescription drug plan and a supplementary Medigap plan. Those who have managed to escape the clutches of Medicare Advantage can still find themselves assigned, without their knowledge, to “value-based” payment schemes such as ACO REACH and other Accountable Care Organizations (ACOs) which privatize traditional Medicare. “Value-based” payment models are touted, without evidence, as reducing costs for Medicare, yet encompass a multitude of for-profit entities and subject patients to physicians incentivized to deny care. There is ample evidence that “value-based” payment schemes do not lower costs for Medicare. Nevertheless, the privatization of Medicare, through Medicare Advantage or ACOs, is now official policy.
The hoax of “value-based” payments, promoted by CMMI, is exposed by the fact that, despite all the assertions of promoting equity, the inequities of health care are expanding.
Medicaid, the program for children and adults with low income, is almost completely privatized, subjecting the recipients to delays, denials and restrictions imposed by the private managed care organizations that control it.
The Center for Medicare and Medicaid Services (CMS) is hurtling down the wrong track. They invite venture capital and health care investors into the Health Care Payment Learning and Action Network (LAN) that they created. CMS holds conferences, seeking advice and collaboration from the very profiteers that are the cause of high cost, low-quality care. The “value-based” payment scheme promoted by CMS has advanced the power of the profit makers, raising costs, cutting care, and pretending to promote equity for minorities and low-income patients.
It’s time to end the chaos. No more foxes in the hen house, no more poison in the system, no more profit in health care.
The toxicity of the health care profit makers that spread unnecessary suffering and death generates the hatred that is poisoning the land.
It’s time to end the chaos. No more foxes in the hen house, no more poison in the system, no more profit in health care. The nation has rejected the insurance company health care model that delays and denies care, demands skin in the game, asserts that there is massive unnecessary care, throws up barriers against care, and walks away with billions. A system that collects money from patients and employers then profits by withholding the promised care is not a business but a fraudulent, diabolical scam.
This system built on profit cannot be tweaked or regulated into better performance. Runaway trains are not deterred by guardrails.
There is one way to heal the nation. Put single payer on the nation’s table and focus the steaming rage to move the engine of change. Raise the demand for removal of profit and enactment of an Improved Medicare for All free from profit to a level commensurate with the damage that our current failing system is causing the patients’ and the country’s goodwill.
Some look at the current Congress, make the assessment that it’s not possible to pass single payer, then change their demand to a lesser proposal. But incremental changes are at the root of the privatization and profit schemes we are locked into now. Fifteen years after the ACA we have a failing health care system. We have witnessed that more incrementalism does more harm than good. Power concedes nothing without a demand, and the demand must be equal to the solution needed.
There is one way to heal the nation. Put single payer on the nation’s table and focus the steaming rage to move the engine of change.
As Marcia Angell, former editor of the New England Journal of Medicine, taught us, in our current private profit-based system, proposals that lower costs also decrease care, and proposals that increase care, raise costs. To improve care and control costs, we must turn to national single payer, free from profit or a national health service.
The status quo is deadly, and people are demanding a stronger more effective fight. We must organize and educate, locally and nationally with a new determination. In every town hall, classroom, union, organization, and neighborhood, people must hear the message and join the fight. Redirect the rage into a positive force for change.
The new anger in the nation makes possible what we could not do before. Many are now discussing the possibility of setting a National Day of Action in 2025 to demand freeing health care from corporate profit and covering everyone under a national single payer plan. That’s a great idea. Actions across the country lifting up that demand could inspire the movement we need.
National Single Payer—an Improved Medicare for All free from profit with everybody in and nobody out. Nothing less can heal the nation.
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Patients, Advocates Push Biden to 'Reclaim Medicare' From Privatized Medicare Advantage
"If Medicare Advantage has it their way, they're going to deny me care and delay me care until I'm dead," said one patient.
Mar 15, 2024
Patients on Medicare Advantage spoke out against the privatized plans this week as part of a coordinated campaign to shed light on the program's care denials, treatment delays, and overbilling—and to pressure U.S. President Joe Biden to rein in the insurance giants raking in huge profits from such abuses.
"These corporations do nothing to increase positive outcomes in medical care. So don't fall for their bullshit," Jenn Coffey, a retired EMT from New Hampshire, said during a livestream hosted by People's Action on Wednesday night.
The stream featured testimony from several patients who have experienced the kinds of delays and denials for which Medicare Advantage is notorious.
Rick Timmins of Puget Sound Advocates for Retirement Action said it took five months and "multiple calls and emails" for his insurance company to approve his referral to a dermatologist for a suspicious lump on his earlobe that turned out to be malignant melanoma. The delay stemmed from a byzantine process known as prior authorization, whereby doctors are required to prove a treatment is necessary before an insurer will cover it.
By the time his referral to a specialist was approved, Timmins said, the previously tiny lump "had tripled in size" and was "quite painful."
MA insurance companies find it financially beneficial to delay essential care to patients.
Medicare (Dis)Advantage plans take the problems of private health insurance and import them into Medicare. @PplsAction #CareOverCost pic.twitter.com/V21nKlkyLj
— Social Security Works (@SSWorks) March 14, 2024
Coffey, for her part,
ended up on a UnitedHealth Medicare Advantage plan after she was diagnosed with breast cancer in 2013. She later developed two rare diseases—including complex regional pain syndrome—and required expensive treatments that her Medicare Advantage plan refused to cover.
"If Medicare Advantage has it their way, they're going to deny me care and delay me care until I'm dead," Coffey, a healthcare advocate, said in a video published Thursday by the advocacy group Be A Hero as part of a social media day of action against the for-profit plans.
"They only make money when they don't have to spend it on you," said Coffey.
Once enrolled in a Medicare Advantage plan, patients often find it difficult to get out.
"They like to tell you: 'Medicare Advantage numbers are so high, can't you tell people love it?'" said Coffey, alluding to the fact that more than half of all eligible Medicare beneficiaries are now enrolled in a Medicare Advantage plan. "No, we don't. We're stuck. It's the Hotel California: You can check in, but you can't get the hell out."
“If Medicare Advantage has it their way, they’re going to deny me care and delay me care until I’m dead.” — Jenn
The greedy health insurance corporations that run Medicare (Dis)Advantage will always put profits above patients. That’s why we’ve got to #ReclaimMedicare. pic.twitter.com/0ED1iHBu0u
— Be a Hero (@BeaHero) March 14, 2024
Next month, the Biden administration is expected to finalize 2025 payment rates for Medicare Advantage, which is funded by the federal government. Medicare Advantage plans frequently overbill the government by making patients appear sicker than they are.
An analysis released last year by Physicians for a National Health Program estimated that Medicare Advantage plans are overcharging U.S. taxpayers by as much as $140 billion per year—an amount that could be used to completely eliminate Medicare Part B premiums or fully fund Medicare's prescription drug program.
Patients and advocacy groups are calling on Biden to "not fork over more money for insurance companies like UnitedHealthcare," as Coffey put it during Wednesday's livestream.
A petition sponsored by Social Security Works urges Biden to "reclaim Medicare" from Medicare Advantage providers, which "have delayed and denied care to millions of Americans in order to turn a massive profit."
"Medicare Advantage isn't really Medicare, and it isn't an advantage to the seniors and people with disabilities who rely on the program," reads the petition, which has over 22,800 signatures as of this writing. "In the 25 years that it has existed, it’s clear that Medicare Advantage is riddled with the same problems as the rest of private insurance: Opaque bureaucracy and extraordinary fees. Seniors who enroll in these for-profit plans are being price-gouged by massive corporations."
The Biden administration has proposed a 3.7% payment increase for Medicare Advantage in 2025—a change that insurers have portrayed as a cut. But Social Security Works noted in response to the industry's complaints that "MA companies are not hurting for profits."
"In 2022 alone, seven healthcare companies that comprise 70% of the MA market brought in over $1 trillion in total revenue and over $69 billion in profits, and spent $26.2 billion on stock buybacks," the group observed. "These same companies claim that if the government doesn't increase their already bloated payment rates, they will have no choice but to slash benefits for patients. This is false, and should be seen for what it is—MA plans holding patients hostage to extort the government for profits."
In an op-ed for STAT last month, former insurance industry insider Wendell Potter—who is now an outspoken critic of private insurers—and John A. Burns School of Medicine professor professor Philip Verhoef wrote that "private plans have no business administering Medicare benefits."
"Traditional Medicare is already more efficient than its private counterpart, in large part because the approval process is much simpler and there aren’t the same incentives to upcode," the pair wrote. "Traditional Medicare spends far less of its funds on administrative overhead, and overall it spends less money per patient than Medicare Advantage while providing far superior access to doctors, hospitals, and treatments."
"Medicare Advantage isn't working for any group: the government, patients, taxpayers, and now even investors," they added. "It's time to turn to what we already know works. We need to support and strengthen traditional Medicare."
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Biden DOJ Launches Antitrust Probe Into Medicare Advantage Behemoth UnitedHealth
"For years, UnitedHealth has unfairly and illegally leveraged each of its businesses to strategically squeeze out competitors and monopolize all corners of healthcare," said one researcher.
Feb 28, 2024
The U.S. Justice Department has launched an antitrust investigation into UnitedHealth Group, the world's largest health insurance company and a major provider of private Medicare Advantage plans that are notorious for
denying necessary care and bilking taxpayers.
The probe, first reported by The Examiner News and confirmed by The Wall Street Journal on Tuesday, drew applause from anti-monopoly campaigners who argue that healthcare industry consolidation has harmed patients through higher costs and worse care.
Matt Stoller, research director at the American Economic Liberties Project, said in a statement Tuesday that the Department of Justice is "right to investigate UnitedHealth Group for monopolization, and we hope to see enforcement action taken soon."
"For years, UnitedHealth has unfairly and illegally leveraged each of its businesses to strategically squeeze out competitors and monopolize all corners of healthcare, from insurance and pharmaceuticals to home healthcare," said Stoller. "In the process, UnitedHealth has degraded patient care, demoralized and devalued doctors and nurses, put independent pharmacies out of business, and ripped off taxpayers."
"United gained its foothold on the system through its relentless path of acquisitions."
The Examiner News reported that the DOJ notified UnitedHealth last October that it had launched a "non-public antitrust investigation into the company." According to the Journal, Justice Department investigators "have in recent weeks been interviewing healthcare industry representatives in sectors where UnitedHealth competes, including doctor groups."
Optum, a subsidiary of UnitedHealth, is the largest employer of doctors in the U.S., and the company is currently working to acquire the home healthcare provider Amedisys in a $3.3 billion deal that has drawn scrutiny from the Justice Department.
As Krista Brown and Sara Sirota wrote last year for the newsletter HEALTH CARE un-covered, "It's not hyperbole to describe UnitedHealth as the bulk of our country's healthcare system—and its $85 billion in publicly disclosed acquisition spending played a big part."
"United gained its foothold on the system through its relentless path of acquisitions," they added, "and each additional business it purchases is, and has been, used to leverage its control of the healthcare industry."
UnitedHealth is currently the nation's largest provider of privately run, publicly funded Medicare Advantage plans, which have faced growing criticism from the Biden administration and Democratic lawmakers for dramatically overcharging the federal government and denying care claims that likely would have been approved under traditional Medicare.
Last year, UnitedHealth ditched the brand name naviHealth, a technology-focused subsidiary that faced backlash after reporting by STAT detailed the company's use of artificial intelligence algorithms to deny essential care to elderly patients.
Additionally, as Brown and Sirota noted, UnitedHealth employees alleged that company executives " pressured them to deny coverage or lose their jobs," sparking a class-action lawsuit.
"In short, naviHealth was transformed from a company meant to better manage post-acute care to a machine that maximizes profits," Brown and Sirota added. "It was UnitedHealth-ified."
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UnitedHealth Touts Profit Surge After Lobbyists Weaken Medicare Advantage Crackdown
UnitedHealth CEO Andrew Witty told investors he "appreciates" the Biden administration's decision to slow the implementation of its Medicare Advantage reforms.
Apr 14, 2023
The chief executive of UnitedHealth Group told investors Friday that he "appreciates" the Biden administration's decision to more slowly implement its crackdown on overbilling in Medicare Advantage, a privately run, government-funded program that the Minnesota-based insurance behemoth touted as a key profit driver in its newly released first quarter earnings report.
UnitedHealth, one of the largest Medicare Advantage providers in the U.S., reported $91.9 billion in revenue for the first three months of 2023—15% growth year-over-year—and more than $8 billion in earnings from operations, exceeding analysts' expectations.
UnitedHealthcare, UnitedHealth Group's insurance business, "is pacing strongly to its outlook for another year of market-leading growth in serving more people through its Medicare Advantage offerings," the company said in its earnings release. The company said Friday that it added 655,000 new Medicare Advantage members in the first quarter of the year.
UnitedHealth's earnings report came after the company helped lead an aggressive lobbying campaign against new Biden administration rules aimed at limiting Medicare Advantage insurers' ability to overcharge the federal government by making patients appear sicker than they actually are.
According to The New York Times, UnitedHealth CEO Andrew Witty appeared on Capitol Hill in person to lobby against the proposed changes, which the lucrative Medicare Advantage industry falsely characterized as cuts to the program that now provides insurance to nearly half of the overall Medicare population.
Late last month, the Centers for Medicare and Medicaid Services (CMS) offered a number of concessions to the industry, agreeing to impose its policy changes over a period of three years instead of all at once and boosting Medicare Advantage payment rates by more than expected.
As STAT reported last week, Wall Street investors were "overjoyed" by the Biden administration's move, which drew criticism from progressive lawmakers and healthcare analysts who warned the slow phase-in will allow Medicare Advantage plans to continue their abusive practices. UnitedHealth, like other Medicare Advantage insurers, has been accused of wrongfully denying or attempting to deny patients necessary care, in some cases utilizing artificial intelligence to determine when to end coverage.
When it comes to excess billing, CMS recently estimated that overpayments to Medicare Advantage totaled $11.4 billion in fiscal year 2022—a significant drain on the Medicare trust fund.
Citing one industry analyst, STAT noted that UnitedHealth could reap $900 million in additional profit next year alone thanks to the administration's decision to delay full implementation of the reforms.
In an analysis published in February, former insurance executive Wendell Potter noted that UnitedHealth is one of just seven large for-profit insurance companies that now control 70% of the Medicare Advantage market, which is dependent on taxpayer money.
According to Potter, who now heads the Center for Health and Democracy, insurance giants UnitedHealth, Cigna, CVS/Aetna, Elevance, Humana, Centene, and Molina saw their combined revenues from taxpayer-supported programs grow 500% between 2012 and 2022.
"They've essentially been bailed out by taxpayers," Potter said of for-profit insurance giants like UnitedHealth in a recent interview with The American Prospect. "And members of Congress, and various administrations, have been just standing on the sidelines, not paying attention to what's been going on."
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Wall Street 'Overjoyed' as Biden Lets Medicare Advantage Insurers Off Easy
One healthcare stock analyst called the Biden administration's weakened reforms a "sigh of relief" for the insurance industry.
Apr 10, 2023
UnitedHealth Group, a dominant force in the lucrative Medicare Advantage market, has seen its stock jump over the past week as Wall Street analysts and investors embrace the Biden administration's decision to delay reforms aimed at tackling abuse in the privately run, government-funded health program.
STAT reported late last week that "Wall Street was overjoyed" by the announcement from the Centers for Medicare and Medicaid Services (CMS), which said it would phase in changes to the model that dictates how much government funding Medicare Advantage insurers receive to cover patient care.
Instead of implementing the changes all at once, the Biden administration will roll out the reforms over a three-year period, allowing Medicare Advantage insurers to continue overbilling the federal government in the meantime.
Recent federal audits and investigative reports have detailed how Medicare Advantage plans overcharge the government to the tune of billions of dollars a year by making patients appear sicker than they are, piling on diagnoses with little to no supporting documentation. Medicare Advantage plans also frequently deny necessary care and use algorithms to prematurely end coverage.
In addition to delaying full implementation of its reforms, CMS—which has faced aggressive lobbying from UnitedHealth and other major Medicare Advantage players in recent weeks—announced it would boost payment rates for Medicare Advantage plans by 3.3% in 2024—a larger-than-expected increase.
CMS said Medicare Advantage payments would rise by nearly $14 billion next year under the new plan.
As STAT's Bob Herman noted, "health insurance companies that participate in Medicare Advantage will retain billions of extra taxpayer dollars next year" thanks to the Biden administration's changes, which drew criticism from progressive lawmakers and some policy experts.
"The phased-in approach will continue to reward those insurers with the most abusive practices over the next two years," warned Mark Miller, executive vice president of healthcare for the philanthropy Arnold Ventures.
Herman reported that following the CMS announcement, "investors raced to buy stocks of the largest Medicare Advantage insurers, including UnitedHealth, Humana, CVS Health, Elevance Health, and Centene." STAT cited one analyst estimate suggesting that UnitedHealth Group could see $900 million in additional profit next year thanks to the CMS policy revisions.
"It was 'a sigh of relief' for the industry, according to Jailendra Singh, a healthcare stock analyst at Truist Securities," Herman wrote. "Chris Meekins, a health policy analyst at Raymond James, called the White House's move 'a clearing event for the space.'"
UnitedHealth, Cigna, Humana, CVS/Aetna, Elevance Health, Centene, and Molina have seen their combined revenues from taxpayer-funded programs like Medicare Advantage soar from $116.3 billion in 2012 to $577 billion in 2022, according to a recent analysis by Wendell Potter, a former Cigna executive who now heads the Center for Health and Democracy.
Those companies have been at the forefront of what The New York Times recently described as a "lobbying frenzy" on Capitol Hill, a blitz that appears to have influenced the Biden administration's decision to go easy on Medicare Advantage despite promising bold reforms.
The Times noted that the administration's earlier proposals to revise the Medicare Advantage risk-adjustment model "unleashed an extensive and noisy opposition front, with lobbyists and insurance executives flooding Capitol Hill to engage in their fiercest fight in years."
"The largest insurers, including UnitedHealth Group and Humana, are among the most vocal, according to congressional staff, with UnitedHealth's chief executive pressing his company's case in person," the newspaper reported. "Since the proposal was tucked deep in a routine document and published with little fanfare in early February, Medicare officials have been inundated with more than 15,000 comment letters for and against the policies, and roughly two-thirds included identical phrases from form letters."
The Better Medicare Alliance, a lobbying organization backed by top Medicare Advantage insurers, purchased a Super Bowl ad decrying the Biden administration's earlier reform proposals as an effort to "cut" Medicare Advantage.
Rep. Pramila Jayapal (D-Wash.), chair of the Congressional Progressive Caucus, said in a statement late last week that she was disappointed by the Biden administration's decision to weaken its reforms in the face of industry pressure.
"It is now clear that Medicare Advantage is simply a profiteering venture that hurts patient care," said Jayapal. "Without a complete overhaul, it will be impossible to stop bad actors. These plans have spent years scamming seniors and overcharging the government to pad their own profits. We were on the cusp of immediate reform when the Biden administration proposed fixes to stop price gouging by insurance companies."
"Sadly," she added, "health insurance companies used taxpayer dollars meant for medical care to instead buy Super Bowl commercials and desperately lobby to stop these changes that would cut down on their profiteering."
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