The Republicans Have An Action Plan To Privatize Medicare If Trump Wins With GOP Majorities

"The Long Leash" by Nancy Ohanian

When I was diagnosed with a rare form of cancer, Medicare picked up the tab and never hassled me, not once. God bless Medicare. Not all Americans feel the same way, though, especially not conservatives. Conservatives would rather poor people die than imagine they are helping to pay for their care. That helps define what a conservative is. Hopefully, one day a team of brilliant geneticists and cytogeneticists will figure out if there’s a chromosome that is related to greed, selfishness, bigotry, psychosis and conservatism and rid the human race of it. Until then, though, we have to deal with the regular occurrences and populist embraces of Hitlers and Trumps plaguing humanity. 

Even with someone as obviously beneficial as Medicare and Social Security… many conservatives are against them. This chart from Kaiser shows that fewer Republicans support Social Security, Medicare, Medicaid and— drastically— ObamaCare than do normal people.

And in terms of "overhauling"— usually defined as privatizing— Medicare, this Gallup poll shows that something like a third of the country would more or less like to— idiots, but they vote as well.

In fact, yesterday Andrew Perez reported that Republicans are planning to totally and quickly privatize Medicare if Trump wins, especially if he has congressional majorities. “Last year,” wrote Perez, “for the first time ever, a majority of Americans eligible for Medicare were on privatized Medicare Advantage plans. If Republicans win the presidential race this year, the push to fully privatize Medicare, the government health insurance program for seniors and people with disabilities, will only intensify. Conservative operatives have already sketched out what the GOP’s policy agenda would look like in the early days of a new Donald Trump presidency. As Rolling Stone has detailed, the proposed Project 2025 agenda is radically right-wing. One item buried in the 887-page blueprint has attracted little attention thus far, but would have a monumental impact on the health of America’s seniors and the future of one of America’s most popular social programs: a call to ‘make Medicare Advantage the default enrollment option’ for people who are newly eligible for Medicare.”

Alan Grayson, the progressive in the Florida Senate contest against sunset-Medicare fanatic Rick Scott, pointed out that “Medicare Advantage completely fails to address the basic problem in every health-for-profit scheme. The Medicare Advantage corporations provide as little healthcare as they can, they charge the Government as much as they can, and they call the difference profit. In this case, since both the price and standards of care are set by the Government, every dollar of profit is one fewer dollar of care. Calling it the ‘Advantage’ program is simply slick marketing, to cover that up.”

Diane Young, the progressive Democrat running in the swing seat north of Detroit (MI-10) was even blunter. Rolling her eyes, she said: “Just another example of how Republicans corporate greed will use our tax payer dollars to line the pockets of their corporate donors.”

Such a policy would hasten the end of the traditional Medicare program, as well as its foundational premise: that seniors can go to any doctor or provider they choose. The change would be a boon for private health insurers— which generate massive profits and growing portions of their revenues from Medicare Advantage plans— and further consolidate corporate control over the United States health care system.  

It would not likely benefit seniors, since the private plans limit the doctors they can see and often wrongfully deny patients’ care. Because the plans are costly, experts say the GOP proposal could threaten the Medicare program’s solvency. 

Philip Verhoef, president of the single-payer advocacy group Physicians for a National Health Program, tells Rolling Stone it would be “disastrous” to make Medicare Advantage the default enrollment option. “To do so would be really just a clear handout to the private insurance industry,” he says.

David Lipschutz, associate director of the Center for Medicare Advocacy, says the plan would “greatly accelerate” Medicare privatization.  

Project 2025, which is being spearheaded by the influential Heritage Foundation, describes its presidential transition project as “the conservative movement’s unified effort to be ready for the next conservative Administration to govern at 12:00 noon, January 20, 2025.” 

…The latest “Mandate for Leadership,” the Project 2025 agenda written by the Heritage Foundation and like-minded conservative organizations, would reshape the future of the Medicare program and push more seniors into alternative, privatized Medicare Advantage plans. 

…Lipschutz, of the Center for Medicare Advocacy, says the Project 2025 plan would “violate the free choice of provider provision and principle of the Medicare Act, which guarantees that people will have a free choice of provider.”

Under traditional Medicare, enrollees are free to visit any doctor who accepts Medicare (nearly all physicians do). Medicare Advantage plans, by contrast, often have limited networks of doctors that patients can choose from, and many providers have stopped accepting the private plans because they so often deny the prior authorization requests they require before patients can receive services.

Lipschutz notes the Project 2025 plan says that Republicans would “give beneficiaries direct control of how they spend Medicare dollars.” He says this is “internally inconsistent” with its proposal to make Medicare Advantage the default enrollment option. Medicare Advantage plans, he says, are “tasked with managing your care, and telling you what you can and can’t do, and what is and is not covered— that is the opposite of putting beneficiaries in control of how they spend their dollars.” 

It’s natural that beneficiaries might see some appeal in Medicare Advantage plans. Traditional Medicare leaves patients with significant out-of-pocket costs— which is why many enrollees in the traditional program pay for supplemental Medigap coverage. Medicare Advantage plans also promise to limit these costs. And unlike the traditional Medicare program, the private plans can offer dental, vision, and hearing benefits.

But the private plans often do not work well for sicker patients — and when they seek to leave the program and enroll in traditional Medicare, they may encounter an expensive problem: Most states allow Medigap plans to deny coverage to patients with preexisting health conditions, so these patients can get stuck with significant out-of-pocket costs. 

While Medicare Advantage plans are required to pay for services covered by traditional Medicare, the government has for years flagged “ persistent problems related to denials of care and payment in Medicare Advantage.” More recently, news reports have found the private plans are using artificial intelligence and algorithms to deny services in bulk, with extreme error rates— allegedly as high as 90 percent, according to one class action lawsuit. 

…The privatized plans have, for years, systematically overbilled the government— mostly by billing the government as if their patients are sicker than they really are. The Biden administration has worked to claw back some of those past overpayments and rein in future outlays. Industry lobbyists and lawyers have aggressively fought these efforts.  

MedPAC, an independent congressional advisory agency, projects that the federal government will overpay Medicare Advantage plans by $88 billion this year.

Lipschutz notes the Project 2025 plan includes a few Medicare Advantage reform ideas that could save the government money, depending on the details. However, he says, if “you increase enrollment in Medicare Advantage, you further threaten and put more pressure on Medicare’s finances.”

Jerrad Christian is running for an Ohio congressional seat occupied with typical conservative privatizer, Troy Balderson. Christian told me that “The push towards privatizing Medicare is a  wreckless move fraught with real risk. This is an example of the far right's constant prioritization of corporate profits over the needs of people. Every time— profits over people. It risks transforming a system designed for public welfare into a profit-driven disaster, where financial gains overshadow patient care. This shift could lead to higher costs, reduced access to essential services, and a degradation of healthcare quality for our seniors. It undermines the core ethos of Medicare: providing reliable, accessible, and equitable health services. We must protect against such changes that threaten the health security of millions, especially our most vulnerable population. All of this on the heels of Joe Biden's medicare negotiation to lower drug costs. If these folks had their way, medicare would be owned by the same people they're negotiating with.” Consider contributing to Jerrad’s race— and to Diane’s— here.