Republican leaders on Tuesday downplayed the possibility of cuts to Medicaid benefits as they seek a reconciliation bill with up to $2 trillion in savings. Speaker Mike Johnson (R-La.) and Majority Leader Steve Scalise (R-La.) sought to reassure the public — and potential jittery members of their own caucus — that the Medicaid changes under discussion include work requirements and fraud reduction, not drastic cuts like lowering the federal match for Medicaid expansion states or instituting a per capita cap.
A bill that makes it harder for insurance companies to deny coverage for mental healthcare passed in the Colorado House on Monday. Under federal law, insurers are required to treat physical and mental health care in the same way, but state Sen. Judy Amabile, the sponsor of the bill, says that many insurers are refusing to cover mental health care based on what their definition of what's medically necessary. The Democrat from Boulder County's bill would establish a standard definition of medical necessity based on criteria developed by mental health professionals.
A free cruise turned into a financial nightmare for Mike Cameron, a Minnesota truck driver of 25 years, and his girlfriend, Tamra. The couple won a free cruise with Norwegian Cruise Line and were excited to celebrate Tamra's recent lung cancer recovery. The pair set sail for the week-long trip in early January, but shortly into the week, Cameron got sick. He said he went to the ship's medical center and was diagnosed with the flu. ... But when it came time to pay the bill, Cameron was shocked to learn that the total cost of his care was more than $47,000.
Trump said last month that he would not make cuts to the country's public health insurance program for low-income and disabled Americans. But the White House and Republicans in Congress are considering a menu of options that could add up to $2.3 trillion in potential cuts to Medicaid over the next decade.
States are absorbing substantial increases in healthcare costs for the poor, as they realize that the people remaining on Medicaid rolls after the COVID-19 pandemic are sicker than anticipated — and costlier to care for. In Pennsylvania, state budget makers recently unveiled the scale of that miscalculation, with Democratic Gov. Josh Shapiro proposing an increase of $2.5 billion in Medicaid spending in the next fiscal year. That amounts to a roughly 5% increase in overall state spending, mostly driven by the cost to care for unexpectedly sick people remaining on the state's Medicaid rolls.
Two months after the killing of UnitedHealthcare CEO Brian Thompson sent shockwaves through the much-reviled U.S. health insurance industry, the company's parent, UnitedHealth Group, is making aggressive moves to protect its image.
Responding to a slew of attacks online, often coupled with the glorification of Luigi Mangione (who was charged with Thompson's murder outside a midtown Manhattan hotel in December, and allegedly wrote a short manifesto calling health insurers "parasites"), the company has hired a law firm that specializes in defamation cases. Clare Locke, the Virginia-based practice, previously represented Dominion Voting Systems in a bombshell defamation suit that saw Fox News pay a settlement of $787.5 million for airing false allegations about the company's supposed role in voter fraud during the 2020 election.
UnitedHealth appears eager to make a similar example of Elisabeth Potter, an Austin, Texas, plastic surgeon, and is accusing the doctor of "using her social media following to perpetuate inaccuracies, which is irresponsible, unethical, and dangerous." On Jan. 7, Potter posted a video on Instagram sharing her frustration with the U.S. insurance system, explaining in a text caption that during a procedure, "I was interrupted by a call from United Healthcare — while the patient was already asleep on the operating table. They demanded information about her diagnosis and inpatient stay justification. I had to scrub out mid-surgery to call United, only to find that the person on the line didn't even have access to the patient's full medical information, despite the procedure already being pre-approved.
"It's beyond frustrating and, frankly, unacceptable," Potter continued. "We should be focused on care, not bureaucracy." The comments were rife with fury at UniteHealthcare and for-profit health insurance more broadly. "Luigi for President," wrote one person, while another put in, "One day these health insurance companies will be dead."
Days later, according to reporting from Bloomberg, Potter's attorney received a letter from Clare Locke instructing her to amend the post, apologize, and disavow threats of violence that UnitedHealth claimed had stemmed from the video. But Potter's legal counsel, Jessica Underwood, has said that there is nothing inaccurate in the video that needs correcting. "Dr. Potter will not be silenced by UnitedHealthcare's attempts to threaten and harass her," Underwood has said. The company, meanwhile, has argued that "Dr. Potter's claims that she was called out of surgery are false." Potter's Instagram video remains up on the platform, where it has received more than 350,000 likes.
Elsewhere, UnitedHealth took measures to prevent the dissemination of internal data about its denials of customer claims. (UnitedHealth Group's individual market plans are known to have one of the highest denial rates among all U.S. insurers, a fact that received much media attention in the wake of Thompson's death.) As The Lever reported, a day after President Donald Trump‘s inauguration in January, UnitedHealth submitted a letter to the Securities and Exchange Commission asking for approval to block a shareholder proposal that it use a third-party auditor to assess "previous customer denial claims, particularly where a death was involved, to determine if denial letters included factually incorrect and insensitive information." In cases where this outside analyst determined that a coverage claim should not have been denied, the proposal says, those individuals and family members affected are to be sent an apology letter hand-signed by both a UnitedHealth executive and a member of the company's board of directors.
UnitedHealth's rationale for refusing a vote on such a policy, as its legal team wrote in the letter, is that the proposal was not submitted before "the applicable deadline."
Then, on Jan. 31, the insurer sent a second letter to the SEC, seeking to prevent a shareholder vote on another proposal related to its claim denials. This proposal, if passed by investors, would recommend that UnitedHealth "evaluate how company practices impact access to health care and patient outcomes, including analyses of how often prior authorization requirements or denials of coverage lead to delay or abandonment of medical treatment and serious adverse events for patients." The report produced through this review is also intended to encompass "the public health-related costs and macroeconomic risks created by the company's practices that limit or delay access to health care."
In their letter, UniteHealth rejected the notion of putting this proposal to a shareholder vote because it is "vague and indefinite," and, it argued, an attempt to "impermissibly micromanage" the company.
The insurance giant's attempts to police social media chatter about its business practices and its overtures to Trump's SEC dovetailed earlier this week when hedge fund billionaire Bill Ackman shared his opinion of the company's future. "If I still shorted stocks, I would short United Healthcare," he posted to X on Tuesday, adding that the SEC "should do a thorough investigation of the company." He further mused, "I would not be surprised to find that the company's profitability is massively overstated due to its denial of medically necessary procedures and patient care."
Ackman later deleted the speculation, but UnitedHealth flagged his comments to the SEC for potential investigation. The company's stock price dipped the following day, and ended the week about 2.7 percent lower than it was on Tuesday. "Health insurance has long been subject to significant regulatory oversight and earnings caps," UnitedHealth said in a statement responding to the outspoken investor, one of many ultra-wealthy figures to back Trump in 2024 and post prolifically on social media about how only the MAGA movement could save the country. "Any claims that health insurers, which typically have low- to mid-single digit margins, can somehow over-earn are grossly uninformed about the structure and strong regulatory oversight of the sector," the company noted.
All told, UnitedHealth is mounting a far stronger defense of its reputation than it did two months ago, when Thompson's slaying unleashed a flood of hostility that caught it somewhat off-guard. Now, the company looks like it's prepared to grind it out as Mangione's parallel state and federal trials get underway, with heated rhetoric likely to flare up once again.