Medicare Advantage is ripe for Comer’s oversight committee to investigate

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Kay Tillow

May 11, 2023 5:40 am

(Getty Images)

Congressman James Comer, of Kentucky’s 1st District and chairman of the House Oversight Committee, is much in the news these days. The oversight committee is supposed to ensure the efficiency, effectiveness and accountability of the federal government and all its agencies.  Comer has been investigating everything from Chinese money laundering to Hunter Biden’s laptop to the origin of Covid-19.  Those may, indeed, be serious concerns, but there is a domestic health care issue that requires urgent attention.

Kentucky health care advocates have asked Rep. Comer to look into an issue central to the nation’s health and financial wellbeing.  Private, for-profit Medicare Advantage (MA) plans are siphoning billions from the Medicare Trust Fund while they delay and deny care to seniors and the disabled.

The Centers for Medicare and Medicaid Services (CMS), the government agency that oversees Medicare, is also in dire need of a thorough investigation. From 2008 to 2023 Medicare Advantage insurers collected $124 billion in overpayments, according to the Medicare Payment Advisory Panel. As terrible as it is to think of profiteers ripping off Medicare funds, it’s even worse that these Advantage plans are cheating on the care they owe to the patients.

Medicare Advantage is ripe for Comer’s oversight committee to investigate

Listen to Single Payer Radio with Dr. Mike Flynn, Dr. Eugene Shively, and Mark McKinley

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Tune in to Single Payer Radio on WFMP-LP at 106.5 FM on Monday at 2:00pm, Tuesday at 7:00 am, and Wednesday at 11:00 am for the latest updates on health care in our community and nation and the struggle to win universal health care.

Retired surgeons Eugene Shively (L) of Campbellsville and Mike Flynn (R) of Louisville in the Forward Radio studio hosting Single Payer Radio. The program is produced by Mark McKinley.

If you are outside the Jefferson County area, you can livestream the program at ForwardRadio.org. Archived programs can be found here or on your favorite podcast.

ACO REACH and the Privatization of Medicare

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Kathleen Healey, MD, Co-Chair of Physicians for a National Health Program–CA, describes how Medicare’s new ACO/REACH program places seniors and the disabled into for-profit plans without their consent. ACO REACH, along with Medicare Advantage, is draining the Medicare Trust Fund as private equity, venture capital, and insurance companies delay and deny care in the pursuit of profit.

Kentuckians for Single Payer Health Care offers free presentations on this topic. Contact us at 502 636 1551, nursenpo@aol.com.

KSPH Reaches Out at the MDC Awards Ceremony

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Jill Harmer and Kay Tillow staffed the single payer table at the March 31, 2023, Awards Ceremony hosted by the Metro Disability Coalition. MDC is a solid supporter of Improved Medicare for All. Jill Harmer made certain that the brochures on single payer and the flyers opposing ACO REACH were placed in many hands. The event was held on the 16th floor of the U of L Rudd Heart and Lung Center.

Kentucky can put Medicare for All on the Ballot

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Kentucky cities can place questions on the ballot by vote of the city legislative body or by petitions

Last November, rural Dunn County, Wisconsin, which twice voted for Trump, voted by a majority for a national, publicly-funded, not-for-profit, health care plan that would cover all medical costs.  Townships in Southern and Central Illinois voted by 64% and 84% majorities for Improved Medicare for All.

These examples open a way to challenge the politicians who say the people oppose single payer.  Can such ballot initiatives inform and energize a grass roots movement in the fight for Improved Medicare for All?

Former State Representative Joni Jenkins has provided us with the Kentucky law that allows Kentucky cities to place such a referendum on the ballot:

83A.120 Procedure for referendum on public question.

“Any public question authorized by statute may be submitted to the voters of a city by either a resolution of the city legislative body or a petition meeting the requirements of this section.”

Are you interested in getting this question on the ballot in your city?

“Shall Congress and the President of the United States enact into law the creation of a publicly financed, non-profit, national health insurance program that would fully cover medical care costs for everyone in the United States?”

Let’s talk about the possibilities. Kay (502) 636 1551, nursenpo@aol.com

Dave McCool, Dr. Edgar Lopez, and Larry Hovekamp carry the banner in Louisville’s Easter Parade

Twice rural Dunn County voted for Trump. In 2022 they voted for public, non-profit health Care.

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On November 8, conservative, rural Dunn County in Wisconsin voted 51.4% for national, publicly-funded, non-profit healthcare for everyone.  That same county had voted for Trump in the last two presidential elections and still in 2022 voted by majority for Republican candidates.

On December 14, 2022,  two members of the County Board of Supervisors, John Calabrese and Monica Berrier, spoke on the meaning of this expression of popular support for single payer health care in a conservative county.

Watch and share the video.

Story on the vote:
https://theintercept.com/2022/11/29/wisconsin-medicare-for-all-health-care/

Video of Dr. Corinne Frugoni on Medicare Privatization and ACO REACH

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On December 15, 2022, Dr. Corinne Frugoni made a powerful presentation for Kentuckians for Single Payer Healthcare, and she has graciously shared her power point slide show as well.  Write to nursenpo@aol.com to request it.


Thanks to Paul Hoppe, the video of the program is up on our youtube channel.  Please share it widely.


We urge you to take action and organize in your community so we can bring understanding about what is happening and, also, build a powerful movement to stop this privatization of Medicare that threatens our seniors and our entire Medicare program.

In addition, below are links to resolutions passed by various organizations, unions, and political bodies.  Please use them to get further resolutions passed, and please send copies of any resolutions passed to nursenpo@aol.com.

Please write to your representative and senators and urge them to encourage President Biden to terminate ACO REACH.  

Save the date: Thur. Dec. 15, 7:00pm EST

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Medicare Privatization: Medicare Advantage and REACH

A threat to seniors and the future of Medicare

Thursday, Dec. 15 at 7:00 pm EST by zoom

Speaker:  Corinne Frugoni, MD

Retired family physician and former Co-chair of Physicians for a National Health Program—California

Recent federal reports and New York Times articles have called attention to the persistent threats to Medicare from private, for-profit Medicare Advantage plans.  These deceptively marketed plans have been exposed for denial of care as they reap billions at the expense of the Medicare Trust Fund.

Unfortunately, Medicare Advantage is not the only imminent danger to Medicare.  An under-the-radar pilot program called Direct Contracting Entities (DCEs), renamed ACO REACH, places seniors who have chosen traditional Medicare into for-profit plans dominated by private equity, venture capital, and insurance companies.  These plans, into which seniors are placed without their consent, create a profit incentive for the denial of care.  The Center for Medicare and Medicaid Services plans to have all seniors in such plans by 2030.

Corinne Frugoni, MD

We now see DCEs operating in Kentucky.  One named “Oak Street” is open at 1731 Dixie Highway and at 5743 Preston Highway.  There are more in Louisville, Lexington, Pikeville, Hazard, Paducah, and Murray.  Most people are unaware of DCEs and ACO REACH and the new threat they pose to Medicare.  That’s why we are inviting you to a free, educational program.

This program is free but you must register in advance:
https://us02web.zoom.us/meeting/register/tZEqdOGupjMvHNDVj8YyT9DjuQCSqqmH7BzJ
After registering, you will receive an email with the zoom link for joining the meeting.

Please spread the word and join us.

The program will be followed by Q and A and your questions and discussion will be welcome.

Many organizations are calling for the termination of ACO REACH which President Biden could end with the stroke of a pen.  A sample resolution is here.  Further info is here.

Action is Urgent to Terminate ACO REACH and End the Privatization of Medicare

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Effective January 2023, the ACO REACH program begins allowing Wall Street firms and insurance companies to turn traditional Medicare into a profit-making enterprise.

(L to R) Dr. Malika Sabharwal and Dr. Sarah Riley Parker, both former presidents of Students for a National Health Program at UofL,

Seniors who have chosen traditional Medicare can be placed into these for-profit entities without their consent, and the program can be implemented without an act of Congress.  In ACO REACH, denial of care brings more profit.

Traditional Medicare has a 2% overhead, while DCEs and ACO REACH can receive up to 40% in overhead and profit. Both seniors and the Medicare Trust Fund will suffer.

Kentuckians for Single Payer Health Care is working with other organizations to terminate ACO REACH before the harm is done.

KSPH is offering a free educational program to any organization that wants to learn more.  Just let us know at 502 636 1551 or nursenpo@aol.com.

In addition, your organization can pass a resolution to terminate ACO REACH.  Here is a sample resolution. https://protectmedicare.net/wordpress/wp-content/uploads/2022/09/WashingtonStateLaborCouncilResolution.pdf