WASHINGTON — President-elect Donald Trump appointed Dr. When Mehmet chose Oz, the new chairman of the Senate Finance Committee, Mike Crapo, R-Idaho, was quick to praise the popular doctor on television and said he was looking forward to his arrival. nomination.
“Too often, patients who rely on federal government health care programs are forced to accept bureaucratic, one-size-fits-all coverage,” Crapo said. “Dr. Oz has been an advocate for providing consumers with the information they need to make their own health decisions.
It turns out that Oz, Trump’s pick to run the Centers for Medicare and Medicaid Services, approved a one-size-fits-all plan for health care just four years ago.
Oz co-authored with a Forbes piece In June 2020, with former Kaiser Permanente CEO George Halvorson, he called for eliminating employer-provided insurance and Affordable Care Act coverage and enrolling “every American not on Medicaid” into Medicare Advantage, which uses private insurance. approved the Medicare Advantage” system. plans to cover registrants. They proposed funding it with a 20% payroll tax on employers and employees.
“It is perhaps ironic that there is a striking similarity to the proposal to provide universal coverage through private Medicare Advantage plans. Kamala Harris’s ‘Medicare for All’ Proposal during the 2020 campaign,” said Larry Levitt, executive vice president for health policy at the nonpartisan research group KFF.
Harris’ plan “came back to haunt him politically,” Levitt said. “It’s hard to imagine Republicans widely embracing a Medicare Advantage plan that requires a big tax increase and more people to be covered by a government entitlement program.”
Four years after Oz unveiled the Medicare Advantage plan for All, Trump announced his choice to run CMS, promising to “reduce waste and fraud at our nation’s most expensive Government Agency,” without explaining how Oz did it.
Spokesmen for Trump’s transition team did not return messages seeking comment.
Sen. James Lankford, R-Okla., said he has not reviewed the 2020 Medicare Advantage proposal, but praised Oz as someone who has “studied these issues a lot.”
“We need someone to be transformative,” Lankford said. “We want to know: where is he going?” What is perspective? Obviously, he has to answer questions about what he did in the past.”
Oz’s evolution in Obamacare and Medicare
Oz’s evolution in health care leaves open the question of how a second Trump administration will reshape health care after what Trump says. had “concepts of plan”. for doing so.
As a CMS administrator, Oz would hardly be a free agent; his mission would be to realize Trump’s vision. But Trump’s lack of specifics on health care could give Oz the power to fill in the blanks.
Returning to the Obama era, Oz suggested qualified definition Because it provides a “safety net” for Obamacare. Trump toned down his rhetoric attacking Obamacare in the final stretch of the 2024 campaign, but still demanded to be changedwithout explaining how.
When he ran for the Senate through 2022, Oz took a more modest stance on health care, saying it did not call for an overhaul of the system, while also criticizing the Affordable Care Act. Oz said AARP survey: “We can expand Medicare Advantage plans. These plans are popular with seniors, provide consistent quality care, and have the incentive to keep costs down.”
Some Democrats are very concerned about CMS being run by Oz.
“No one should doubt that Dr. Oz and the Trump administration pose a very real threat to Medicare, Medicaid and health care as we know it,” said Health, Education Sen. Patty Murray, D-Wash. Labor and Pensions Committee. “Trump has undermined the Affordable Care Act at every opportunity and sent health care costs through the roof.”
Senate Finance Committee Chairman Ron Wyden, D-Ore., who will become ranking member in January, said the CMS administrator’s job is “one of the most influential jobs in American health care.”
“We’re going to spend $4.5 trillion on American health care this year,” he said. “And a lot of that comes down to the type of framework it’s going to consider. And I have some real questions.”
Is Medicare Advantage changing on the horizon?
If Oz is approved and chooses to push more people into Medicare Advantage, he may not have too much of a hard time. Tricia Neuman, executive director of the Medicare policy program at KFF, said enrollment has been rising steadily for several years, so in some ways Medicare is already on the path to privatization.
Still, Neuman said Oz will walk a tightrope to avoid upsetting Medicare enrollees: While Medicare Advantage is increasingly popular, surveys show older adults like options when choosing coverage.
“In our focus groups, people say they are satisfied with both traditional Medicare and Medicare Advantage, and they make their choices based on different preferences,” Neuman said.
Arthur Kaplan, chief of medical ethics at NYU Langone Medical Center in New York, said pushing private plans may not address a major concern of patients — the high cost of care.
A Report from the Commonwealth Fund in 2022A health research center reported that nearly 1 in 4 adults with Medicare skip services such as dental care because of high costs. A similar share avoided visits to specialists or follow-ups with doctors for the same reason.
“There’s a dream that Republicans have had forever, and he had this dream when he was running for Senate in Pennsylvania, that the solution to Medicare is privatization, but it’s only about taking some of the money off the government’s books,” Kaplan said. “It doesn’t really address the wasteful spending that we do in Medicare. “The prices are too high and it really doesn’t allow access.”
Wyden said Oz “expects questions” about practices under Medicare Advantage, such as “prior authorization,” where insurance companies determine whether services are medically necessary before using them. “There’s a growing concern among seniors and other vulnerable people that these insurance companies are getting away with all kinds of razzmatazz to deny people the coverage they’re paying for,” Wyden said.
Lankford said Medicare Advantage is “not working as designed” because hospitals are “frustrated” and insurers are “denying claims” or “not paying on time.”
Sen. Mike Rounds, RSD, said there is “no such thing as a perfect plan” for health care.
“We’ll be able to ask him questions, but we’re starting to give the president the benefit of the doubt,” he said.
How would Trump and Oz manage drug prices?
Another open question is how Trump will manage popular politics in the Democrats’ Inflation Reduction Act to give Medicare the power to negotiate drug prices, an idea many Republicans have called price-fixing and the GOP unanimously voted against.
“President-elect Trump has not directly said that he would defend the renegotiation provisions in the Inflation Reduction Act or seek to roll them back during the campaign,” Neuman said. “It’s not clear what’s happening with drug pricing in general or drug negotiations specifically.”
Neuman said CMS’s deadline to select the next 15 drugs for negotiations is in February, though it’s unclear if the agency will be able to meet the deadline so close to the opening.
Oz should probably apply for Medicaid as well. Some Republicans see the government’s plan for low-income people as a potential source of funding to pay for Trump’s tax cut extension.
“There are too many children and too many disabled people on Medicaid, and when you push back what should be covered, reduce eligibility for benefits, or just go to states, poor states — Alabama, Mississippi and Arkansas — you’re going to have very, very limited eligibility,” Kaplan said. “So it really risks harming very vulnerable people.”
Oz lost the 2022 Senate race to Democrat John Fetterman, who at the time questioned his commitment to protecting safety net programs like Medicare. he claimed that he would “destroy” him.
Now he says he’s “open to dialogue” with Oz.
“We’ll have to hear what his answers are and then we’ll go from there,” Fetterman said in an interview. “His positions will be the same as Trump’s.”
“He will choose people who disagree with me and they will never be my first choice. So that’s how democracy tends to work,” Fetterman said. “It’s not Thanksgiving right now, and I’m not going to be part of the collective frenzy.”