Trump’s nomination of Dr. Oz to lead the CMS is raising healthcare access concerns

The news: President-elect Donald Trump’s nomination of Dr. Mehmet Oz to serve as the Centers for Medicare and Medicaid Services (CMS) administrator is raising concerns over consumers’ ability to access and pay for healthcare.

For context, Oz still needs Senate confirmation before officially assuming the role of CMS Administrator.

Why it matters: Should Oz helm the CMS, he would oversee programs providing healthcare to more than 160 million Americans at a time when their access to affordable care is increasingly at risk.

Here’s what an Oz-led CMS could mean for the future of Medicare, Medicaid, the Affordable Care Act (ACA), and consumers enrolled in these plans:

1. Oz could double down on his Medicare Advantage (MA) push. He has a history of promoting MA and has regularly called for an expansion of its plans.

Oz could try to make MA plans the default choice for Medicare beneficiaries as recommended in the Project 2025 report, a right-wing blueprint for a Republican administration.

This could raise conflict of interest concerns for Oz, who has previously reported owning up to $550,000 in UnitedHealth Group (UHG) stock. For context, UnitedHealthcare, the insurance business of UHG, enrolls 29% of all MA members.

2. He may prioritize cutting waste and fraud from Medicaid and Medicare. When making his CMS nomination announcement, Trump said Oz “will also cut waste and fraud within our country’s most expensive government agency.” Medicaid and Medicare accounted for over $100 billion in improper payments that were either incorrect or shouldn’t have been made at all in 2023, according to an April report from the US Government Accountability Office.

Another idea that’s been floated to cut Medicaid costs is altering the rules on who qualifies for benefits by instituting a work requirement to receive them. Approximately 21 million Medicaid enrollees would be at risk of losing their coverage if a work requirement was implemented, per a 2023 HHS analysis.

3. Changes are likely to come to the ACA, spurred by expiring subsidies. Higher subsidies under the IRA helped boost record-breaking enrollment in ACA plans this year, with 21.3 million people ultimately signing up.

With Republicans in control of Congress and the White House next year, it’s likely that these subsidies will be left to expire. Should this happen, the uninsurance rate would increase by 16% and subsidized marketplace coverage would drop by 42%, per a recent analysis by the Urban Institute.

Our take: Efforts to cut costs—particularly waste and fraud—are noble endeavors, especially as healthcare spending continues its meteoric rise across the US. But if these efforts go too far, as could be the case with Medicaid and ACA plans, consumers could lose their health insurance coverage and throw a wrench into the new administration’s plan to Make America Healthy Again.

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