WASHINGTON — When President-elect Donald Trump nominated Dr. Mehmet Oz to the powerful executive branch job overseeing Medicare, incoming Senate Finance Committee Chairman Mike Crapo (R-Idaho) immediately announced on television He praised the renowned doctor and said he looked forward to considering him for the nomination.
“Too often, patients who rely on federal health programs are forced to accept bureaucratic, one-size-fits-all insurance,” Crapo said. “Dr. Oz has been an advocate of providing consumers with the information they need to make their own health care decisions.”
It turns out that Oz, who President Trump nominated to run the Centers for Medicare and Medicaid Services, supported something like a one-size-fits-all plan for health care just four years ago.
Oz co-wrote Forbes article In June 2020, former Kaiser Permanente CEO George Halverson announced that he would eliminate employer-sponsored insurance and the Affordable Care Act, and that “everyone who doesn't have Medicaid He supported the “Medicare Advantage for All'' system, which would have required “Americans'' to enroll in Medicare Advantage through private healthcare providers. Planned to target new students. They proposed funding it by splitting a 20% payroll tax between employers and workers.
“This proposal to provide universal coverage through private Medicare Advantage plans… Kamala Harris's “Medicare for All” proposal during the 2020 election campaign,” said Larry Levitt, executive vice president of health policy at KFF, a nonpartisan research group.
Harris' plan “has once again put her in trouble politically,” Levitt said. “It is unlikely that Republicans will broadly embrace a Medicare Advantage for All plan that would require significant tax increases and government benefit programs to cover more people.”
Four years after Oz announced the outline of his Medicare Advantage for All plan, President Trump announced his choice to run CMS, saying Oz would “reduce waste and fraud within our nation's most costly government agency.” He promised to do so, but did not explain how.
A spokesperson for Trump's transition team did not respond to messages seeking comment.
Sen. James Lankford (R-Okla.) said he is not considering the 2020 Medicare Advantage proposal, but praised Mr. Oz as someone who has “really studied these issues.”
“We need people who are going to make a difference,” Lankford said. “What we want to know is where is he going? What perspective? Obviously we need to answer the question of what has he done in the past?”
The evolution of Oz on Obamacare and Medicare
Oz's evolution in the medical field leaves open the question of how the second Trump administration will overhaul health care after President Trump said he had a “vision of a plan” to do so. be.
As a CMS administrator, Oz is unlikely to become a free agent. His mission will be to carry out Trump's vision. But President Trump's lack of specificity on health care could give Oz the power to fill the void.
Back in the Obama era, Oz proposed: qualified praise Supports Obamacare for providing a “safety net.” Trump toned down his attacks on Obamacare in the final stages of his 2024 campaign, but still called for replacing it without explaining how.
By the time he ran for the Senate in 2022, Oz had taken a more moderate stance on health care, not calling for overturning the system, while also criticizing the Affordable Care Act. Oz said this on one of his shows. AARP survey: “We can expand our Medicare Advantage plans. These plans are popular among seniors and have the incentives they need to consistently provide high-quality care and keep costs low.”
Some Democrats are deeply concerned about Oz running CMS.
“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 a senior member of the Department of Health and Education. said Sen. Patty Murray, D-Washington. Work and Pensions Committee. “Trump is notorious for violating the Affordable Care Act at every opportunity and driving 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 important jobs in American health care.”
“We're going to spend more than $4.5 trillion on American health care this year,” he said. “And a lot of that fits into the framework that he's going to consider. And there are some real questions.”
Are Medicare Advantage changes on the horizon?
If Mr. Oz is approved and chooses to push more people into Medicare Advantage, as he proposed, he might not have as much trouble. Tricia Newman, executive director of KFF's Medicare policy program, said enrollment has been steadily increasing in recent years, and in some ways Medicare is already on the path to privatization.
Still, Newman said Oz will walk a tightrope to avoid upsetting Medicare enrollees. Medicare Advantage is becoming increasingly popular, but research shows seniors like having options when choosing coverage.
“In our focus groups, people say they are satisfied with both traditional Medicare and Medicare Advantage and are making choices based on a variety of preferences,” Newman said.
Arthur Caplan, director of medical ethics at New York University Langone Medical Center in New York City, said the push toward private plans may not address patients' biggest concern: the high cost of treatment. .
a 2022 Report from the Commonwealth FundRoughly one in four seniors on Medicare report not using services such as dental care because of high costs, a survey by a health care think tank found. . The same was true for those who avoided seeing a specialist or following up with a doctor for similar reasons.
“Republicans have had this dream forever, and he had that dream when he ran for the Pennsylvania Senate. All you have to do is withdraw your money,” Caplan said. “It doesn't really solve wasteful spending in Medicare. It's so expensive that it's not really accessible.”
Wyden said Oz should “expect questions” about practices such as “prior authorization” under Medicare Advantage, where insurers determine whether a service is medically necessary before using it. . “There's a growing concern among seniors and vulnerable populations that these insurance companies are using all kinds of outrageous tactics to deny people the coverage they paid for,” Wyden said. said.
Lankford said Medicare Advantage is “not working as designed” because hospitals are “frustrated” and insurance companies are “denying claims” or “not paying on time.”
Sen. Mike Rounds (R.S.D.) said “there is no such thing as a perfect plan” when it comes to health care.
“You can ask the president questions, but you start by giving the president the benefit of the doubt,” he said of the candidates.
How will Trump and Oz deal with drug prices?
Another unresolved issue is how President Trump will handle the popular Democratic anti-inflation bill, which would give Medicare the power to negotiate drug prices, a proposal many Republicans have criticized as price manipulation. Republicans unanimously voted against it.
“President-elect Trump has not directly said whether he will defend the bargaining provisions of the Inflation Control Act or whether he will try to reduce them during the campaign,” Newman said. “It's not really clear what's going on with drug pricing in general and drug negotiations specifically.”
CMS has a February deadline to select the next 15 drugs to negotiate, but with Inauguration Day just around the corner, it's unclear whether CMS will meet that deadline, Newman said.
Oz will probably also need to address Medicaid. Some Republicans see the government's low-income programs as a potential source of funding for the Trump tax cut extension.
“Medicaid has a lot of children and people with disabilities, and if we defer what should be covered, cut eligibility for benefits, or leave it to poorer states like Alabama, Mississippi, and Arkansas, “Eligibility is going to be very limited, so there's a real risk of harm to very vulnerable people,” Caplan said. Ta.
Oz lost his 2022 Senate race to Democrat John Fetterman, who at the time questioned his commitment to protecting safety net programs like Medicare. he claimed to “destroy” it.
He now says he is “open to dialogue” with Oz.
“We're going to have to hear his answer and we'll go from there,” Fetterman said in an interview. “His position will be Trump’s position.”
“He's going to pick someone who disagrees with me, and they're never going to be my first choice. So that's how democracies tend to work,” Fetterman said. said. “It's not even Thanksgiving and I'm not going to join in the collective freakout.”
