Dive Brief:
Democratic lawmakers are pushing for answers from Mehmet Oz, President-elect Donald Trump’s pick to lead the CMS, about his advocacy for expanding Medicare Advantage.
In a letter sent Tuesday, Sens. Elizabeth Warren, D-Mass, Ron Wyden, D-Ore., and Dick Durbin, D-Ill., said Oz had argued to eliminate the traditional Medicare program in lieu of privatized MA plans — and raised questions about his financial ties to insurer UnitedHealth.
The legislators also scrutinized Oz’s qualifications for the job, which oversees health insurance that covers 160 million Americans. “Although you were a renowned heart surgeon, you have no management experience relevant to running these critical health care programs,” they wrote.
Dive Insight:
Oz, a former TV personality who was nominated to serve as CMS administrator last month, has previously advocated for more investment in MA — which raises questions about his suitability for the job, the lawmakers wrote in the letter.
The increasingly popular MA program has received heightened scrutiny from lawmakers and regulators. A Senate report published in late October argued the nation’s largest MA payers, including UnitedHealth, Humana and CVS, used algorithmic tools to deny more claims, reducing beneficiaries’ access to care.
Last month, the CMS proposed a rule that would add more guardrails to MA plans’ utilization management policies, forcing plans to follow national and local coverage determinations and general coverage and benefit conditions included in traditional Medicare regulations.
MA insurers have also been criticized for using allegedly fraudulent or misleading marketing practices and driving up costs compared to the traditional Medicare program. Medicare spends an estimated 22% more for enrollees covered by MA programs than it would if they were insured under traditional Medicare, according to congressional advisory group MedPAC.
In a piece published in Forbes in 2020 before he ran for Senate, Oz proposed covering all Americans who weren’t on Medicaid with MA plans. When he ran for Senate in Pennsylvania in 2022, he also suggested expanding MA in a Q&A with the AARP.
The lawmakers also criticized alleged conflicts of interest with the nation’s largest MA payer. Oz reported owning over $550,000 worth of stock in UnitedHealth during his Senate run, according to the letter.
“Given your financial ties to private insurers, combined with your view that the traditional Medicare program is ‘highly dysfunctional’ and your advocacy for eliminating it entirely, it is not clear that you are qualified for this critical job,” the legislators wrote.
The letter was also signed by Sens. Richard Blumenthal, D-Conn., Ben Cardin, D-Md., and Jeff Merkley, D-Ore., as well as Rep. Lloyd Doggett, D-Texas.
Trump’s transition team didn’t respond to a request for comment by press time.
Oz isn’t the upcoming administration’s only controversial health pick. In November, the president-elect chose Robert F. Kennedy Jr. to lead the HHS, a move that raised concerns among some public health experts due to his advocacy of debunked theories about the safety of vaccines.
