(1/6) I just spent the last two weeks diving into the "Big 7" for-profit health insurance companies earnings reports for 2023.

It was pretty mind-numbing work. Hundreds of pages, decimal points and headaches.

But boy, oh, boy – as you will see – it was worth it. Let me explain: (2/6) NEW ANALYSIS: In 2023, the Big 7 for-profit health insurers raked in a whopping $1.39 Trillion (up 346% from a decade ago!)

CEO compensation is up (totaling $136.5 million); Profits are up (totaling $70.7 billion); and stock prices are up for each of the Big 7.

But how?

(1/6) NEW DOC: “American Hospitals: Healing a Broken System,” a documentary I helped produce, is being released everywhere on 11/10.

Anyone who's had to go to a hospital in the last 5 yrs will find this documentary particularly insightful. Let me explain: fixithealthcare.com (2/6) "American Hospitals" details the unequal fortunes of U.S. hospitals – how a few tax-exempt hospitals are sitting on mountains of cash and paying their execs millions of dollars, while others serving rural + urban Americans have closed or are on the verge of being shuttered.

(1/4) AMERICAN DISGRACE: Mary Lou Retton, America’s first Olympic gymnastic gold medalist, is the new face of an American disgrace – millions of Americans are now buried under medical debt and must turn to crowdfunding campaigns to stave off collectors and get the care they need. (2/4) Retton, once an Olympic icon, joins nearly half of Americans that struggle to pay their medical bills and it is not just the uninsured; even those with insurance are going bankrupt.
kff.org/health-costs/i…

(1/6) ICYMI: Brookings Institution & The Wall Street Journal shined a light on Pharmacy Benefit Managers (PBMs) in health care. Researchers warned that while bipartisan legislation seeks to reform PBMs, insurers will likely find new ways to protect profits.

Let me explain: (2/6) Brookings researchers rightfully put the PBM debate in the broader context of "market failure" in US health insurance – thanks to health insurers (and PBMs) relentless quest for profits at the expense of patients and employers.
brookings.edu/articles/a-bri…

(1/5) Elevance had one of the highest denial rates among MCOs, according to the OIG.

And no where are these high denial rates more clear than in Ohio, Virginia and other states where Elevance manages taxpayer-supported Medicaid and Medicare Advantage plans.

Let me explain. (2/5) More than 1-out-of-7 Medicaid beneficiaries in the U.S. is now enrolled in a plan managed by Elevance.

One way insurers avoid paying claims in both their MA and Medicaid businesses is by refusing to cover treatments and medications patients’ doctors say are necessary.

(1/7) LATEST: Cigna released its Q2 2023 earnings report – the company made billions but it still disappointed investors.

As a former Cigna exec, I know that Cigna's C-Suite is scrambling to find ways to get back into Wall Street's good graces.

Let me explain: (2/7) While revenue from customers increased in Q2, profits took a dip. The medical loss ratio (% spent on claims), inched up, triggering concern by Wall Street – dropping the stock price 4%.

And when it comes to executives at big health insurers – stock price is everything.

(1/7) This is a big week for Christopher Nolan, Hollywood director of Oppenheimer, and Medicare, one of America’s most important institutions.

Bare with me, but Oppenheimer and Medicare have more things in common than you may think.

Let me connect some dots (w/o any spoilers)! (2/7) Last night I went to see Oppenheimer. In between handfuls of popcorn while I waited for the film to start, I decided to google the director, Christopher Nolan.

As it turns out, Nolan's birthday is July 30 – the same as the U.S. Medicare system. There are other parallels.

(1/6) LATEST: CEOs from the 7 big health insurance companies pulled in $335 million in just 2022 alone.

How did they do it?

By imposing high out-out-pockets requirements and premiums; stock share repurchases; and by gaming the Medicare and drug supply chain. (2/6) Not much has changed in how insurer CEOs are compensated since I left Cigna in 2008. Except they’re making way more.

Most of CEOs' pay depends on how well their company does on Wall Street.

(1/6) BREAKING: UnitedHealth Group (UNH) released its Q1 earnings report for 2023.

UNH sucked $27.4 billion from the drug supply chain and spent $3.5 billion buying back its own stock.

There's much more. Let's dive into UNH's first 3 month of 2023.
wendellpotter.substack.com/p/q1-2023-unit… (2/6) When I was VP at Cigna my name was on every earnings report released by the company. And, boy, I know I’d be very excited to have my name on UnitedHealth’s Q1 '23 earnings report.

From 1/1/23-3/31/23, UNH  took in$91.9 B in revs (+15% since lst yr). Profits reached $8.1 B.

(1/6) Now that over 90% of health-plan revenues at Humana, Centene and Molina come from government programs – it's encouraging to see Medicare Advantage plans are starting to get the scrutiny they deserve.

Let me update you on what's going on:
wendellpotter.substack.com/p/insurers-usi… (2/6) Last week, @SenWarren and @SenJeffMerkley cited our analysis of the 2022 revenue and earnings reports of the 7 big for-profit health insurers when calling on Congress and the Biden admin to address the profiteering of those companies in MA plans.
warren.senate.gov/oversight/lett…

The Biden admin is taking steps to address some of the billions in overpayments to Medicare Advantage (MA) plans but corporate insurance lobbyists are fighting back.

Can you take a few minutes to support the Biden admin and protect older Americans?
nytimes.com/2022/10/08/ups… The Centers for Medicare + Medicaid Services (CMS) is proposing improvements 2 the system it uses 2 determine what 2 pay privatized Medicare plans (MA).

If finalized, it would eliminate billions of $ in waste, rein in Part B premiums and strengthen Medicare, but they need you!

BREAKING: In 2022, when 100 million Americans, most of them with health insurance, were saddled with medical debt, the profits from the "Big 7" for-profit insurers soared to $69.3 billion.

So, how did they do it?
wendellpotter.substack.com/p/big-insuranc… The premiums & taxes paid by Americans enabled the Big 7 to make those profits last year on revenues that reached a stunning $1.25 trillion (+300% since '12)

The main sources of all that money:

1. Pharmacy benefit management (PBM)

2. Gov't programs like Medicare Advantage (MA)

Rather than keep 250K NYC municipal retirees on REAL Medicare, NYC Mayor Eric Adams, proposed moving retirees into “Medicare Advantage” plans – essentially running millions of U.S. tax $ through a private health insurer.

Thankfully it hasn’t happened—yet.
wendellpotter.substack.com/p/judge-halts-… A Manhattan appellate court upheld a ruling that found a key part of Adams’ Medicare Advantage migration plan was unlawful.

This is great news not just for the EMTs, firefighters, cops and other city workers that would have been affected but also for taxpayers all over the U.S.

If you or someone you love is Medicare age, you should take a look at a piece that @janschakowsky and I just had published in @Newsweek.

For starters, we wrote this because many Medicare Advantage plans are a corporate SCAM.

Let me explain:
newsweek.com/how-medicare-a… I'm sure you've seen the ads on television for Medicare Advantage plans. They feature folks like Joe Namath, JJ Walker and William Shatner. They may bombard your mailbox with letters and brochures.

But the devil truly is in the details when it comes to Medicare Advantage plans.

The insurance industry's grip on American lives is getting tighter.

A new @KHNews survey shows that despite paying more in premiums, year in and year out, the value of employer-sponsored coverage diminishes every year b/c of hikes in out-of-pocket costs.
wendellpotter.substack.com/p/as-health-in… With 100 million Americans ALREADY saddled with medical debt, thanks primarily to ever-growing out-of-pocket obligations, this new survey shows that Americans are now paying a whopping 61% MORE in out-of-pockets than they did 10 yrs ago.

kff.org/health-costs/r…

.@UnitedHealthGrp's shareholders are fatter cats than ever because of the neat trick the nation’s biggest insurer is pulling off in plain sight–thanks to taxpayers, employers, and politicians.

And it’s allowed them to take in $81 billion in Q3 2022 alone!
wendellpotter.substack.com/p/exclusive-un… I discovered by going through a decade’s worth of UNH’s profit reports that the company ran off 370,000 customers over the past 10 years but they’re making FAR MORE now than in 2012.

So, how do they do it?

Let me be clear: For many American seniors, probably most, there’s no advantage to Medicare Advantage plans. Nothing. Zero.

Those who benefit from MA plans are seniors who will never get sick and insurers that market those plans.

And, of course, insurers’ Wall Street investors.

https://twitter.com/democracynow/status/1580177957674442753

MA may be the biggest transfer of wealth from American taxpayers and seniors to corporate executives and shareholders in U.S. history.

And the scary part is, Congress has allowed nearly HALF of Medicare-eligible Americans to get lured into these highly profitable private plans.

Thank you, @JonStewart, for having me on your show!

Be sure to watch @TheProblem with Jon Stewart this Friday for an episode focussed on the ongoing and often fraudulent transfer of American taxpayer dollars to big corporations and their shareholders.

https://twitter.com/TheProblem/status/1580558987539451904

Jon and his team came across @CforHD's recent analysis of how health insurers’ BILLION DOLLAR profits are being subsidized by American taxpayers and seniors.

All while high out-of-pocket expenses and other barriers to health care are on the rise.

Taking a page out of the Big Insurance playbook, hospital megasystems have implemented hundreds of mergers and acquisitions that have created huge hospital monopolies.

And FINALLY these deals, and their consequences, are receiving overdue scrutiny.
wendellpotter.substack.com/p/hospital-meg… Just last week, @ShannonBrownlee took aim at hospital monopolies in @Monthly:

"there’s no evidence that megasystems are consistently providing higher-quality care" and "and certainly no less expensive, than smaller institutions."

And there's more.
washingtonmonthly.com/2022/09/21/how…

On top of what you/your employer already pay insurance companies in annual premiums + out-of-pocket expenses — insurers also get a skim of your taxes!

So much *skim* that a MAJORITY of insurers' health plan revenues are subsidized by American taxpayers!

wendellpotter.substack.com/p/the-majority… I looked at the big seven for-profit insurers’ recent earnings reports and did a little simple math to figure out how much they were bilking American taxpayers.

I’ll share my findings in the next tweets:

I would like to remind @MarshaBlackburn that many Tennesseans are alive today and arguably enjoy a higher standard of living b/c of a gov’t program many people assailed and labeled “socialism” back in the day.

https://twitter.com/marshablackburn/status/1564229937996906498

.@MarshaBlackburn, I’m talking about the Tennessee Valley Authority, which employs 10,000 people in Tennessee and neighboring states.