Prospective CMS Administrator Mehmet Oz, MD, has been a major supporter of Medicare Advantage, while Robert F. Kennedy Jr., President-elect Donald Trump’s pick for HHS secretary, does not have clear public views on Medicare and Medicaid.
On Nov. 14, President-elect Donald Trump named Mr. Kennedy as his nominee for secretary of Health and Human Services. Shortly after, Mr. Trump nominated Dr. Oz, a television personality and professor emeritus of cardiothoracic surgery at Columbia University, to lead CMS.
Here are 10 things to know:
1. Dr. Oz proposed expanding Medicare Advantage plans to "all Americans who want them" during his bid for Senate, CNN reported in 2022. A spokesperson for Dr. Oz's campaign told CNN the plan was called "Medicare Advantage plus."
2. Dr. Oz and former Kaiser Permanente CEO George Halvorson published an op-ed in Forbes in July 2020 proposing an expansion of Medicare Advantage plans to everyone not already enrolled in Medicaid. The proposal included rebranding the program as "Medical Advantage" and funding coverage for all citizens through a 20% payroll tax, with half paid by employers.
3. The op-ed critiques Medicare and the effect of a fee-for-service healthcare system where "standard Medicare providers make more money when their patients are in poor health."
"Some in the U.S. have argued for extending our standard Medicare program to all Americans, but this would be more difficult on multiple levels," the two wrote. "Our government doesn’t directly administer standard Medicare today, and doing so would require an entirely new infrastructure with intermediaries. More important, that would continue the highly dysfunctional approach of buying every item of care by the piece, which incentivizes abuse and cripples systematic process improvement."
4. The op-ed also alleges the proposal would eliminate Medicare fraud: "When using this approach, Medicare fraud actually disappears entirely as a government expense, because the payment for each patient in a Medicare Advantage plan is a monthly capitation and not a fee-payment system; there are no relevant piece-work payments, which are what invite, enable and allow most Medicare fraud today."
5. Campaign disclosures from 2022 show Dr. Oz and his wife owned up to $550,000 in shares of UnitedHealth Group, the largest Medicare Advantage insurer, and up to $50,000 in shares of CVS Health.
6. According to a Politico report, Mr. Kennedy does not have a clear public view on Medicare and Medicaid, which could give Dr. Oz significant control over CMS.
7. Richard Hughes, an attorney at Epstein Becker & Green, in Washington, D.C., told Bloomberg that Mr. Kennedy is likely to focus on issues related to science and evidence, with less attention on CMS. Despite previous efforts from the Republican Party to repeal and replace the Affordable Care Act, "there’s so much popularity around coverage expansions that it would be really hard to see a rollback of any of the commercial coverage requirements" in the ACA, Mr. Hughes told the publication.
8. Mr. Hughes told Bloomberg that Medicaid could be "an easy target" when Congress and the administration are looking to lower costs. The Republican Party has previously tried to cut Medicaid through block grants that proved unpopular because they could increase state costs.
9. Marc Samuels, founder and CEO of consulting firm ADVI Health, told Bloomberg that if Mr. Kennedy's focus remains in other areas of healthcare, "he may defer to his CMS Administrator for Medicaid policy decisions."
10. In a Nov. 19 statement on //truthsocial.com/@realDonaldTrump/posts/113511606000227032" style="text-decoration: none;">Truth Social, Mr. Trump said Dr. Oz will work closely with Mr. Kennedy to "take on the illness industrial complex, and all the horrible chronic diseases left in its wake."