At the same time that UnitedHealth is growing its Medicare Advantage business, it is growing many of its other businesses and controlling a sizeable portion of the health care sector, often to the detriment of patients and providers. Dan Diamond, Christopher Rowland and Daniel Gilbert report for the Washington Post on the attention Congress is now giving to UnitedHealth. Will Congress rein in UnitedHealth and hold it accountable for its bad acts. Can the federal government break up UnitedHealth at this point, or is it too big to fail?
Chairman Ron Wyden, who heads the Senate Finance Committee, is holding a hearing with Sir Andrew Witty, UnitedHealth’s CEO. United is now a $400 billion company, with $22 billion in profits in 2023, and the biggest health insurer, as well as the biggest employer of physicians in the US; it employs about 10 percent of providers. It also processes about a third of provider claims for reimbursement through its Change Healthcare subsidiary. Recently, its cybersecurity system was hacked, and UnitedHealth forced tens of thousands of physicians and hospitals to go without pay; some providers were forced to take out loans and some patients had to pay out of pocket for care.
It is not at all clear why UnitedHealth did not address grave gaps in Change Healthcare’s security when it acquired the company a few years ago. Nor is it clear that UnitedHealth is holding anyone at the corporation accountable for this failure.
How can Congress help ensure UnitedHealth appropriately covers care and coverage and hold the corporation account when it fails to do so? In the words of Don Berwick, former head of the Centers for Medicare and Medicaid Services, “They’ve grown too big for this country’s good, and for their own good.” “They became the best at playing the game of charging the federal government more and using that wealth to gain political power, advertising power, some changes in benefits.” Some say UnitedHealth presents an economic and national security risk.
Republicans and Democrats agree that the size and power of UnitedHealth raises serious concerns. Senator Wyden, a Democrat, wants Witty to explain his company’s use of prior authorization, which too often keeps people from getting needed care. He is concerned with the ways UnitedHealth increases health care costs. Congressman Buddy Carter, a Republican, says “It needs to be busted up.” Here, here!
The Justice Department has tried to prevent some of UnitedHealth’s mergers and acquisitions, but UnitedHealth has put up legal challenges and tends to prevail. Hayden Rooke-Ley, a senior fellow at the American Economic Liberties Project, an antitrust-focused nonprofit, explains the consequences: “What we are seeing now is there are really significant risks of letting a company like United own a physician group, ambulatory surgical centers, a mail order pharmacy, home health providers … and claims processing and revenue cycle management.”
The fact remains that a number of Democrats and Republicans receive significant campaign contributions from UnitedHealth, which they depend upon. Moreover, many policymakers receive veiled threats from UnitedHealth if they don’t support the corporation. For now, you can expect UnitedHealth to grow and our healthcare system to remain at serious risk of higher costs and inappropriate denials of care as a result.
Here’s more from Just Care:
- UnitedHealth’s denials of critical rehab services is under investigation
- Hospitals, physicians and pharmacies left unpaid after a UnitedHealth cyberattack
- UnitedHealth deprives members of critical rehabilitation care
- 200,000 UnitedHealth enrollees in North Carolina likely losing coverage
- UnitedHealth Group profits by restricting people’s coverage
