CMS pick Dr. Oz touts Medicare Advantage, invests in healthcare

Modern Healthcare – Thursday, November 21, 2024
By Michael McAuliff

President-elect Donald Trump’s choice to head the Centers for Medicaid and Medicare Services, Dr. Mehmet Oz, is best known for his television program. But he also has an extensive history as a healthcare investor and a Senate candidate that offers some insights into how he might perform the job.

CMS impacts some 150 million people through programs such as Medicare, Medicaid, the Children’s Health Insurance Program and the health insurance exchanges. Oz has made statements and invested in companies that implicate all of those.

Oz has been both praised and derided for promoting alternative medical and nutritional ideas that seem to fit with Trump’s pick for secretary of Health and Human Services, Robert F. Kennedy, Jr. Indeed, the Dr. Oz YouTube channel features a playlist entitled, “Make America Healthy Again: Dr. Oz’s Essential Guide to Health & Wellness” that borrows Trump and Kennedy’s “Make America Healthy Again” slogan.

For the healthcare sector, however, Oz’s political comments and business activities are likely to be of greatest importance and to affect his confirmation prospects.

One of the most consequential decisions the Trump administration will confront is how to administer the Affordable Care Act of 2010 and whether to attempt to preserve any of the subsidies that President Joe Biden and Democrats expanded in 2021 and 2022, and which expire at the end of next year.

Oz, a cardiothoracic surgeon affiliated with New York City-based NewYork-Presbyterian in addition to a TV host, lost the 2022 Senate race in Pennsylvania to now-Sen. John Fetterman (D). In Twitter posts at the time, Oz was critical of the ACA, suggesting he’s aligned with Trump’s and Republicans’ hostility to the law, although he was more supportive when it passed in 2010. Oz also blasted Fetterman’s support for single-payer healthcare.

Oz’s support for Medicare Advantage stands out. He has often touted the program on “The Dr. Oz Show.” In August, he aired a segment in which he advised older Americans to sign up for zero-premium Medicare Advantage plans, for instance.

In 2020, Oz co-authored a Forbes article with George Halvorson, the former CEO of Oakland, California-based Kaiser Permanente, that turned the single-payer Medicare for All idea on its head by advocating Medicare Advantage for All. The Heritage Foundation’s Project 2025 also promotes that policy. Oz and Halvorson argued it was needed to shore up the healthcare system during the COVID-19 pandemic, and would have financed it with a 20% payroll tax.

One of the most favorable responses to Trump’s selection of Oz came from the Better Medicare Alliance, a coalition of insurance companies and providers.

“Dr. Oz recognizes the value of Medicare Advantage and the high-quality, affordable and comprehensive healthcare it provides to more than 34 million seniors and individuals with disabilities,” President and CEO Mary Beth Donahue said in a news release Tuesday. “As the leading research and advocacy group supporting Medicare Advantage, we look forward to working with Dr. Oz to protect and strengthen this vital program for seniors.”

Dr. Oz’s healthcare investments

Oz has also been a prolific healthcare investor. Although financial disclosure will not occur until Trump actually nominates him next year, information Oz disclosed during his Senate campaign remains publicly available.

Besides showing that Oz is very wealthy, the filings detail millions of dollars in healthcare investments.

Many were typical stock holdings, such as up to $550,000 in UnitedHealth Group and up to $50,000 each in CVS Health, Nashville, Tennessee-based HCA Healthcare, AbbVie and McKesson. Others were significant holdings in startups, such as $5 million to $25 million in the digital health company ShareCare. He was also a significant but lesser investor in fertility company Prelude Fertility Holdings.

The Trump transition team did not respond to a request for up-to-date information about Oz’s finances, or to a question about how he intends to deal with investments in companies that might profit from dealings with Medicare, Medicaid or the health insurance exchanges.

Dr. Robert Steinbrook, the director of Public Citizen’s Health Research Group, said Oz and the incoming administration would have to carefully consider financial conflicts.

“He shouldn’t be involved in decisions about companies that he’s had a financial interest in,” such as UnitedHealth Group, Steinbrook said, although he noted many of Oz’s past investments aren’t relevant to CMS.

Republican views on Dr. Oz

Most Republicans on the Senate Finance Committee, which would hold confirmation hearings on Oz, did not provide comments when contacted. Sen. Mike Crapo (R-Idaho), who will chair the panel next year when Republicans take over from Democrats, offered qualified praise.

“Far too often, patients relying on federal government healthcare programs are forced to accept bureaucratic, one-size-fits-all coverage,” Crapo said in a news release Tuesday. “Dr. Oz has been an advocate for providing consumers with the information necessary to make their own healthcare decisions. I look forward to learning more about his vision for CMS and considering his nomination before the Finance Committee.”

Sen. Dr. Bill Cassidy (R-La.), who sits on the Finance Committee and is poised to become chair of the Health, Education, Labor and Pensions Committee next year, expressed pleasure at Trump’s choice in a post on X, formerly known as Twitter.

“Glad to hear @DrOz has been nominated for CMS administrator. It has been over a decade since a physician has been at the helm of CMS, and I look forward to discussing his priorities. This is a great opportunity to help patients and implement conservative health reforms,” Cassidy wrote Tuesday.

Republicans would need to stay mostly unified to confirm Oz. The GOP will have only a three-senator majority next year, not counting any potential tiebreaking votes from Vice President-elect JD Vance in his constitutional capacity as president of the Senate. Vance is currently a Republican senator from Ohio.

That’s assuming Trump does not follow through with his plan to circumvent the normal Senate process by appointing officials during congressional recesses, a ploy he has demanded Senate Republicans accept.

Although the GOP swept the national elections and will control Congress and the White House year, there are Republicans who need to be circumspect because they have reelection contests looming.

One is Sen. Thom Tillis (N.C.), whose home state went for Trump but also elected Democrat Josh Stein as governor. Tillis will face voters in 2026 after narrowly defeating Democratic candidate Cal Cunningham in 2020.

Tillis, a member of the Finance Committee, articulated his position on Oz carefully in an interview. “I know him as a very reasonable person I supported in the Senate primary. That’s in the context of a U.S. senator. Now, I’ve got to look at it in the context of somebody heading CMS,” he said.

“We’re talking about a very specific role with a very specific scope and very specific positions that have to be viewed in light of the leadership position that he’s pursuing,” Tillis said. “We’ve just got to go through that process.”

Democrats are unlikely to help, as evidenced by current Finance Committee Chair Ron Wyden (D-Ore.), who hammered Oz in a news release Wednesday,

“Trump’s healthcare agenda is all about empowering fraudsters and big business while everyday Americans are stuck with the bill,” Wyden said, with apparent reference to some of the health products Oz has promoted. “Dr. Oz is no stranger to peddling nonsense to innocent Americans without facing consequences.”

“This is one of the most consequential positions in American government, touching millions of seniors and families who count on Medicare and Medicaid for affordable healthcare,” Wyden said. “Americans deserve a leader at CMS who will stand up to Big Pharma and insurance fraudsters who are misleading seniors and denying them essential healthcare, and I’m not sure a talk show host is up for the fight.”

Dr. Oz on the Affordable Care Act

Indeed, Oz likely has a learning curve.

When he ran against Fetterman, Oz posted on Twitter that the ACA had destabilized insurance markets and imposed mandates on Pennsylvanians.

Cynthia Cox, director of the Program on the ACA at the health policy research institution KFF, wrote in an email that the health insurance exchanges are very different now.

“Since 2018, the ACA markets have stabilized: Premiums have been mostly flat, more insurers have entered the market and insurers are profitable,” Cox wrote. “And particularly since 2021 with enhanced subsidies, the average premium payment has fallen and the markets have reached record high enrollment and record high insurer participation.”

Oz would also have to reckon with the popularity of fee-for-service Medicare if he wants to expand Medicare Advantage, Tricia Neuman, director of the KFF Program on Medicare Policy, wrote in an email.

“Both traditional Medicare and Medicare Advantage enjoy high satisfaction ratings among seniors,” Neuman wrote. “With a fully privatized Medicare, seniors would lose the ability to choose coverage under traditional Medicare, and that may not sit well with those who prefer traditional Medicare because it offers greater control over their healthcare and choice of doctors.”

In addition, some Republicans have grown more concerned about Medicare Advantage, and have proposed bills to rein in growing use of prior authorization by the plans.

Healthcare groups on Dr. Oz

Most healthcare trade associations took a cautious approach to the news of Oz’s pending nomination.

Asked for comment, the American Hospital Association referred Modern Healthcare to a Nov. 6 news release that predates the Kennedy and Oz announcements: “The AHA has congratulated President-elect Trump and looks forward to working with his administration on our priorities.”

The Federation of American Hospitals offered a slightly more upbeat reaction Tuesday: “We congratulate Dr. Mehmet Oz on his nomination to be CMS administrator, and we look forward to working with the administration to advance Americans’ healthcare outcomes and protect 24/7 patient care,” the federation said in a news release.

AHIP, which represents insurers, made a similar comment. “We are looking forward to working with the incoming administration and new Congress to protect and strengthen the quality, affordable healthcare coverage options that Americans rely on,” a spokesperson said in a statement.

An executive at one trade group that has to work with the next CMS leader issued a blistering response, however.

Shortly after the Oz announcement, Dr. Atul Grover, executive director the Association of American Medical Colleges’ Research and Action Institute, posted a photo on X of a burning dumpster bearing a caduceus, with the word “Wheeeeeeee” atop it

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