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Wednesday is here!
Hello, Curse and Coffee friends,
Today, we explore the TV Doc destroying Medicare.
Hit reply and let us know what you think (we read all of your kind words).
Coffee at the ready…
The Big Sip
The take: Dr. Oz praised Medicare Advantage in his confirmation hearing. Yesterday, he cut its funding to nearly zero.
What happened: A proposed 0.09% rate increase for 2027. Insurers had priced in 4-6%.
Why it matters: UnitedHealth crashed 19% (its worst day ever). Then announced its first revenue decline since the Berlin Wall fell.
What to watch: Final rule drops April 6. Oz told Congress insurers "make too much money." Don't expect a bailout.
Humana fell 21%. CVS dropped 14%. The Dow lost 330 points. The S&P 500 hit an all-time high. Same day. Same country. Different casino.
Sponsor Break
Before we slurp into today’s brew…
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Here’s Your Brew
Here's how the game works.
Medicare Advantage pays insurers a flat fee per member. Sicker members mean bigger cheques.
So insurers made members look sicker.
They sent aides to seniors' homes. Noted every possible diagnosis. "Vascular disease" because someone used a cane. "Possible diabetes" from a single blood test.
Conditions that never got treated (but got billed).
MedPAC calls it "upcoding." It costs taxpayers $76 billion this year.
CMS just proposed banning diagnoses from home visits that don't lead to actual care.
That one rule costs insurers $7 billion. Medical costs are rising 10% a year. The fed offered 0.09%.
Do the math.
Someone's getting squeezed.
Two Sides, One Mug
Pro: Overpayments drain Medicare's trust fund. Cracking down keeps the program solvent for everyone who'll need it.
Con: Seniors in rural counties — the ones with fewest options — pay for billing games played by executives in Minneapolis.
Our read: Someone was going to eat $1.2 trillion in overpayments. Shareholders just found out it's them.
Receipt of the Day
CMS 2027 Advance Notice (PDF) — Bans diagnoses not linked to actual care from risk scoring. Home aide notes "possible diabetes"? If no doctor treats it, insurers can't bill for it.
That's the loophole that made Medicare Advantage a money machine.
It's closing.
Spit Take
89 cents of every premium dollar now goes to medical claims at UnitedHealth.
Three years ago?
Low-80s.
That 7-cent swing is why your benefits are shrinking.
Your Coffee Break Links (and water cooler chatter)
A Republican surgeon faced 8 care denials — for his own treatment. Rep. Greg Murphy looked insurance CEOs in the eye last week and said: "You put profits above patients." He voted for Trump.
Where does $1.2 trillion go? CRFB maps how upcoding bleeds Medicare dry through 2035.
CMS isn't backing down. Medicare's director: "This is about making MA work for the people it serves."
Mugshot Poll 📊
What happens by April 6?
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Enjoy your Wednesday, keep it caffeinated.
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