Cigna's "Transparency Report" Is Just a PR Stunt
After UnitedHealthcare CEO Brian Thompson was killed, a wave of patient stories forced insurers to confront public anger. Cigna responded with a multi‑year reform agenda and released a Customer Transparency Report claiming a 15% cut in prior‑authorization volume by removing requirements for 345 services. The same week the industry, coordinated by AHIP, pledged to standardize electronic prior‑authorization forms, a move timed before Cigna’s Q1 earnings call. Critics argue the initiatives are PR‑driven, offering cosmetic change without real accountability or independent data on denial rates.
Tennessee Revolts Against Pharmacy Middlemen
Tennessee lawmakers passed the FAIR Rx Act, requiring pharmacy benefit managers (PBMs) to divest any pharmacies they own, directly targeting the vertical‑integration model of giants like CVS Health. The bipartisan vote was overwhelming—86‑7 in the House and 24‑9 in the...
Flash Drives and Funny Numbers: What Elevance Health’s Earnings Really Reveal
Elevance Health posted Q1 adjusted earnings of $12.58 per share, surpassing analysts' forecasts and lifted its full‑year adjusted EPS outlook. The company simultaneously disclosed a $935 million charge representing its best estimate of potential Medicare Advantage overpayments tied to seven years...
Prior Authorization: Care, Delayed | EP 3
In this episode of Healthcare Uncovered, hosts Joe Rotino and Wendell Potter expose how prior authorization has become a pervasive barrier that delays critical care, inflates administrative costs, and contributes to patient harm, illustrated by the tragic death of a...
The Cleanest Port-a-John at the Fair
Kaiser Permanente released its 2025 financial results, showing a $9.3 billion net income largely driven by investment returns and a 146 percent jump in operating income to $1.4 billion. A Lown Institute study revealed a $1.5 billion tax benefit versus $963 million in charitable care,...
UnitedHealth Q1 '26 Earnings: Wall Street Is in Love Again
UnitedHealth Group posted Q1 2026 revenue of $111.7 billion and adjusted earnings per share of $7.23, beating the $6.57 consensus by 11%. The company raised its full‑year adjusted EPS guidance to over $18.25 per share and saw its stock jump about 9%...
Court Rejects Anthem’s Attempt to Relitigate Arbitration Losses Under No Surprises Act
A California federal judge dismissed Anthem's federal claims against billing firm HaloMD, ruling that the No Surprises Act permits only extremely limited judicial review of Independent Dispute Resolution (IDR) arbitration outcomes. The court held that the statute already provides mechanisms...
How Private, For-Profit Health Insurance Fails the Most Basic Test of Economics
The piece argues that private, for‑profit health insurance in the United States is a textbook case of market failure. It cites information asymmetry, adverse selection, and lack of genuine competition as structural flaws that let insurers prioritize shareholder returns over...
I Helped Sell HSAs. They're a Bad Deal.
A former Cigna communications chief reveals that high‑deductible health plans (HDHPs) paired with health savings accounts (HSAs) are a bad deal, especially for low‑income and chronically ill patients. The promised consumer‑driven model never delivered price transparency, and most users lack...
Introducing The Health Insurance Influence Tracker
The Center for Health and Democracy Education Fund launched the Health Insurance Influence Tracker, an online tool that maps corporate PAC contributions from major health insurers to members of Congress. Using Federal Election Commission data, the tracker reveals that 86%...
WSJ's Editorial Board Contradicts What Its Newsroom Has Reported on Medicare Advantage
The Wall Street Journal’s editorial board defended Medicare Advantage even as its own newsroom revealed a $50 billion overbilling scheme and MedPAC projected $76 billion in overpayments for 2026. The editorial relies on an industry‑funded study to claim cost savings, while reporters...
Hospitals That Sue You for Getting Sick
A joint GWU‑Stanford report reveals that Virginia hospitals filed 1.15 million lawsuits from 2010 to 2024, seeking $1.4 billion in unpaid medical debt. More than 400,000 wage and bank garnishments followed, with attorneys earning $87 million in fees and courts adding $46 million in...
60 Minutes Returns to Remote Area Medical
60 Minutes revisited Remote Area Medical (RAM), showing its expansion from 12 to 90 clinics and over one million patients served. The segment highlighted patients traveling hundreds of miles, sleeping in cars, and waiting in sub‑zero temperatures for basic dental...
This Is Ascent Health Services – the Secretive Swiss Company at the Heart of the Express Scripts Scandal
Ascent Health Services, a Swiss‑registered group purchasing organization created by Cigna’s Express Scripts in 2019, channels billions of dollars in manufacturer‑paid fees that should be passed through as rebates. The GPO’s offshore structure lets Cigna and its partners keep these...
Inside Big Insurance’s $1.7 Trillion Year | EP 2
In this episode of Healthcare Uncovered, hosts Joe Rettino and former Cigna insider Wendell Potter dissect the 2025 earnings of the seven biggest for‑profit insurers, which together generated $1.7 trillion in revenue and $54 billion in profit despite covering 10 million fewer people....
Aetna’s New Automatic Algorithm for Paying Doctors Less
Aetna has introduced a black‑box algorithm that automatically downcodes physician claims, lowering payments for high‑severity ER visits without chart review. The system reclassifies Level 5 services to Level 4, forcing doctors to submit appeals to the same insurer that made the reduction....
Why More U.S. Doctors Are Moving to Canada
U.S. physicians are increasingly relocating to Canada, driven by frustration with insurance‑driven bureaucracy and high patient out‑of‑pocket costs in the United States. Recruitment firm CanAm reports a 65 % surge in inquiries during the early Trump administration, while the Medical Council...
We Destroyed One of the Best Health IT Systems Ever Built — and Replaced It With Something Worse
Veterans Affairs’ homegrown VistA electronic health record, praised for usability and clinical outcomes, was replaced by Cerner’s commercial Millennium platform through a sole‑source $10 billion contract. The transition has ballooned to an estimated $37‑$50 billion, far exceeding the roughly $2 billion that modernizing...
The Wall Street Chameleon: Big Insurance at an Inflection Point | EP 1
In the debut episode of the Healthcare Uncovered Show, hosts Joe Rettino and veteran health‑policy insider Wendell Potter discuss the rapid rise of giant insurance conglomerates like UnitedHealth, CVS/Aetna, and Cigna, describing them as Wall Street‑driven "chameleons" that have taken...
New Deductible Rules Allow for $31,000 Out-of-Pocket Maximum
The Trump administration is proposing a rule that revives catastrophic, or "junk," health plans with a $31,000 family deductible, effectively undoing the ACA’s ban on such high‑deductible products. These plans, once sold by major insurers like Cigna, Aetna and UnitedHealthcare,...
How Much Longer Will Americans Wait for Real Health Reform?
The episode examines the deepening crisis in U.S. health care, highlighting recent data that shows health insurance costs now outrank basic necessities for two‑thirds of Americans and that 1.2 million households lost coverage after premium subsidies were cut. Host Trudy Lieberman discusses...
In FTC Settlement, Cigna Agrees to Change Some PBM Business Practices, Charge Customers Less for Insulin
The episode examines Cigna’s settlement with the FTC over its Express Scripts PBM, which was accused of inflating insulin prices through opaque rebate deals. Key provisions require Cigna to prioritize lower‑cost drug versions, base patient copays on net prices, increase...
UnitedHealthcare Tightens Specialist Access for Medicare Advantage Enrollees
The episode examines UnitedHealthcare's new policy requiring primary‑care referrals for specialist visits in its Medicare Advantage HMO and HMO‑POS plans, a change that will fully take effect after April 30. Through the stories of seniors like Theresa Schwartz and Pamela...
University of Minnesota Medical School Nixes Its Classroom “Partnership” With UnitedHealth Group After HEALTH CARE Un-Covered’s Expose
The episode examines the University of Minnesota Medical School’s decision to discontinue a UnitedHealth Group‑sponsored course after investigative reporting by Dr. Allison Leopold exposed the curriculum as corporate propaganda rather than unbiased medical education. Leopold, a participant in the pilot,...
Private Insurance Is Seeping Into Every Public Health Program: Warning Signs From the Veterans Health Administration
The episode examines how private insurance is infiltrating the Veterans Health Administration via the Veterans Community Care Program (VCCP) and the proposed Community Care Network (CCN) Next Generation, a move that could channel up to $1 trillion of taxpayer money into...
ICYMI: Patients Vs. Profits, Exposing the Insurance Middlemen (The Chad Prather Show)
In this episode of The Chad Prather Show, host and health‑care writer discuss the recent congressional hearing on big‑insurance CEOs, exposing how insurers have built vertically integrated conglomerates that drive up premiums, deductibles, and Medicare Advantage denials. They highlight the...
Hawley and Warren Introduce “Break Up Big Medicine Act” To Force Separation of Insurers, PBMs and Providers
Senators Josh Hawley and Elizabeth Warren introduced the Break Up Big Medicine Act, a "Glass‑Steagall"‑style bill that would prohibit common ownership of health‑care providers with insurers, PBMs, or drug/medical device wholesalers, forcing divestiture within a year. The legislation targets vertically...
The Misleading Chart That Killed the ACA Subsidies
The episode dissects a misleading chart promoted by the Paragon Health Institute that Senate Majority Leader John Thune used to argue against extending ACA subsidies, claiming Obamacare premiums have skyrocketed. Health policy experts, including Brookings senior fellow Matthew Fiedler, explain that the...