A Health Insurance Scandal Unfolds in Texas
A Medicaid contractor admits to spying on families and officials. The scandal raises urgent questions about the privatization of public health programs.
A troubling story broke late last week in The Dallas Morning News that should alarm every taxpayer and policymaker in America. The CEO of Superior HealthPlan, a subsidiary of the big for-profit insurer Centene, admitted under oath to hiring private investigators to dig up information on patients, lawmakers, and even a journalist. The executive, Mark Sanders, was promptly fired after his testimony, but the questions raised by his actions—and the company’s silence for years—demand far more than a personnel change.
Sanders’ admission came during a hearing before the Texas House Delivery of Government Efficiency Committee, which is investigating Medicaid procurement practices. The company he led and which claims to be the largest Medicaid managed care company in Texas with more than two million enrollees, had reportedly ordered surveillance and background checks starting in 2017. Those targeted included families with children enrolled in Medicaid, health care providers, and elected officials who oversee state contracts. The rationale? According to Sanders, it was just “general research” using publicly available data.
But it seems that lawmakers haven’t bought that explanation — and neither have I.
According to reports, some of the background checks went so far as to dig into lawmakers’ divorce records, photograph patients’ homes and run credit reports. These tactics appear to have been employed while Centene and Superior were facing scrutiny for denying coverage and profiting handsomely off taxpayer-funded programs. Republican Attorney General Ken Paxton, who reportedly will challenge incumbent U.S. Sen. John Cronyn in next year’s Republican primary in Texas, has now launched a formal investigation, citing concerns about potential blackmail and misuse of public funds.
This is the same type of stuff I saw when I was in the health insurance industry. Private insurers tasked with managing public programs like Medicaid have every incentive to reduce care and maximize profit. What’s becoming clear in Texas is how far one company may have gone to protect its bottom line — again – not through better care, but through surveillance and intimidation.
Centene, for its part, claims this is all in the past and not reflective of the company’s current leadership or values. To that end, Republican state Rep. Giovanni Capriglione, who chairs the Texas House Delivery of Government Efficiency Committee, said, “This is a culture within the company.” And if Capriglione is correct, the responsibility goes beyond Sanders.
How I see it: The scandal is sleazy-and-all but it points to a larger problem: what happens when state and federal officials get in bed with for-profit insurers to run tax-supported public health programs. This is how many of the so-called “public-private partnerships” really work. They’re great for the shareholders and executives of the private companies but not so great for the public. Texans — and all Americans — deserve better.
I completely agree with your statement at the end. The circumstances are salacious, but it is the result of Profit over Patient mentality in for-profit-run healthcare insurance and services for our most vulnerable (Medicare and Medicaid)
It's like cockroaches. If you catch one, you know there are thousands more behind the walls. If anyone wonders why so many people metaphorically high-fived the accused murderer of United Healthcare's CEO, look no further than this slimy example of healthcare privateering. Original Medicare for everyone! Thank goodness I have lived long enough to have original Medicare. I will not ever choose Medicare Advantage. I resent my tax dollars yet again fattening private profits (Medicare Advantage) while siphoning off money that could be directed toward actual healthcare. Raise taxes on the 1 percent and neither Medicare nor Social Security would have funding problems!