A Playbook to Protect Insurers’ Medicaid ATM

With Medicaid front-and-center as Republicans scramble to fund the President Trump’s domestic policy agenda, it’s worth highlighting one insurer that greatly benefits from the program: Centene.

The political debate over whether to cut Medicaid is heating up on Capitol Hill. Some conservatives are pushing for steep cuts, while other Republicans warn they won’t support anything that strips seniors, people with disabilities, or low-income Americans of coverage. One thing is becoming clear: the House Energy and Commerce Committee, tasked with finding $880 billion in cuts, can’t meet that goal without seriously considering slashing either Medicaid or Medicare – or both.

But before any cuts are made, the American people need to understand a critical — and often hidden — fact: almost every state has already handed over the administration of Medicaid to Wall Street-controlled, for-profit insurance companies.

One of the biggest players is Centene, the largest Medicaid managed care company in the country. If it doesn’t ring a bell, it’s because the company tries to keep a relatively low profile and even markets most of its insurance plans under names like Ambetter and Health Net. But make no mistake, it’s a huge corporation that is a big player in almost all of the government’s health care programs.

In fact, 98% of Centene’s health plan enrollment today is from taxpayer-funded programs: Medicaid, Medicare Advantage and Obamacare marketplace plans. Just 448,200 of its 20 million enrollees are in "commercial" plans. Meanwhile, Centene reported taking in $46.6 billion in revenue in just the first three months of this year, with almost all of it coming from the taxes we pay.

And where does that money go? A significant chunk goes to the company’s notoriously well-paid executives. Until his death a couple of years ago, Centene’s founder, Michael Neidorff was consistently the highest paid of the CEOs of the biggest for-profit health insurers, even more than the CEOs of much bigger companies like UnitedHealth and Cigna. This despite Centene being a less-than-stellar investment on Wall Street (the company’s stock is worth less today than it was five years ago.)

If you’re a regular reader, you know that we write quite a bit about Centene and that it behaves more like a defense contractor than a health insurer — fueled by billions of our tax dollars with relatively little accountability to the public. And despite the company’s aversion to publicity, some of Centene’s executives have found themselves in the headlines in recent months, and not for being good corporate citizens.

In fact, in recent weeks, Centene has become its own worst enemy in the press – finding itself in two scandals – raising ire and red flags in the country’s two biggest red states.

Follow the Money in Florida

Last year, Centene agreed to settle a Medicaid fraud case with the state of Florida after admitting it had overbilled taxpayers by $67 million for medications. But instead of returning the full amount to the state and federal treasuries — as the law requires — some government officials allowed $10 million of it to be diverted to "Hope Florida," a charity run by Governor Ron DeSantis’ wife.

Read the Miami Herald’s article by clicking here.

According to The Miami Herald, Hope Florida then sent the money to two dark money nonprofits, which quickly funneled $8.5 million to a political committee tied to DeSantis’ top aides.

So $10 million that should have been used to pay for health care for poor Floridians instead wound up in a political slush fund. And Centene — a company already under fire in multiple states for Medicaid irregularities — knowingly went along with it.

It’s a case study in how deeply enmeshed Big Insurance government contractors are in political shenanigans — all at taxpayer expense.

Snooping on Sick Families and Lawmakers in Texas

If that wasn’t bad enough, Centene’s Texas subsidiary, Superior HealthPlan, was recently caught doing something equally alarming: spying on patients, lawmakers, and even journalists.

As I wrote last month, the scandal came to light when the CEO of Superior HealthPlan admitted under oath that the company had hired private investigators to dig up dirt on elected officials responsible for overseeing state contracts, health care providers and even families with children enrolled in Medicaid. Agents of the company reportedly delved into divorce records, photographed patients' homes, and ran credit reports — all while Centene was under scrutiny for denying care.

Read the Independent’s article by clicking here.

And what was the excuse? Centene’s executive claimed it was just “general research.”

Cutting through the B.S.: It suggests that rather than improving care or fixing problems, Centene’s first instinct when under pressure was to intimidate the very people it was supposed to serve — and the officials meant to hold it accountable.

Republican state lawmakers in Texas are saying this wasn't the work of a "bad apple" but part of a toxic culture within Centene itself.

A Rotten Business Model for the American People

These two examples — diverting Medicaid money in Florida and spying on families in Texas — show why Wall Street-backed insurers should never have been trusted with public health programs in the first place.

Handing more Medicaid dollars to companies like Centene — especially while talking about cutting coverage for vulnerable Americans — is nothing short of a betrayal of taxpayers. The problem isn’t just "waste" or "inefficiency." It’s that our government, and politicians from both parties, have allowed profit-obsessed corporations to run Medicaid and other public programs like private ATM machines.

If Congress really wants to "save money," it should start by ending the gravy train for big health insurers like Centene — not by cutting care for seniors, kids and folks with disabilities.