by Peter Hancock
by Judith Ruiz-Branch
by Terri Dee
Project 2025, a “presidential transition project” of the Heritage Foundation, helpfully lays out how a group of former Trump officials would like to transform the country into a right-wing dystopia where the rich thrive and the rest of us die aspiring to be rich.
Declaring in its Mandate for Leadership that “unaccountable federal spending is the secret lifeblood of the Great Awokening” (really!), the plan focuses heavily on reversing social progress on the rights of racial and sexual minorities.
It also promises to decimate the most popular benefits programs in the U.S.: Medicare and Medicaid.
In a section dedicated to the Department of Health and Human Services, Project 2025 declares that “HHS is home to Medicare and Medicaid, the principal drivers of our $31 trillion national debt.”
This is a popular conservative framing used to justify ending social programs. In fact, per person Medicare spending has plateaued for more than a decade and represents one of the greatest reductions to the federal debt.
While admitting that Medicare and Medicaid “help many,” the authors of Project 2025 nonetheless declare that the programs “operate as runaway entitlements that stifle medical innovation, encourage fraud, and impede cost containment, in addition to which their fiscal future is in peril.”
To solve these imaginary problems, they suggest making “Medicare Advantage the default enrollment option” rather than traditional Medicare.
But Medicare Advantage (MA) is not a government-run healthcare program. It’s merely a way to turn tax dollars into profits for private health insurers. The more that MA providers deny coverage, the more money their shareholders make. There is no incentive for them to cover the health care needs of seniors.
There is plenty of evidence that MA programs not only fleece taxpayers by submitting inflated reimbursement bills to the government but also routinely deny necessary medical coverage.
In other words, they’re drinking out of both sides of the government trough.
The Center for Economic and Policy Research pointed out in a March 2024 paper that the “insurance companies that run these MA plans spend significant sums of money to blanket seniors with marketing” while relying on “heavily restricted networks that damage one’s choice of provider along with dangerous delays and denials of necessary care.”
But Project 2025 claims, without evidence, that “the MA program has been registering consistently high marks for superior performance in delivering high-quality care.”
Medicaid, the government program that covers health care for the lowest-income Americans, including millions of children, is also a major target of the conservative authors.
They want to add work requirements to the benefit, adopting the familiar conservative trope of low-income Americans living off tax dollars because they’re too lazy to work. And like the MA programs, they want to allow private insurers to get in on the game.
But a June 2024 report by the Center on Budget and Policy Priorities concludes that Medicaid’s expanded eligibility rules have helped insure millions of Americans who would otherwise be uninsured and saved money in state budgets.
Most encouragingly, “the people who gained coverage have grown healthier and more financially secure, while long-standing racial inequities in health outcomes, coverage, and access to care have shrunk.”
Project 2025 claims to have the underlying ideology to “incentivize personal responsibility,” as if its authors simply want Americans to begin acting like responsible grownups. But they mysteriously don’t apply this same standard to wealthy elites — perhaps because that’s precisely who they are.
by Glenn Mollette, Guest Commentator
Dr. Mollete was a senior minister for 39 years and served as President of the Kentucky Baptist Convention. He is the author of 13 books including Uncommon Sense, the Spiritual Chocolate series, Grandpa's Store, Minister's Guidebook insights from a fellow minister. His column is published weekly in over 600 publications in all 50 states.
The views expressed are those of the author and are not necessarily representative of any other group or organization. We welcome comments and views from our readers. Submit your letters to the editor or commentary on a current event 24/7 to editor@oursentinel.com.
As Medicare Advantage continues to gain popularity among seniors, three Southern California companies are pioneering new types of plans that target cultural and ethnic communities with special offerings and native-language practitioners.
Clever Care Health Plan, based in Huntington Beach, and Alignment Health, based in nearby Orange, both have plans aimed at Asian Americans, with extra benefits including coverage for Eastern medicines and treatments such as cupping and tui na massage. Alignment also has an offering targeting Latinos, while Long Beach-based SCAN Health Plan has a product aimed at the LGBTQ+ community. All of them have launched since 2020.
While many Medicare Advantage providers target various communities with their advertising, this trio of companies appear to be among the first in the nation to create plans with provider networks and benefits designed for specific cultural cohorts. Medicare Advantage is typically cheaper than traditional Medicare but generally requires patients to use in-network providers.
“This fits me better,” said Clever Care member Tam Pham, 78, a Vietnamese American from Westminster, California. Speaking to KFF Health News via an interpreter, she said she appreciates the dental care and herbal supplement benefits included in her plan, and especially the access to a Vietnamese-speaking doctor.
“I can always get help when I call, without an interpreter,” she said.
Proponents of these new culturally targeted plans say they can offer not only trusted providers who understand their patients’ unique context and speak their language, but also special products and services designed for their needs. Asian Americans may want coverage for traditional Eastern treatments, while LGBTQ+ patients might be especially concerned with HIV prevention or management, for example.
Health policy researchers note that Medicare Advantage tends to be lucrative for insurers but can be a mixed bag for patients, who often have a limited choice of providers — and that targeted plans would not necessarily solve that problem. Some also worry that the approach could end up being a new vector for discrimination.
“It’s strange to think about commodifying and profiting off people’s racial and ethnic identities,” said Naomi Zewde, an assistant professor at the UCLA Fielding School of Public Health. “We should do so with care and proceed carefully, so as not to be exploitive.”
Still, there’s plenty of evidence that patients can benefit from care that is targeted to their race, ethnicity, or sexual orientation.
A November 2020 study of almost 118,000 patient surveys, published in JAMA Network Open, underscored the need for a connection between physician and patient, finding that patients with the same racial or ethnic background as their physicians are more likely to rate the latter highly. A 2022 survey of 11,500 people around the world by the pharmaceutical company Sanofi showed a legacy of distrust in health care systems among marginalized groups, such as ethnic minorities, LGBTQ+ people, and people with disabilities.
Clever Care, founded by Korean American health care executive Myong Lee, aimed from the start to create Medicare Advantage plans for underserved Asian communities, said Peter Winston, the senior vice president and general manager of community and provider development at the company. “When we started enrollments, we realized there is no one ‘Asian,’ but there is Korean, Chinese, Vietnamese, Filipino, and Japanese,” Winston added.
The company has separate customer service lines by language and gives members flexibility on how and where to spend their allowances for benefits like fitness programs.
Winston said the plan began with 500 members in January 2021 and is now up to 14,000 (still very small compared with mainstream plans). Herbal supplement benefit dollars vary by plan, but more than 200 products traditionally used by Asian clients are on offer, with coverage of up to several hundred dollars per quarter.
Sachin Jain, a physician and the CEO of SCAN Group, said its LGBTQ+ plan serves 600 members.
“This is a group of people who, for much of their lives, lived in the shadows,” Jain added. “There is an opportunity for us as a company to help affirm them, to provide them with a special set of benefits that address unmet needs.”
SCAN has run into bias issues itself, with some of its employees posting hate speech and one longtime provider refusing to participate in the plan, Jain recounted.
Alignment Health offers a plan targeting Asian Americans in six California counties, with benefits such as traditional wellness services, a grocery allowance for Asian stores, nonemergency medical transportation, and even pet care in the event a member has a hospital procedure or emergency and needs to be away from home.
Alignment also has an offering aimed at Latinos, dubbed el Único, in parts of Arizona, Nevada, Texas, Florida, and California. The California product, an HMO co-branded with Rite Aid, is available in six counties, while in Florida and Nevada, it’s a so-called special needs plan for Medicare beneficiaries who also qualify for Medicaid. All offer a Spanish-speaking provider network.
Todd Macaluso, the chief growth officer for Alignment, declined to share specific numbers but said California membership in Harmony — its plan tailored to Asian Americans — and el Único together has grown 80% year over year since 2021.
Alignment’s marketing efforts, which include visiting places where prospective members may shop or socialize, are about more than just signing up customers, Macaluso said.
“Being present there means we can see what works, what’s needed, and build it out. The Medicare-eligible population in Fresno looks very different from one in Ventura.”
“Just having materials in the same language is important, as is identifying the caller and routing them properly,” Macaluso added.
Blacks, Latinos, and Asians overall are significantly more likely than white beneficiaries to choose Medicare Advantage plans, according to recent research conducted for Better Medicare Alliance, a nonprofit funded by health insurers. (Latino people can be of any race or combination of races.) But it’s not clear to what extent that will translate into the growth of targeted networks: Big insurers’ Medicare Advantage marketing efforts often target specific racial or ethnic cohorts, but the plans don’t usually include any special features for those groups.
Utibe Essien, an assistant professor of medicine at UCLA, noted the historical underserving of the Black community, and that the shortage of Black physicians could make it hard to build a targeted offering for that population. Similarly, many parts of the country don’t have a high enough concentration of specific groups to support a dedicated network.
Still, all three companies are optimistic about expansion among groups that haven’t always been treated well by the health care system. “If you treat them with respect, and bring care to them the way they expect it, they will come,” Winston said.
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Give all Americans the option to buy into Medicare.
I've paid into Social Security and Medicare my entire life. I'm still paying to be on Plan B and Supplemental Coverage. I also pay for prescription insurance. I often feel like a coffee coupon from McDonald's would pay for about as much medicine as my prescription card pays.
I no longer pay over $1600 a month in medical insurance but I still pay about $450 a month even with Medicare. Nothing is free.
Americans should have the option to buy into Medicare especially if medical insurance will not cover them and they can't afford the sky rocketing premiums. It's also time to get rid of medical supplements and prescription cards. Make Medicare a single payer of the doctor's visits, prescription costs and all the above.
The government has more power to control the cost of big pharmacies and hospital costs. Most medical providers have "one price" but then the "price" they will accept from Medicare. Under President Trump Hospitals will have to display their secret negotiated rates to patients starting in January, 2021. This gives you the option to shop around.
I'm all for having medical insurance available. Make it available from state to state. Make it easy for Americans to buy from pharmacies in Canada. Let senior Americans at age 55 buy 20-year term medical insurance plans if they would prefer to do so. Some Americans have no idea how desperate other Americans are when it comes to medical treatment.
Why make it so hard for Americans who do not have access to healthcare? Let them buy into Medicare. If they are unemployed or disabled then give them the Medicaid option. However, this is just more bureaucracy. This system needs to become one.
It's also time to make 60 the age that retired Americans go on Medicare.
In your late fifties and early sixties Americans have to start going to the doctor more. A friend of mine is waiting until she turns 65 and has Medicare so she can have a badly needed surgery. She needs it now. If she could buy into Medicare she could go ahead and move forward with her needed surgery.
We also need to turn the age back to 65 for collecting full Social Security benefits. American men die by the time they are 76.1 years old. Many die much younger. This is very little time to enjoy retirement. Sadly, many Americans aren't having much of a retirement in their golden years. Many are working longer and spending less time doing what they had hoped to do.
The government waste our Social Security contributions. They've spent trillions on foreign wars. They now tell us Social Security has be reduced by 25% in a few years. Rich political leaders want to push the age until 70 for you to collect your Social Security. This is not working for the American people. We are working longer with the prospects of collecting less. On top of this, older Americans are having to pay more of their dwindling retirement dollars for medical bills.
Bringing our troops home and spending less money in Iraq, Afghanistan and on rebuilding foreign nations is a start. We can and we must fix our medical insurance dilemma.
Dr. Glenn Mollette is a syndicated American columnist and author of American Issues, Every American Has An Opinion and ten other books. He is read in all 50 states. The views expressed are those of the author and are not necessarily representative of any other group or organization.
This article is the sole opinions of the author and does not necessarily reflect the views of PhotoNews Media. We welcome comments and views from our readers.
