Claim Denied: The Medicare Heist Hiding in Plain Sight

How UnitedHealth, Trump’s DOGE, and Project 2025 are turning America’s most trusted program into a profit machine and putting lives at risk.

In Oregon, where I live and across the country, the story of Medicare is quietly being rewritten, not by voters or lawmakers, but by corporate shareholders. What began as a sacred promise to care for seniors in their twilight years has become the testing ground for a larger agenda: the wholesale privatization of essential public services. And at the center of this slow-motion heist sits UnitedHealthcare, the nation’s largest Medicare Advantage provider, and a glaring warning sign of what happens when public money meets private profit.

UnitedHealth controls 27% of Oregon’s Medicare Advantage market, making it the top player in the state. On paper, it offers enrollees enticing extras, dental, vision, gym memberships. In practice, those perks come wrapped in narrow networks, denied treatments, prior authorizations, and bureaucratic runarounds that wear patients down until they give up or go without. Jenn Coffey’s experience, being locked out of a cancer clinic she’d used for years, isn’t an exception. It’s the model. A model designed to extract value not by improving care, but by denying it.

This is not a side effect. It’s the business plan. UnitedHealth has become a $400 billion behemoth in large part by gaming the Medicare Advantage system. Through a practice called “upcoding,” the company claims its patients are sicker than they really are, triggering inflated reimbursements from the Medicare trust fund. In 2021 alone, the company reportedly received $8.7 billion in payments for diagnoses that were never treated. Algorithms have replaced human decision-makers in many of these schemes, like the AI system UnitedHealth used to deny rehabilitation stays for elderly patients, 90% of which were later overturned by federal judges.

These facts, damning as they are, fail to capture the larger, more dangerous shift now underway. Because what UnitedHealth has accomplished through sheer scale and lobbying power, the Trump administration and its acolytes are attempting to make permanent through policy. Project 2025, the Heritage Foundation’s blueprint for government under Trump 2.0, calls for making Medicare Advantage the default option for all new enrollees. That would mean forcibly steering people away from traditional Medicare and deeper into the grasp of private insurers, removing even the illusion of choice.

Meanwhile, the Department of Government Efficiency (DOGE), Elon Musk’s crown jewel of bureaucratic sabotage, has quietly played its part. While marketed as a cost-saving task force, DOGE has turned its sights toward “streamlining” federal healthcare delivery by promoting models like Direct Contracting and “value-based care.” In theory, these models reward outcomes over volume. In practice, they introduce middlemen into traditional Medicare who profit by limiting care. Critics have called these programs “Medicare Advantage in disguise”, a Trojan horse to hollow out what’s left of public healthcare.

It’s not hard to see where this is going. If the Trump-Oz-Musk trifecta has its way, privatized health insurance won’t be one option among many. It will be the system. And what we’ve learned in Oregon, and across the nation, is that privatization doesn't improve essential services, it monetizes their failure. In the world of Medicare Advantage, a patient denied care isn’t a failure; they’re a profit center. Every delay, every hoop, every denial is another dollar saved for the insurer and billed to the taxpayer.

And yet, there is no outcry from Congress. No corporate perp walks. No consequences. The same executives who sign off on mass denials get bonuses, not subpoenas. Which is why, when Luigi Mangione allegedly pulled the trigger on UnitedHealthcare’s insurance division CEO, a disturbing number of Americans didn’t recoil in horror. They nodded in grim recognition. They’ve lost loved ones to the silent violence of denied care. They’ve watched the system pretend their deaths were just a cost of doing business.

Mangione’s act of violence is not the answer. But the conditions that may have motivated him? Those are a warning. A signal that we’ve crossed a threshold where corporate indifference to suffering is so normalized, so automated, it barely makes headlines anymore.

This is what happens when every essential service, healthcare, housing, water, even disaster response, is handed over to private profiteers. We don’t just lose accountability. We lose the very idea of a social contract. We lose the moral clarity that some things, like caring for our elders, should never be for sale.