FOR IMMEDIATE RELEASE: February 13, 2022
Media Contact: Gaurav Kalwani, PNHP communications specialist, gaurav@pnhp.org
In a speech given to the California Public Employees’ Retirement System (CalPERS) on January 17, Center for Medicare and Medicaid Innovation (CMMI) Director Liz Fowler revealed that there are no plans to further expand the number of organizations or beneficiaries in the controversial Medicare REACH model.
Speaking about REACH at CalPERS’ Board Education Day, Fowler stated, “We have no plans to open up another application period…there will not be any more than 132 organizations in the model, and most likely no more than 2.1 million beneficiaries in the model.”
REACH, which began officially operating in January, is a redesigned version of the Trump administration’s Medicare Direct Contracting program, which allows third-party entities (often private insurers) to administer traditional Medicare benefits. The program has faced sustained criticism from progressive activists, grassroots organizations, and members of Congress. In March of last year, PNHP delivered a petition to the Centers for Medicare and Medicaid Services (CMS) signed by over 250 allied organizations calling for an end to REACH.
“While the fight against REACH and Medicare privatization more broadly isn’t over, this is a great step forward,” said PNHP President Dr. Philip Verhoef. “It proves that our voices are having an effect, and that we must keep pushing to protect our public insurance programs against greed and profiteering.”
This was not the first instance in which CMMI adjusted the program in response to criticism. In December, 21 members of Congress, led by Representative Pramila Jayapal and Senator Elizabeth Warren, sent a letter to CMS Administrator Chiquita Brooks-LaSure raising serious concerns about REACH, based on initial research by PNHP. The letter described documented histories of bad behavior by numerous insurers and other profit-driven entities set to participate in the program. These companies faced allegations of overcharging Medicare and Medicaid, inflating diagnoses in an effort to increase payments, misleading seniors through dubious marketing, and more—often paying tens or even hundreds of millions of dollars to federal and state governments in settlements and fines.
Following the sending of the letter, several of the organizations mentioned were removed from the REACH program’s 2023 roster of participants.
“I am grateful to hear that CMS has no further plans to expand the REACH program which, let me be clear, is Medicare privatization,” said Rep. Jayapal. “I hope that CMS will stand by this announcement and instead of privatizing Medicare, explore other care models that put patients over profits. This step would not have been possible without the fierce advocacy of organizers across our country calling for an end to Medicare privatization and the partnership of my fellow members of Congress to push back against CMS.”
For more information on the REACH program and the danger it presents to our public insurance programs, please visit protectmedicare.net.
Physicians for a National Health Program (pnhp.org) is a nonprofit research and education organization whose more than 25,000 members support single-payer Medicare for All reform.