A right-wing coalition that's been laying the policy groundwork for another Trump presidency has developed a plan to further privatize Medicare by making fraud-riddled Medicare Advantage "the default enrollment option" for newly eligible beneficiaries.
The plan, highlighted Monday by Rolling Stone's Andrew Perez, is outlined about halfway through Project 2025's 920-page playbook for the first six months of a conservative presidency.
Republican administrations and right-wing groups have long advocated funneling people who are newly eligible for Medicare into Medicare Advantage plans, which are funded by the federal government and run by for-profit insurers. During his first White House term, former President Donald Trump took steps to actively encourage seniors to choose Medicare Advantage plans over traditional Medicare and expanded the benefits that the privately run plans are allowed to offer.
Those efforts have had an impact. As Perez noted, "Last year, for the first time ever, a majority of Americans eligible for Medicare were on privatized Medicare Advantage plans."
"If Republicans win the presidential race this year," he wrote, "the push to fully privatize Medicare, the government health insurance program for seniors and people with disabilities, will only intensify."
Every year, new and existing Medicare recipients have an opportunity to enroll in Medicare Advantage plans, which engage in aggressive and often highly deceptive advertising practices to lure seniors who are often seeking out benefits not currently offered by traditional Medicare, such as vision and dental care.
Once enrolled in Medicare Advantage plans—which offer limited networks of doctors and overbill the government to the tune of $140 billion a year—patients often feel trapped and are subjected to care denials and other deep flaws in the program that have drawn growing attention from lawmakers in recent years.
If Project 2025, which is led by the right-wing Heritage Foundation, gets its way, Medicare Advantage providers would be given even greater power over the critical government insurance program. The Trump administration embraced many of the Heritage Foundation's policy recommendations during its first year in power.
"Donald Trump and his MAGA Republican cronies plan to totally privatize Medicare if they win in November's election," the progressive advocacy group Social Security Works wrote in response to Rolling Stone's reporting. "Hell no. Hands off our earned benefits."
Philip Verhoef, president of Physicians for a National Health Program, told Rolling Stone that Project 2025's plan to make Medicare Advantage the default enrollment option would be "disastrous."
"To do so would be really just a clear handout to the private insurance industry," Verhoef said.
Project 2025 has said that it doesn't "speak for any presidential candidate," but Trump's reelection campaign has relied on parts of the coalition's proposed agenda for second-term planning.
Trump's team has faced backlash over some of Project 2025's work, including draft executive orders that would use the Insurrection Act to deploy the U.S. military against demonstrators. As The Washington Post reported in December, Trump campaign senior adviser Susie Wiles complained privately to Project 2025's director and asked the coalition to "stop promoting its work to reporters."
Seth Schuster, a spokesperson for President Joe Biden's reelection campaign, warned in a statement Monday that "if Donald Trump wins this November, he and Republicans will continue their push to end Medicare as we know it for millions of Americans."
"Trump will leave millions of seniors with fewer benefits and less access to doctors—all to benefit his big insurance donors," said Schuster. "In Trump's America, the special interests win and seniors and working families lose. Worse care, broken promises, and higher costs—that's Trump's plan for seniors and working families."
In addition to making Medicare Advantage the default enrollment option for Medicare, Project 2025 is calling for the revival of the Global and Professional Direct Contracting Model, a Medicare privatization scheme that the Biden administration rebranded as ACO REACH and slightly modified—to the dismay of physicians, healthcare campaigners, and progressive lawmakers who called for the repeal of the Trump-era pilot program.
