Wendell Potter
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Articles by Wendell Potter
Updated Sunlight Report Reveals 2,807 Entities Across UnitedHealth Group’s Corporate Empire
The Center for Health & Democracy has released the latest edition of its Sunlight Report on UnitedHealth Group, revealing 2,807 entities that make up the world’s largest health care conglomerate, including 376 additional entities identified since the report’s initial release in July 2025.
Medicare Open Enrollment Starts Tomorrow. Here's What the Ads Won't Tell You.
Medicare’s annual open enrollment period begins tomorrow, Oct. 15, and runs through Dec. 7. This year, seniors have more reason than usual to take a close look at their coverage. Major insurers are dropping Medicare Advantage plans and pulling out of counties across the country, forcing millions of people to find new coverage. Even beneficiaries whose plans survive may face significant changes in 2027.
Q3 2026: UnitedHealth’s Profits Soar as it Covers Fewer People, Pays Less for Care
UnitedHealth's Q3 profits surged 75% to $4.1 billion even as revenue declined, medical spending fell by $3 billion and millions lost coverage. Three weeks to the day before Americans go to the polls, the nation’s biggest insurance conglomerate just gave voters all they need to know about why health care has become increasingly unaffordable and inaccessible. It is because of all the things UnitedHealth and the other giants must do to keep Wall Street happy – and their investors rich.
No, Dr. Oz, Medicare Advantage Isn't "Stable"
CMS's 2027 preview leads with falling premiums. But it leaves out the plan exits, higher out-of-pocket caps and bigger deductibles that seniors will actually feel. The Centers for Medicare & Medicaid Services recently released its annual preview of the Medicare Advantage and Part D plans that will be on the market when open enrollment begins a week from today. The Trump administration, CMS said, has successfully stabilized the Medicare Advantage program.
The Doctors We Are Losing
Prior authorization, denied care and endless battles with insurers are taking a toll on the physicians trying to do their jobs. Last month, on National Physician Suicide Awareness Day, Reps. Haley Stevens (D-MI) and Brian Fitzpatrick (R-PA) introduced a bipartisan resolution asking Congress to formally recognize it.
Trump Wants to Give $90 to Seniors and $76 Billion to Health Insurers
Washington is sending seniors a one-time payment while CMS is on track to overpay private insurers more than $1 trillion over the next decade. With less than a month from the midterm elections, President Trump announced that more than 20 million seniors would get a payment of “nearly $100” to help with their Medicare Part B premiums.
When Insurance Says No, Some Patients Are Going Straight to the Top
After UnitedHealthcare denied his surgery, Donald Grant took his 11-page legal and medical appeal straight to UnitedHealth Group CEO Stephen Hemsley — and got his request approved. Last month, Elizabeth Nicholas wrote in Vanity Fair about being diagnosed with breast cancer at 36 and then watching her insurer refuse to pay for a recommended course of chemotherapy. Her oncologist delivered the news.
Half of Denials Get Reversed. So Why Deny Them in the First Place?
New data shows patients who appeal prior authorization denials win about half the time and in some health plans, as often as nine out of ten. Bloomberg’s John Tozzi, Tanaz Meghjani, and Ike Swetlitz analyzed 2025 prior-authorization data that insurers have been required to disclose under new federal rules.
RFK Jr. sells health insurers a seat at the table
The MAHA movement built its brand on fighting corporate capture. Its big Washington summit is bankrolled by the companies it claims to fight, including two of the country’s largest health insurers and the AI giants now reshaping how care gets approved and denied. In the past year, President Trump has spent a lot of energy attacking health insurers.
No, the UnitedHealth AI-Denial Lawsuit Isn’t New. Here’s Where It Actually Stands.
The lawsuit over UnitedHealth’s nH Predict algorithm was filed nearly three years ago. Since then, it has survived a major challenge and forced the company to turn over internal information. If your feed served you a “BREAKING” post last weekend about UnitedHealth using an AI with a 90% error rate to deny care, you should know that the story is real, but it’s not new. I flagged the underlying reporting back in November 2023, when STAT first exposed the algorithm.
The Biggest Health Care Companies in America Don't Treat Anyone
If you rank the ten largest health care companies in America by revenue, you will not find a single hospital system or drugmaker. Not Pfizer, not Eli Lilly, not the Mayo Clinic or HCA. Every company in the top ten is a middleman, and together they take in about $2.6 trillion a year. Below is a list showing how much of every dollar of revenue each company keeps as net income. Then read about what these companies actually do.
Trump Bashes Insurers in Public. RFK Jr.'s Summit Sells Them a Seat at the Table.
The MAHA movement built its brand on fighting corporate capture. Its big Washington summit is bankrolled by the companies it claims to fight, including two of the country’s largest health insurers and the AI giants now reshaping how care gets approved and denied. In the past year, President Trump has spent a lot of energy attacking health insurers.
UnitedHealth Wants to Shine “Sunlight” on Providers. It Should Try Some on Itself.
Wayne DeVeydt, UnitedHealth Group’s chief financial officer, stood in front of a room of investors in Boston a few days ago and reached for a phrase that should never come out of that company’s mouth with a straight face. “We’re putting a lot of sunlight on the IDR process,” he told the crowd at a Wells Fargo health care investor conference, referring to the No Surprises Act’s independent dispute resolution system.
John Oliver Takes on UnitedHealth Group, Cites CHD’s Sunlight Report
We’ll admit it: It’s pretty damn cool to see John Oliver talking about our work. On Sunday’s episode of HBO’s Last Week Tonight, Oliver devoted the entire show to UnitedHealth Group — and featured the Sunlight Report on UnitedHealth Group, the massive investigation published by the Center for Health & Democracy in 2025, to help make his case. Parts of the episode sounded like they were lifted right off the Sunlight Report website.
Job Lock Is Real. The ACA Doesn’t Fix It.
Nearly 40% of Americans say they’ve stayed in a job longer than they wanted to because they or a family member needed the health coverage that came with it. That’s the headline finding of a new survey from ValuePenguin, and it’s more common among Gen Z and millennial workers, and more common among parents with young children (53%) than nonparents (32%).
PR STUNT: UnitedHealth’s Big Prior Authorization Cut
UnitedHealthcare, the subsidiary of the massive parent company UnitedHealth Group, announced that it will eliminate prior authorization requirements for roughly 1,700 medical procedure codes beginning next month, a move the nation’s largest health insurer says will cut its prior authorization requirements by 30%. The changes reportedly will apply across its commercial, Medicare Advantage, Medicaid, individual exchange and Oxford plans.
Washington Wants AI Regulation. It Should Start With Health Insurers.
Barack Obama spent an hour last week telling House Minority Leader Hakeem Jeffries and a room of Democratic donors that artificial intelligence is “moving very fast in private hands” and that the party needs a real plan before it gets away from them entirely. He said a public framework on AI safety was urgently needed and that Democrats should make AI safety a “central agenda” in January when the next Congress is sworn in and when attention begins to shift to the 2028 elections.
The Music Industry’s Health Insurance Problem Is Bigger Than Chappell Roan
When the outspoken pop-music phenom Chappell Roan won the Grammy for best new artist in 2025, she took the stage in Los Angeles to collect her statuette and to issue a warning to her industry – pay your artists, and give them something else they desperately need: health insurance. “Record labels need to treat their artists as valuable employees with a livable wage and health insurance and protection,” the 27-year-old Roan told more than 15 million TV viewers.
Florida Sues Two Giant PBM-Middlemen
A few days before the holiday, Florida Attorney General James Uthmeier filed a lawsuit against pharmacy benefit managers (PBMs) Express Scripts and Prime Therapeutics, making The Sunshine State the latest player on the country’s growing PBM-crackdown game board. The state’s suit alleges that the two companies entered into an illegal price-fixing agreement that dramatically reduced what Prime pays pharmacies for prescription drugs. HEALTH CARE un-covered is a reader-supported publication.
How Much Is the No Surprises Act Costing the U.S. Health Care System?
The No Surprises Act solved a very real patient problem. Before the law took effect in 2022, a patient could do almost everything “right” — choose an in-network hospital, use insurance, seek emergency care — and still receive an out-of-network bill from a doctor or another clinician the patient never meaningfully chose. The law largely moved that fight away from the patient.
Congress Wants to Crack Open Health Care’s Black Box. One Sentence Could Keep It Shut.
For years, employers and other plan sponsors, such as unions, have been fighting to get the one thing they need to better control their own health care spending: the claims data their insurers/third-party administrators and pharmacy benefit managers generate on their behalf but routinely refuse to hand over. A bill working its way through Congress – the Patients Deserve Price Tags Act (PDPTA) – would finally force that data into the open.
UnitedHealth Shareholder Lawsuit: Company Rushed Change Integration to Make It Irreversible, Killed Medicare Audit
Back in 2024, two of UnitedHealth’s own shareholders did something relatively unusual when they sued the company’s board and top executives — not to recover their own losses, but on behalf of UnitedHealth itself. That’s what’s called a shareholder derivative suit. The theory is that when a company’s leadership breaches its duties and costs the company money, the company is the injured party, and shareholders can step into its shoes and sue in its name to get that money back.
JD Power: Medicare Advantage Satisfaction Falls for Second Year in a Row
Americans enrolled in Medicare Advantage plans are becoming increasingly less satisfied with their coverage (and increasingly skeptical that their insurers are looking out for them) according to the new 2026 U.S. Medicare Advantage Study from JD Power. The study found that overall satisfaction with Medicare Advantage plans fell for the second year in a row (dropping 12 points) and has dropped41 points since 2024. On JD Power’s 1,000-point scale, the average Medicare Advantage plan now scores 611.
The Health Care Scare Is Back
If you want a sense of where the health care debate is headed as we enter the final stretch before the midterm elections, take a look at what has been published over just the past week.
IRS Probes UnitedHealth Group Over Foreign Money Transfers
In a big scoop this week, STAT’s Bob Herman revealed that the Internal Revenue Services is investigating UnitedHealth Group over what the agency says was an underpayment of taxes between 2017 and 2020 involving transfers of money to a foreign subsidiary. According to STAT, the IRS is “seeking to significantly increase taxable income” reported by the company during those four years, and the dispute could extend to tax years after 2020.
Prior Auth Is Costing Billions and Delaying Care. A New Report Says Ban It.
Last summer, the Trump administration, physician advocates, public health academics and activists requested a voluntary commitment from commercial health insurance industry CEOs to streamline the prior authorization process.
The FTC Continues to Let Big Insurers’ PBMS Off the Hook
Remember when the media and policymakers in Washington became outraged over the cost of insulin and lambasted drugmakers for profiteering?
The CEO Who Built Modern Cigna
David Cordani joined Cigna in 1991, two years before I did. I arrived in 1993, recruited from Humana to support the health care division, which was based in Bloomfield, Connecticut. I spent four years there before being promoted and transferred to Cigna’s Philadelphia headquarters. I would soon become vice president of corporate communications for the company. In those Bloomfield years I often saw Cordani in the offices and in the company gym.
Fourth Court Rejects Insurers' No Surprises Act Litigation Campaign
A federal judge in Georgia has handed Elevance Health another defeat in its campaign to use the courts — rather than the arbitration process Congress built — to fight the No Surprises Act. U.S. District Judge Thomas Thrash Jr. has dismissed a lawsuit that Blue Cross Blue Shield Healthcare Plan of Georgia (an Elevance company) had filed against medical billing company HaloMD and two physician groups.
The Hospitals That Close, and the Hospitals That Open, Are Not in the Same America
As I wrote a few days ago, 700 rural hospitals are in danger of closing because they’re not getting enough money from either private insurers or Medicare and Medicaid to stay open. That would be on top of the 743 general acute-care hospitals that have closed across the United States since 2000. In that same stretch of years, however, hundreds more hospitals have opened. Taken together, that sounds almost reassuring — a sector in churn, but not in freefall.
Why I Wrote a Letter to the Wall Street Journal About Medicare Advantage
The Wall Street Journal recently published an opinion piece by John C. Goodman titled, “Why Do Democrats Hate Medicare Advantage?“ The target of much of the piece wasn’t just Medicare reform — it was Rep. Lloyd Doggett, whose bipartisan bill would curb some of the program’s most abusive practices, including excessive taxpayer overpayments to private insurers. HEALTH CARE un-covered is a reader-supported publication.
Judge Throws Out UnitedHealth's Defamation Lawsuit Against The Guardian
A Delaware Superior Court judge has thrown out UnitedHealth Group’s defamation lawsuit against The Guardian, dismissing all six of the claims the insurance giant had leveled against the news outlet over its investigation into how the company pays nursing homes. The lawsuit, filed in June 2025, came after The Guardian published an investigation into UnitedHealth’s Institutional Special Needs Plans — Medicare Advantage plans built for people who need nursing-home-level care.
Insurers Are Rejecting More Prescriptions Than Ever, New Study Finds
A new study published in JAMA puts hard numbers behind something patients and doctors have been telling me for years: getting a prescription filled increasingly means running an obstacle course of denials, prior authorization forms, and step therapy requirements — and a lot of people never make it through. HEALTH CARE un-covered is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.
UnitedHealth Helped Write the Law It Now Blames for Your Rising Premiums
UnitedHealth Group, the country’s biggest health insurance conglomerate, wowed Wall Street last week when it announced that its profits increased a whopping 55% during the second quarter of 2026, from $5.2 billion at the end of 2Q 2025 to $8 billion in 2Q 2026. That puts the company on track to post profits for the year north of $30 billion.
Cigna’s Express Scripts Pressured Over TRICARE Contract in Senate Hearing
A Senate Armed Services Subcommittee on Personnel hearing last week highlighted growing concerns about the Pentagon’s relationship with Cigna’s Express Scripts, the pharmacy benefit manager (PBM) that oversees the military’s TRICARE pharmacy program. Express Scripts is the nation’s largest PBM and serves as the exclusive administrator of TRICARE’s pharmacy benefit, overseeing prescription drug coverage for roughly 9.6 million active-duty service members, military retirees and their families.
ELEVANCE 2Q26 EARNINGS ANALYSIS: The Company Beat Wall Street’s Estimates. Investors Punished It Anyway. Here’s Why.
Elevance Health, the giant health insurance conglomerate that operates Blue Cross plans in 14 states under the Anthem brand, reported second-quarter profits yesterday that blew past Wall Street’s expectations. The company reported adjusted earnings per share of $7.45, well above Wall Street financial analysts’ consensus estimate of $6.21. Revenue growth also exceeded expectations and the company raised its full-year 2026 earnings guidance to at least $27 a share.
The ACA Death Spiral Is No Longer Just a Theory
I’ve long warned that letting the enhanced ACA subsidies expire could set off a classic insurance death spiral: healthier people priced out first, a sicker risk pool left behind, higher premiums as a result, more healthy people priced out — rinse and repeat. Reports this week from KFF News and other media outlets about 2027 rate filings is the first time I’ve seen that mechanism actually measured rather than predicted.
Who's Really Gaming the No Surprises Act?
Health insurers have a new talking point – based on a new “study” by the giant health insurance conglomerate Elevance Health – and it goes something like this: Doctors are exploiting the No Surprises Act’s (NSA) arbitration process to extract outrageous payments, and something must be done before the whole system collapses under the weight of runaway awards. HEALTH CARE un-covered is a reader-supported publication.
Senators Introduce Bill to Cap Traditional Medicare Out-of-Pocket Costs at $5,000
For as long as traditional Medicare has existed, it has had a flaw so obvious and so consequential that it is understandable why many seniors have enrolled in private Medicare Advantage plans despite the many downsides of doing so: There is no limit on what a beneficiary enrolled in traditional Medicare can owe in a single year. Get seriously ill, face a hospitalization, live with a chronic condition that requires intensive care — and the bills pile up with no ceiling.
Elevance Had to Give $342 Million Back to Taxpayers
Elevance Health, one of the nation’s biggest health insurance conglomerates, wired more than $342 million to the Centers for Medicare & Medicaid Services a few weeks ago after the agency threatened to suspend enrollment in the company’s Medicare Advantage plans over what CMS described as years of “substantial and persistent noncompliance” with federal billing requirements.
UnitedHealth Has a Bank. Now Washington Wants More Insurers to Act Like One.
Most Americans are familiar with UnitedHealth, the largest private health insurer in America – if not because the corporate giant provides their medical coverage, then because of the massive publicity when the CEO of its key subsidiary was assassinated on a Manhattan street in December 2024.
Trump Plans – I Mean – Junk Plans Are Back
The Trump administration has announced that it will significantly expand access to so-called catastrophic health insurance plans, which are policies with comparatively low monthly premiums but deductibles so high they often leave families effectively uninsured until a medical crisis strikes. CMS described the move as giving Americans “flexibility” and improving access to “affordable healthcare coverage.” But what I call them are “junk plans”.
Cigna Said No. His Doctors Said It Could Save His Life.
Keaton Herzer’s year-and-a-half-long fight against a rare form of cancer could supply the plot for a TV drama series. Along the way, Herzer, a 35-year-old Colorado software engineer and new dad, accumulated a lot of followers on social media sites like TikTok, with videos about his struggle – not just with the cholangiocarcinoma attacking his liver, but also with Cigna, the insurance giant managing his health plan.
The PBM Lobby Has Launched the Biggest Advertising Campaign in Its History
Only a few months after Congress enacted some of the most significant federal reforms to date of the business practices oft pharmacy benefit managers, the PBM industry’s chief lobbying group says it has launched the biggest advertising campaign in its history. The largest PBM trade group in the nation, the Pharmaceutical Care Management Association (PCMA), is now spending millions of dollars trying to convince Main Street and Pennsylvania Avenue that PBMs are misunderstood.
No One Likes Medicare Advantage [Episode Clips]
Concern about Medicare Advantage is no longer limited to patient advocates and health care reformers. Increasingly, lawmakers from across the political spectrum are questioning whether the program is serving seniors and taxpayers as intended. Below are three clips from our latest episode of the HEALTH CARE un-covered Show featuring former Congressman Jim Greenwood (R-PA), Rep. Greg Murphy (R-NC) and Rep. Mark Pocan (D-WI). HEALTH CARE un-covered is a reader-supported publication.
Federal Fraud Watchdog Documents How Medicare Advantage Fails People When They Are Most Vulnerable
When my mother broke her hip, I watched a Medicare Advantage plan try to cut her recovery short. I knew enough from my years in the industry to fight back — and eventually I got her out of that plan entirely and into traditional Medicare, where she could choose a quality skilled nursing facility without asking anyone’s permission.
The Margin Myth: Why One of the Insurance Industry’s Favorite Talking Points is Designed to Mislead You
When UnitedHealth Group reported its first-quarter 2026 results, it disclosed something that didn’t make many headlines: an annualized return on equity of 26.2%. That number — not the profit or operating margin — is what Wall Street uses to evaluate whether a business is making good use of the money investors have put into it.
The Blind Spot in Congress's Health Care Transparency Bill
The House Energy & Commerce Subcommittee on Health will hold a hearing Wednesday on a package of bills framed around price transparency and lower costs for patients. One of those bills would require mandatory public reporting of ownership structures, mergers, acquisitions, and beneficial owner information for a broad range of health care entities — hospitals, ambulatory surgical centers, independent emergency departments, and physician practices, including those backed by private equity.
No One Likes Medicare Advantage | EP 4
For years, Big Insurance and their allies have argued that the Medicare Advantage program represents the future of Medicare — a more efficient alternative to Traditional Medicare that delivers better care at lower cost. But as too many Americans know, the reality has turned out quite differently. HEALTH CARE un-covered is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.
The $490,000 Denial
When Pamela Talley came home from an Arizona cycling vacation with a surgically repaired broken left wrist and elbow, she knew – as a retired family physician – that she’d be facing a tough recovery. What the 62-year-old Colorado retiree wasn’t expecting was the letter she received not long after she got home last year from her health insurer, Anthem Blue Cross and Blue Shield.
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