Dr. Oz Nominated to Run the Centers for Medicare and Medicaid Services (CMS)

The Centers for Medicare and Medicaid Services (CMS) is a federal agency overseeing the two programs that provide benefits to roughly 75 million Americans. Recently, President-elect Donald Trump announced that former TV talk show host and heart surgeon Dr. Mehmet Oz would lead the CMS under his administration.

“I have known Dr. Oz for many years, and I am confident he will fight to ensure everyone in America receives the best possible Healthcare, so our Country can be Great and Healthy Again!” Trump said in a statement upon announcing the nomination.

Who is Dr. Mehmet Oz?

Dr. Mehmet Oz obtained a medical degree from the University of Pennsylvania School of Medicine. He then completed his surgical training in cardiothoracic surgery at New York Presbyterian Hospital and eventually became Professor Emeritus of Surgery at Columbia University College of Physicians and Surgeons in 2018.

Oz began his TV career by making appearances on “The Oprah Winfrey Show” before getting his own series, “The Dr. Oz Show,” which aired between 2009 and 2022.

What Are Dr. Oz’s Plans as Administrator of CMS?

Dr. Oz has long been a supporter of Medicare Advantage, which are plans offered by private insurers to Americans 65 and over, as well as eligible enrollees under age 65 with specific conditions or circumstances. Medicare Advantage plans are required to offer at least the same level of coverage as Original Medicare, but these plans commonly offer supplemental benefits, sometimes at no additional premium beyond the cost of Medicare Part B.

Does Dr. Oz Want to End Medicare?

Dr. Oz doesn’t want to end Medicare, but he’s made it clear that he supports a broad shift to Medicare Advantage plans – not just for older Americans, but Americans as a whole.

In a 2020 Forbes article he co-authored, Oz stated that Medicare Advantage enrollees get optimal coverage thanks to the fact that there are competing plans. Oz proposed a Medicare Advantage for All program that would be funded through payroll taxes and apply to anyone not eligible for Medicaid.

How Will Dr. Oz Work with Robert F. Kennedy, Jr.?

Robert F. Kennedy Jr. has been selected to oversee the Department of Health and Human Services. As part of his “Make America Healthy Again” campaign, his aim is to reduce the incidence of chronic disease. He’s also been very vocal about the ill effects of ultra-processed foods and poor nutrition.

Oz and RFK Jr. share certain core opinions about wellness and have been known to have controversial views in the context of mainstream medicine. RFK Jr. has the reputation of having an anti-vaccine stance (though he claims he’s not an anti-vaxxer), while Oz has long touted the benefits of supplements that lack scientific backing.

It’s hard to say how well the pair will work together, but they seem to share a certain common ground. Whether that will translate into better healthcare for Americans is yet to be determined.

Is Dr. Oz in Favor of Medicare for All?

Dr. Oz doesn’t support Medicare for All so much as Medicare Advantage for All. Oz feels that broad access to Medicare Advantage plans could lead to better benefits and care overall.

What Could this Mean for Medicare Advantage Plans?

Medicare Advantage plans commonly appeal to Americans because they offer coverage beyond the scope of Original Medicare. They also cap enrollees’ annual spending, whereas Original Medicare doesn’t. And with many Medicare Advantage plans charging a $0 premium, it’s easy to see why millions of Americans have already signed up.

That said, there are drawbacks to Medicare Advantage. These plans limit enrollees to narrow provider networks, and many of these plans require prior authorization for treatments that can serve as a bottleneck for getting care.

In his new role, Oz will likely seek to expand Medicare Advantage plans and promote a shift toward them for enrollees in Original Medicare. He may also loosen some guidelines in the context of marketing Medicare Advantage plans in an attempt to make them more appealing to potential enrollees.

It’s unclear as to whether Oz will seek to expand supplemental benefits under Medicare Advantage plans, or whether he’ll address the issue of prior authorization denials that have caused many providers and healthcare networks to cut ties with these plans.

What Can this Mean for Medicare Supplement (Medigap) Plans?

Dr. Oz is clearly in favor of a shift toward Medicare Advantage. But Medicare Advantage plans are not compatible with Medicare Supplement plans, otherwise known as Medigap.

The purpose of Medigap is to help cover the cost of out-of-pocket expenses Original Medicare enrollees face, like deductibles, coinsurance, and copays. It’s not meant to cover expenses Original Medicare won’t pay for, like dental care, eye exams, and hearing aids. Most Medicare Advantage plans offer coverage for these services.

Looking Toward 2025

During his presidential campaign, Trump pledged not to cut Medicare. But he has pledged to cut wasteful spending related to Medicare.

In announcing Dr. Oz’s nomination, Trump said that Oz will “cut waste and fraud within our Country’s most expensive Government Agency, which is a third of the Nation’s Healthcare spend, and a quarter of our entire National Budget.”

Both Trump and Oz have pledged to make prescription drugs more affordable, but it’s unclear as to what steps they’ll take to that end.

At this point, what Dr. Oz does with Medicare is almost anyone’s guess. As someone with a lofty vision and limited bureaucratic experience, it’ll be interesting to see what changes arrive in the new year. It’ll also be interesting to see what steps Oz takes to address the primary shortcomings of Medicare Advantage plans – namely, restrictive provider access and routine denials of care.

In 2024 alone, 32 healthcare systems announced their intent to drop Medicare Advantage plans, citing slow payments and excessive prior authorization denial rates as primary reasons why. It will be a pretty monumental task for Oz to promote a shift toward Medicare Advantage given the known shortcomings associated with these plans. But if Oz is able to improve access to care under Medicare Advantage plans, they could become an even more popular choice going forward – and in that case, for good reason.