Health Insurers Are Looking For Maha Wins

LAS VEGAS — Insurers and doctors' groups, often divided over how to rein in health care costs, are now facing off over the Make America Healthy Again movement.

The insurance industry is embracing MAHA, while the doctors' lobby is pushing against the movement's leader, Health Secretary Robert F. Kennedy Jr., who many physicians see as a danger to public health.

The opposing forces could shape Kennedy's policy decisions on issues ranging from how much doctors earn to treat Medicare patients to how the government regulates medical services.

At the five-star Wynn Las Vegas hotel and casino this month, insurers curried favor with the administration, touting all the ways they’re prioritizing the health secretary's big issue, combatting chronic diseases. Meanwhile, members of the doctors’ leading lobby, the American Medical Association, voted at their home base in Chicago this month for an uncompromising Kennedy critic as president-elect.

Kennedy controls big money that both sides would love to get more of. His Health Department determines the rates Medicare pays both. Insurers shuddered when President Donald Trump pressured them to lower prices last year. Then in April, the administration agreed to raise insurers’ Medicare Advantage payment rate nearly 19 times more than it had proposed in January — though still far less than the companies had hoped for. Doctors caught a break when Congress boosted their Medicare fees in last year’s One Big Beautiful Bill Act, but face a cut in 2027. Kennedy has hinted he’d like to take a broader look at how Medicare pays doctors, with the aim of paying less.

The insurers are better-positioned than the doctors to embrace MAHA.

While outbreaks of infectious diseases like measles and Kennedy’s push to change childhood vaccine policy have prompted handwringing among physicians, insurers are not fighting an ideological battle. Kennedy hasn’t asked insurers to make any changes to vaccine coverage even as he’s pushed to reduce the number of shots the government recommends for children. (A lawsuit spearheaded by doctors has put that reduction on hold.)

For insurers, leaning into MAHA has meant launching specialized plans targeting chronic disease, embracing artificial intelligence, expanding coverage of so-called functional medicine that targets the root causes of disease and pushing payment models focused on improving health outcomes. They’ve also teamed up with the administration to streamline the prior authorization process, where insurers require doctors to seek approval before providing some types of care, a move Trump administration officials have lauded as helping to advance the MAHA agenda.

Aligning their interests with those of Trump and Kennedy might help insurers avoid Trump’s wrath as Republicans target health care industries for driving up costs. Lawmakers of both parties are scrambling for ideas to address the cost crisis that will resonate with Americans.

At the health insurance conference hosted by the industry trade group America’s Health Insurance Plans, companies' MAHA fervor was on full display, along with arguments that adoption of MAHA policies will reduce costs.

“Make America healthy again is a beautiful effort," Dawn Maroney, CEO of Alignment Health Plan, told POLITICO, explaining that she agreed with Kennedy that American health care focuses too much on treatment and not enough on prevention: "We are so in an environment of paying for the service, not preventing the service from happening.”

She noted Alignment Health offers insurance plans that provide free gym memberships and grocery benefits, in line with the MAHA movement’s focus on food and exercise.

Insurers’ focus on prevention demonstrates how the companies are using the Trump administration’s MAHA agenda to their advantage in their struggles with doctors over money. Like the administration, they aim to push doctors and hospitals toward care models that base payments on quality of care and health outcomes rather than the number of services provided.

The Trump administration has been shifting toward that model for government health programs, including Medicare. Mehmet Oz, the Centers for Medicare and Medicaid Services administrator, has said his goal is for Medicare to be the “leading payer” on that kind of care.

“I am a huge advocate of what the president is doing,” Maroney said. “It's huge and needs to continue on for years to come, even in future administrations.”

Insurers go MAHA

Insurers’ moves to target chronic disease hit on a number of the key tenets of Kennedy’s movement, from implementing food-focused interventions to launching AI chatbots to help manage care.

Aetna plans to launch a model later this year to better coordinate care for children with autism who have chronic diseases that are associated with the condition, such as obesity and sleep disorders, said Katerina Guerraz, executive vice president and chief operating officer for the company, the third-largest insurer.

“You can't just treat the mental health condition, you have to treat these other physical things,” she told POLITICO. Aetna is planning similar models for cancer, maternal and mental health care, which could mean coordinating stable housing and food supplies for patients, she added.

The company is also leveraging AI in coordinating patient care — something Oz has been bullish about pursuing at his own agency. Aetna is using the technology to match patients with providers and schedule appointments.

Blue Shield of California, a large nonprofit health plan, is using its “Wellvolution” platform to provide digital health tools to members to access lifestyle-based programs to help people lose weight or prevent and treat diabetes.

“There's a number of goals that align very closely [with MAHA] — trying to keep people healthy, trying to avoid and prevent chronic illness and disease, doing things like making sure there's access to good nutrition and good healthy habits for individuals,” said Paul Markovich, CEO of Ascendiun, the parent company of Blue Cross of California.

Elevance Health, the nation’s second largest insurer, is also working to advance MAHA principles through clinical programs, including ones for oncology and behavioral health, said Ratnakar Lavu, its chief digital information officer. The company is using concierge care — a digital program connecting qualifying patients with chronic diseases to a dedicated care team to help manage their treatment at no additional cost.

Drawing the line

Though insurers seem bullish on MAHA, the companies largely disagree with Kennedy on a key issue: vaccines.

Kennedy overhauled the Centers for Disease Control and Prevention’s outside panel of vaccine experts, which recommends vaccines that insurers are then required to cover at no charge. His new panel of hand-picked advisers, some of whom are longtime vaccine skeptics, has voted to scale back several vaccine requirements, including for the Covid shot and the hepatitis B vaccine for newborns. Most of those decisions are on hold after a March court ruling.

While Kennedy's moves raised concerns among patient advocates about inconsistent vaccine coverage, AHIP and large employer groups were quick to commit to maintaining free coverage of the shots.

“Coverage decisions for immunizations are grounded in each plan’s ongoing, rigorous review of scientific and clinical evidence and continual evaluation of multiple sources of data,” AHIP said in September. “These decisions reflect an operating environment shaped by federal and state laws, as well as program and customer requirements.”

Insurers reiterated those commitments in a number of panel discussions at the AHIP conference. Company executives said they’d continue to follow the science on vaccines, including the recommendations of independent medical associations outside of the CDC, like the American Academy of Pediatrics or the American Academy of Family Physicians.

“When it comes to any given vaccine or any other type of intervention or treatment, we're just going to follow the evidence,” said Markovich. “At this point the evidence says these vaccines are safe and effective."

For insurers, there’s a financial incentive to cover vaccines at no cost. Paying for immunizations against diseases like Covid and the flu keeps members out of the hospital and saves on downstream health costs.

At one of the AHIP vaccine panels, Heidi Kabler, a field medical head with Sanofi vaccines, explained that a 1 percent drop in the flu vaccination rate can lead to thousands more hospitalizations and tens of millions of dollars in extra health care spending.

“That’s troubling,” replied Chris Regal, AHIP’s director of clinical innovation.

‘A solution to the problem’

Discord over vaccines hasn’t stopped insurers from seizing opportunities to engage with the administration on other aspects of the MAHA agenda. Embracing MAHA is also a chance to one-up providers, who they argue are among the main culprits driving up health costs.

Both insurers and drugmakers — two of Washington's most powerful lobbies— aim to take advantage of lawmakers’ health cost concerns ahead of the midterms by convincing them to regulate how much hospitals charge for medical services.

While all three sectors have been in the hot seat this year, both drugmakers and insurers agreed to deals with the Trump administration — with pharma companies promising to lower prices and insurers promising to speed up care approvals. Over the past few months, drugmakers and insurers have launched ad blitzes blaming hospital pricing and provider consolidation for rising costs.

Meanwhile, lawmakers and the Trump administration are considering cutting providers’ Medicare fees, cracking down on their mergers and scaling back their drug discounts — reforms insurers and drugmakers have pushed for.

“It takes the entire system actually to make a difference, and so we want to engage with the administration,” said Lavu. “We want to be a solution to the problem, but we also need other parties, like providers, to actually engage, to be able to make this simple.”

Insurers might do well to throw in with MAHA, given that going after corporations is becoming increasingly popular among Republicans, who have historically favored pro-business policies.

Still, whether insurers’ efforts are enough to win over Republicans in power remains to be seen. Though Trump appears to have cooled off after criticizing insurers harshly last year, some Republicans in Congress are still bullish on reforms that could hit insurers’ bottom lines. Those include a plan to redirect insurance subsidies to Americans’ tax-advantaged health savings accounts. Trump has previously said he’d support such a move.

“It is time for us to stand up and defend the American people against the lobby interests for big insurance and big hospital and big pharma," said Rep. Chip Roy (R-Texas), at a Wednesday press conference where the budget hawk and other Republicans advocated for the health savings account plan.

Insurers and their ilk, he added, "are standing in the way of the American people being able to get the care that they deserve."