Kicking people off Medicaid for big bucks

All health insurers have people whose job it is to find reasons to deny coverage. That's bad enough, but this seems even worse as most of their victims will have no other realistic options.

As more than seventeen million people stand to lose health insurance in the unfolding Medicaid eligibility review disaster, there’s one company licking its lips: Maximus, a little-known federal contractor that is one of the biggest players in privatizing essential government services previously done by civil servants — in particular, taking over states’ capacity to determine who is eligible for Medicaid and who isn’t.

In a February earnings call for shareholders and Wall Street analysts, Maximus’s CEO Bruce Caswell announced that the current nationwide eligibility review of ninety million people on Medicaid and other government health insurance programs “is unprecedented in its scope,” and will allow Maximus “to gain traction in the market.” As a result of the deluge in Medicaid “redeterminations,” Caswell said, “we expect improvement to operating margin.”

The company has accordingly boosted its earnings estimate by $100 million. Maximus’s share price is closing on its all-time high, up nearly 50 percent since October. Caswell earned $6.3 million in 2022.

Outsourcing Medicaid eligibility reviews to Maximus has major implications beyond the company’s expanding bottom line. It also removes essential government services from the realm of public accountability, while draining resources from governments. - Jacobin