February 11, 2023

Dear Medicare supporter,

For the past 18 months, an incredible coalition of Medicare champions has worked tirelessly to push back against the privatization of our most important and beloved public health program. We’ve raised the alarm about the REACH program, which places third-party middlemen between Traditional Medicare beneficiaries and the care they need.

Despite our efforts, the program has continued to grow, from 53 Direct Contracting Entities in 2021, to 99 such entities in 2022, to 132 REACH entities as of January 1. But in a major victory for our campaign, I’m happy to report that the growth of Medicare REACH ends today.

Don’t take my word for it. Listen to what Elizabeth Fowler, Deputy Administrator and Director of the Center for Medicare and Medicaid Innovation, told the California Public Employees' Retirement System recently:

“We have no plans to open up another application period [for REACH],” she told the CalPERS Board. “There will not be any more than 132 organizations in the model and most likely no more than 2.1 million beneficiaries.”

This is in sharp contrast to Fowler’s publicly stated goal of moving all 36 million Traditional Medicare beneficiaries into a program like REACH by the end of this decade.

Why the change of heart? Because over 300 grassroots organizations from across the country—representing seniors, people with disabilities, workers, medical professionals, and community advocates—joined us in demanding an end to REACH. Because members of Congress like Sen. Elizabeth Warren and Rep. Pramila Jayapal pressed the Biden administration about this Trump-era program and the threat it poses to their constituents. And because nearly 20,000 advocates like you signed our petition to protect Medicare.

It is important to recognize this victory, but it is equally important to continue demanding fundamental changes to the way federal policymakers conduct business.

We must renew our commitment to …

  • End the REACH program, for the sake of the 2.1 million Medicare beneficiaries who have been assigned a middleman without their full knowledge or consent;
  • Call out “bad actors” that have been allowed to administer Medicare benefits through REACH despite long and troubling histories of bad behavior;
  • Guard against REACH 2.0, recognizing that the policymakers who developed this program—and the corporate entities that lined up to participate—aren’t going away;
  • Replace Medicare Advantage and its limited provider networks, prior authorization requirements, and high out-of-pocket costs with an improved version of Traditional Medicare that builds on the successful, public elements of the program; and
  • Win single-payer Medicare for All, the only health care reform that is compatible with economic, racial, and health justice.

Help sustain the fight against Medicare REACH! Make a tax-deductible donation to PNHP, or find other ways to take action today.

Wall Street investors have been trying to get their hands on Medicare for decades, but they’ve overplayed their hand with REACH. We must continue to press the issue—and continue to build the kind of people power we will need to take on an industry that is laser-focused on generating profits … and indifferent to the suffering of patients.

Together, we can reverse the course of privatization in Medicare and build a brighter future that includes publicly funded, publicly administered, and publicly accountable health care for all.


Phil Verhoef, M.D., Ph.D.

Physicians for a National Health Program
29 E Madison St Ste 1412 | Chicago, Illinois 60602
312-782-6006 | info@pnhp.org

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