Prof. Joel Cantor Reflects on Dr. Oz’s Nomination

November 21, 2024

Bracing for the Dr. Oz effect on health care

Read the original post on NJ Spotlight News, November 21, 2024

The health insurance coverage for 3.5 million vulnerable New Jersey residents will be overseen by a cardiologist and former television personality known for promoting highly questionable cures, if resident-elect Donald Trump gets his way.

The incoming Republican president announced Tuesday he will nominate Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services, or CMS, which provides health care and insurance coverage for more than 160 million Americans. Trump has embraced some of Oz’s more controversial claims, including his promotion of the antimalarial drug hydroxychloroquine to treat COVID-19, despite a lack of evidence.

“America is facing a Healthcare Crisis, and there may be no Physician more qualified and capable than Dr. Oz to Make America Healthy Again,” Trump said in a statement, claiming Oz would take on the “illness industrial complex” and promote disease prevention.

Oz — who owns property in Cliffside Park — is known primarily for his role as host of “The Dr. Oz Show,” which ended in 2022 when he ran for U.S. Senate as a Republican in Pennsylvania, losing to Democratic Sen. John Fetterman. Oz has no government experience.

Health insurance coverage

Trump’s picks could also weaken coverage and increase costs within the commercial insurance market, others have suggested, and those changes could include employer-sponsored health insurance plans used by nearly 5 million New Jersey residents. Joel Cantor, director of Rutgers University’s Center for State Health Policy, said he expects the Trump administration could reduce protections created by former President Obama to guarantee free preventive services, like mammograms and colonoscopies, and comprehensive behavioral health treatments.

Joel Cantor, director of Rutgers University’s Center for State Health Policy, said he’s concerned about what Oz would do to the Obamacare marketplace.
“I can easily see backsliding on preventative services,” Cantor told NJ Spotlight News. “And there will be no more forward momentum making sure people with mental health or substance use conditions have full access under the law.”

Cantor is also concerned about the impact Oz’s appointment could have on the Obamacare marketplace, which the state says covers 61% more people than it did in 2020, the year after Gov. Phil Murphy took over control of the exchange from the first Trump administration. Republicans in Congress are eager to cut subsidies for these plans that were expanded under President Joe Biden and Cantor fears increased cost to consumers — along with regulatory changes that limit coverage — could scare off healthy people, leaving a higher concentration of sickly patients with more costly needs to shoulder the costs.

“That will start to fracture the market,” Cantor warned, noting that the impact would be greatest on those with the tightest budgets.

What’s in store for Medicaid?

Medicaid coverage, which is overseen by the state and funded by a mix of state and federal dollars, could also suffer under Oz, Cantor said. New Jersey has significantly modernized its program to address social determinants of health — issues that include housing, partner violence and food insecurity that greatly impact wellness — and Cantor worries Trump’s team will stall or block these initiatives if they appear politically unpopular with some constituents. Cantor said he also anticipates calls to shift funding, which is now done per person, to a block-grant system in which states are provided a set funding amount, regardless of enrollment shifts.

Oz’s connection to Trump dates to at least 2016, when then-candidate Trump joined his show to announce the results of his physical exam.

But big government systems take a long time to change, Cantor and others agreed, given the level of detail involved in implanting complex social service programs. “Inertia is on our side” when it comes to protecting changes New Jersey has made in Medicaid, Cantor said.

Some experts noted that Oz’s promise to focus on disease prevention and healthy lifestyles could be beneficial for a nation struggling with high rates of obesity, diabetes and other avoidable conditions. But they worried that Oz, a TV personality, might also use his platform to promote untested or possibly unsafe treatments, as he’s done in the past. If nothing else, Oz — and his boss RFK Jr. — could bring unprecedented attention to agencies that serve large, vulnerable populations, but don’t usually benefit from the limelight, one observer said.

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