CONGRESSMAN PAT RYAN LEADS HUDSON VALLEY COMMUNITY SPEAK OUT AGAINST DEVASTATING MEDICAID CUTS, OPTUM CONSOLIDATION
Congressman Pat Ryan Leads Hudson Valley Community Speak Out Against Devastating Medicaid Cuts, Optum Consolidation
This month, 59% of Americans said they worry “a great deal” about health care costs; Trump’s Budget proposal mathematically requires catastrophic cuts to Medicaid, which covers more than 240,000 NY-18 residents including 100,000+ children and 22,000+ seniors
Threats to Medicaid come amidst unprecedented health care consolidation in Hudson Valley; Congressman Ryan recently released the bombshell results of his community inquiry into Optum, a subsidiary of UnitedHealth Group which has purchased medical practices across the Hudson Valley
Chief among the concerns raised by the community were a declining quality of care, an increase in fees and incorrect billing, and issues with customer service and accessibility negatively impacting people’s ability to get health care
In the last two months, Ryan has led Community Speak Outs on protecting Social Security and saving the inpatient care unit at Castle Point VA
TOWN OF POUGHKEEPSIE, NY – Tonight, amidst unprecedented threats to Medicaid and following the shocking results of Congressman Ryan’s community inquiry into Optum, Congressman Pat Ryan led community members from across the Hudson Valley in a Speak Out to protect Medicaid and fight back against UnitedHealth’s growing monopoly on health care in the Hudson Valley. This month, 59% of Americans said they worry “a great deal” about health care costs, yet Trump’s budget proposal mathematically requires catastrophic cuts to Medicaid, which covers more than 240,000 NY-18 residents including more than 100,000 children and more than 22,000 seniors. This comes amidst unprecedented health care consolidation in the Hudson Valley; Congressman Ryan recently released the bombshell results of his community inquiry into Optum, a subsidiary of UnitedHealth Group which has purchased medical practices across the Hudson Valley. In the last two months, Ryan has led Community Speak Outs on protecting Social Security and saving the inpatient care unit at Castle Point VA.
Tonight’s speakers included:
- Shawn Federighi, Facilitated Enrollment Director for Independent Living, a Newburgh consumer-directed, cross-disability advocacy and service organization dedicated to enhancing the quality of life for people with disabilities.
- Sparrow Tobin, of New York State United Teachers (NYSUT)
- Margaret Franks, BSN, RN, and Treasurer of the New York State Nurses Association (NYSNA)
- Mici Simonofsky, RN from Marlboro
- Barbara Scott, a former Optum patient from Kingston
“I hear it from folks every day – it’s impossible to afford health care, and quality of care is plummeting. Trump’s cuts to Medicaid and UnitedHealth’s growing monopoly on care are making that problem immeasurably worse,” said Congressman Pat Ryan. “Our community is standing up with one voice because we refuse to let the harm continue. Whether it’s greedy corporations ripping us off or corrupt politicians screwing us over, we the people are fighting back, together.”
“Medicaid isn’t some abstract program—it’s what helps pay the salaries of school nurses, psychologists, and special ed teachers. It’s what puts physical therapists in classrooms. It’s what makes sure that when your child has a disability, they still get the support they need to succeed. And this isn’t just about some kids—this is about every student,” said Sparrow Tobin, HVALF President & NYSUT Election District Director. “Because when schools lose Medicaid dollars, services get cut. That hurts the entire school. That hurts your kid. So let’s stand up. Let’s speak out. And let’s remind every lawmaker: when you mess with Medicaid, you’re messing with all of us.”
“The nurses who live and work in this community are concerned about health care right now. Healthcare corporations keep saying that patient care and efficiencies improve when mergers take place. That’s not what we have seen,” said New York State Nurses Association Treasurer Margaret Franks, BSN, RN. “Optum’s merger shows how the opposite happens when health care mergers take place. Optum, a UnitedHealthcare subsidiary, has dramatically worsened care and working conditions at CareMount and Crystal Run after taking over. For the Hudson Valley to thrive, we need more quality, affordable healthcare for all, not profit-driven consolidation and Medicaid cuts. We need to send the message to Washington: hands off our healthcare! Stop the cuts!”
“The Administration’s threats to cut hundreds of billions from Medicaid will have absolutely devastating impacts on people across the Hudson Valley and around the country, especially including seniors, children, and people with disabilities,” said Shawn Federighi of Independent Living, Inc, a consumer-directed, cross-disability advocacy and service organization dedicated to enhancing the quality of life for people with disabilities. “It's important to remember that Medicaid is the primary payer of and only public health insurance that covers long term and nursing home care for seniors and people with disabilities throughout the state. I do this for a living, and I can tell you for a fact that this will be devastating to the seniors in the Hudson Valley I work with every single day. That’s why I am speaking out today, and why I am grateful to Congressman Ryan for fighting with us.”
“After the purchase by Optum, I experienced sub-par medical care from doctors in the network. With conglomerates purchasing doctors networks, our choices will be ever more limited,” said Barbara Scott, a former Optum patient from Kingston. “I was lucky to have my internist as a true advocate for me and my care, but that shouldn’t be how this has to work. Doctors are having to doctor by the book- 10 minutes per patient, very little direct communication and are restricted to money-saving treatments rather than good care. Optum is putting their own profits above patient care, and people are suffering for it.”
“As a provider, for years I have been advocating for reforms to Managed Care. I have to deal with reimbursements on a weekly basis, and I only deal with United Healthcare or Optum insurance, the carrier for most of my patients,” said Mici Simonofsky, a Registered Nurse from Marlboro. “Pre Approval is timely and can restrict my approach to their care. Reimbursement can take 4-6 weeks, and it is time consuming and frustrating to be able to speak with an actual representative to address problems on my patient's behalf. Thank you Congressman Ryan for your attention to this issue that affects so many of us, and especially here in the Hudson Valley.”
“What Optum has done is put a corporate wall between my children and their physician and therefore their overall health. After the Optum takeover, their doctor became less attentive and less relaxed in our visits, and seemed to need to push us out the door to see the next patient,” said Naomi from Marlboro. “Now, I just heard that their doctor is leaving, and I can’t blame him. He didn't seem anything like himself the last time we met with him, he was distracted and rushed through the meeting. I can't even get in touch with him to say goodbye or thanks for the 7 years of caring for my kids because the new portal they started doesn't give me access to my kids charts and I cannot call offices directly. All around, it's a mess, truly. For the patients and doctors alike.”
“I’m joining my neighbors speaking out today because Optum’s billing practices are absolutely criminal. They incorrectly processed doctor’s visits for my son, which led to an overcharge that wasn’t covered by insurance,” said Sarah from Wappingers Falls. “I paid the copay amount in good faith and called to have the bill corrected. I was told they would resubmit, but I still ended up getting a collections notice! I’m glad that Congressman Ryan is spreading the word about this fraud because I know there have to be others getting taken advantage of like I was.”
“I worked at Crystal Run for a long time, and can confidently say that the purchase by Optum has accelerated the decline in the patient experience. The management doesn’t listen to the providers, and makes it near impossible for them to leave and provide care elsewhere in the Hudson Valley. They don’t care that we’re overworked, and manage us through fear and edict,” said a former Crystal Run provider. “The care given in the office is still great care. The doctors are still doing a great job, but they are overwhelmed, under staffed and have very low morale. The patients are suffering for this, and I’m grateful to Congressman Ryan for bringing them together for the sake of their own care and the sake of doctors and providers across the Hudson Valley.”
Trump’s budget proposal would cut nearly a trillion dollars from the Medicaid budget to fund tax cuts for the top 1% richest people in the country. In NY-18, that would mean threatening access to health care for more than 244,000 Medicaid recipients, including more than 100,000 children and 22,000 senior citizens.
In 2022, Optum purchased CareMount Medical, a medical group with over 2,100 providers and 1.6 million patients in the tri-state area. In 2023, Optum further consolidated the market for physician services in the Hudson Valley with its acquisition of Crystal Run Healthcare, with about 400 providers. Patients across the Hudson Valley have reported that the shift to Optum has worsened the quality of their care and reduced access to medical providers in our area. This includes difficulty scheduling doctor’s appointments, inaccurate billing, unexplained fees, long wait times, and poor customer service. In addition, Optum employees have reported layoffs and chaotic, overburdened work schedules, leading to staff burnout.
Across the country, Optum has purchased doctor’s offices at an aggressive pace. It has become the largest employer of doctors, with one in ten physicians nationwide now under its control. Optum’s parent company, UnitedHealth Group, also owns the largest insurance company, one of the three largest Pharmacy Benefit Managers, and the largest medical claims manager. United has used this vast power to rip off patients and enrich its shareholders, with profits of $14 billion in 2024.
In the Hudson Valley, concerning reports have emerged that United may be paying its own Optum practices more in order to squeeze local competitors, as well as manipulating patients’ medical records in order to receive higher payments under the Medicare program. United is facing multiple investigations by the Department of Justice, including an antitrust review of Optum’s acquisition of doctor’s offices that was opened in February 2024. According to reports, investigators are looking into anticompetitive harms for patients and providers.
Throughout his time in office, Congressman Ryan has always emphasized the importance of lowering costs, specifically when it comes to health care. He supports landmark legislation which has already lowered the prices of ten of the most common high-cost pharmaceuticals, fought to lower premiums for 20 million Americans receiving healthcare through the Affordable Care Act, and secured more than $2 million to expand services at Sun River Health in Beacon.
Congressman Ryan is a cosponsor of the Drug Price Transparency in Medicaid Act, which would prohibit PBMs from charging Medicaid more than they paid pharmacies for a drug. He also co-leads the Pharmacists Fight Back Act, comprehensive legislation to require adequate reimbursements to pharmacists, prohibit PBMs from steering patients to their own pharmacies, and eliminate PBM restrictions on patient choice. Large portions of these bills were set to be included in the December government funding legislation until they were removed at the last minute.
Congressman Ryan also recently reintroduced the Stopping Pharma’s Ripoffs and Drug Savings for All Act, as a part of his broader Affordability Agenda; the Congressman’s first legislation of the 119th Congress which aims to lower costs across the board. The Stopping Pharma’s Ripoffs Act would rein in Big Pharma’s current abuse of U.S. patent law, and make it easier to produce less-costly generic drug alternatives.
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