On October 21, Wendell Potter, a former high ranking health insurance executive and whistle blower, wrote the following in Healthcare Uncovered, the newsletter of the Center for Health and Democracy.

"In 2024, United Health Group (UNH) -- the nation’s largest health insurer -- paid AARP a one-time upfront royalty payment of just over $9 billion for the rights to use AARP’s name in marketing Medicare Advantage-type plans and Medicare supplement policies. According to financial statements for AARP, this windfall came as part of a restructured deal with UNH’s insurance unit, United Healthcare, extending their partnership for an additional 12 years and recording a balance of about $8.72 billion in deferred revenue as of December 31.

"What makes a deal like this so troubling is its implication: the organization that millions of older Americans consider their trusted advocate -- AARP, with its packed magazines and covers featuring Bon Jovi, Samuel L. Jackson, and Sally Field -- is in fact functioning as a multimillion-dollar marketing arm for an insurer whose business model increasingly depends on enrolling seniors in private Medicare plans."

A recent Kaiser Family Foundation study found that Medicare Advantage (MA) enrollees will have access to approximately 50% of the healthcare providers that Original Medicare (OM) enrollees can access in regions across the country. In addition, the study found that OM enrollees were more likely to receive care in the highest-rated hospitals and skilled nursing facilities. In 2023, the number of prior authorization requests to MA insurers was approximately 50 million and frequently were determined using Artificial Intelligence (AI). Prior authorization is rarely used in OM. The corporate MA insurance system poses significant risks for beneficiaries because of delays and denials of care resulting from prior authorizations.

Corporate Medicare Advantage also threatens the viability of the entire Medicare system. MA costs the Medicare Trust Fund approximately 35% more per beneficiary than OM. According to MedPAC, a nonpartisan congressional agency that provides Congress with analysis of the Medicare program, MA overcharged the Medicare Trust Fund in 2024 an estimated $84 billion dollars. AARP is being paid to promote United Healthcare’s Medicare insurance which threatens, along with the other MA plans, the financial future of the Medicare system.

United Healthcare is by far the largest corporate for-profit MA insurer. In March, 2025, United Health was estimated to have nearly $10 million MA enrollees. The insurer was compensated an average of $5,000 per enrollee. AARP provides a significant customer base and credibility to United Healthcare. No wonder AARP has been paid just over $9 billion for a 12-year agreement.

How does this financial relationship impact AARP’s decision making? We can only speculate, but WISeR presents an interesting case study. The Centers for Medicare & Medicaid Services (CMS) and an agency within CMS, the Center for Medicare & Medicaid Innovation (CMMI), have initiated the WISeR program to expand artificial intelligence (AI) prior authorization to 16, and maybe more, medical procedures in Original Medicare (OM). This unwelcome expansion in the number of prior authorizations in OM will still be a small fraction of the number in MA. Despite the fact that healthcare providers and patients have expressed strong dislike for practices that intervene between the provider-patient relationship, CMS plans to proceed with the WISeR pilot program beginning January, 2026.

Private companies who will determine the required prior authorizations in OM must have AI capability to be eligible to engage in reviews for the WISeR program. These companies will be paid based on the amount they save the Medicare system, i.e. higher compensation for denials.

What is AARP’s position on WISeR? According to an AARP spokesperson, they are “watching carefully." The organization states it supports efforts to address Medicare fraud and abuse, which is the public justification for WISeR by CMS. AARP also states it prioritizes the health care of older Americans and that nobody should be denied legitimate, medically necessary treatment.

Nice words, but we know that AI prior authorization does deny medically necessary treatment frequently in MA and that one of the most consistent users of AI prior authorization is United Healthcare. Regarding fraud and abuse, MedPAC noted there is approximately $5.8 billion in treatments that may be unnecessary. Compare this to the MedPAC estimate of $84 billion in overcharges by corporate MA insurers.

On the AARP website WISeR is listed as one of the changes to Medicare in 2026. They acknowledge that “If successful, the pilot project could lead to wider uses of prior authorization in original Medicare...” They state the experiment in six states, including Washington, could involve up to 6.4 million beneficiaries. AARP goes on to provide CMS’s justification for the program. They then state “Technology companies that participate will be paid based on savings from denied medical claims, which has drawn the ire of the American Medical Association and consumer organizations.” Note, it has not drawn the ire

of AARP, which one might think is a consumer organization.

The final paragraphs in the posting state: “The pilot project comes amid concerns from lawmakers, government watchdogs, and others that Medicare Advantage plans’ prior authorization procedures can create burdens for caregivers, who have to figure out how to appeal, and risk the health of patients by delaying or denying care that would otherwise be covered under original Medicare.”

If we believe the concerns of caregivers and consumer organizations to an expansion of AI prior authorization in OM are legitimate (and PSARA emphatically does), we question the failure of AARP to support those of us in this fight.

To quote Wendell Potter in his discussion of the relationship between United Health and AARP: “All this being said, AARP taking money from a giant corporation is not the least bit unusual in Washington. And advocacy on behalf of consumers and patients requires resources. But when an organization is simultaneously lobbying Congress on Medicare and cashing billion-dollar checks from the largest Medicare Advantage insurer, it’s no longer just an advocate for consumers and patients.”