The Fight for Medicare in 2026

The attack by the Trump administration and their Republican sycophants on healthcare coverage will land with tragic consequences on a very large number of people in the US. With compassion for the suffering caused by the Trumpian attacks and determination based on belief in social and economic justice, the movement for Improved Medicare for All will grow and become more and more vocal.

Meanwhile, our fight to preserve and expand original public Medicare will continue, as will our educational work exposing the consequences of for-profit Medicare Advantage (MA) and the introduction of the WISeR pilot program. We know the drive for increasing profits leads to abuse and fraud by the insurance companies. Requiring frequent prior authorizations (more than 50 million in 2024), upcoding, cherry picking and lemon dropping (i.e. offloading sicker patients), and offer-ing a limited network of providers are all about profit. The growing trend of large corporations like United Health Group owning subsidiaries like Optum that employ provider networks and/or pharmacy benefit managers create multiple opportunities to extract profit from the Medicare Trust Fund. Their practices will continue until we build a strong enough movement to stop them.

The WISeR pilot program began on January 1, 2026 in Washington. That’s bad news. It expands the use of prior authorization in Original Medicare, adding 17 procedures. It also introduces the use of private, for-profit corporations to determine whether these 17 procedures will be covered by Medicare. These corporations are required to use AI to make the determination and will be paid a larger reimbursement for denials.

The good news is that our education and advocacy work has been very effective, and our members have made a big difference. Most recently, Sen. Patty Murray introduced S. 3480, a bill prohibiting the Secretary of Health and Human Services from implementing the WISeR pilot program in Medicare. There are 18 Senators co-sponsoring the legislation including Sen. Cantwell. Sen. Murray’s bill is companion legislation to Rep. DelBene’s legislation in the House. HR 5940 also bars the Secretary of Health and Human Services from implementing WISeR. Introduced in November, HR 5940 has 38 co-sponsors, including all the Democratic representatives in Washington, except for Rep. Glusenkamp Perez. We will try to get her support in 2026. It is unlikely these bills will pass in 2026, but they are a good organizing tool. Our work in 2026 will include building momentum to end WISeR before the scheduled six-year termination date.

PSARA is a member of the national Reclaim Medicare Coalescence, which includes a number of organizations that have a significant presence in Washington, DC, and wide national outreach.  The coalescence has adopted as a goal the introduction of the Level the Play-ing Field legislation, hopefully in 2026. Members of the coalescence also play a major role in researching and exposing the abuses of the Medicare Advantage corporations, and they advocate for regulations and legislation to put an end to these abuses. We are all working to terminate WISeR, and many of the organizations in the Reclaim Medicare Coalescence support Rep. Jayapal’s Improved Medicare for All legislation (HR30069).

Here are some things our members can do to help in the coming year:

1. Help us find venues where we can educate and advocate about leveling the playing field, about achieving Improved Medicare for All, and ending the abuses and fraud of Medicare Advantage.

2. If you or someone you know has a personal story of problems related to the healthcare being provided by a Medicare Advantage plan or if you are on Original Medicare and have a personal story related to the use of prior authorization in the WISeR program, please email organizer@psara.org to let us know. Personal stories are powerful. We will not use your name unless you give us permission.

3. When you receive emails urging you to contact elected officials, please continue to respond with action. For example, we will be working to have legislation introduced in Congress to level the playing field related to benefits between Original Medicare and Medicare Advantage. We are educating and advocating for the legislation to set an affordable cap on out-of-pocket costs in Original Medicare, making it unnecessary to purchase Medigap insurance. It will also include hearing, dental, and vision coverage. When the legislation is introduced, we will need assistance in getting co-sponsors from the Washington Congressional delegation.

4. In the state legislature we will be educating and advocating for the passage of SJM 8002, which puts the state legislature on record calling for Congress to stop the fleecing of the Medicare Trust Fund by Medicare Advantage and level the play-ing field between Original Medicare and Medicare Advantage. We want Medicare beneficiaries to have a real financial choice between the public plan and the private for-profit plans. We will also support efforts to restore the cuts to Medicaid.

Will Parry, the former inspirational leader of PSARA, would frequently sing the song "Carry It On," made famous by Joan Baez. In 2026, we will resist attacks on Medicare and Medicaid and demonstrate there is a better way. We will carry it on.