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The Retire Advocate < Back to Table of Contents June 2026 Vertical Integration: How UnitedHealth Group Uses and Abuses Our Health Data Katie Harris In my series on vertical integration of health care, I’ve been looking at the staggering reach of health care behemoths like UnitedHealth Group (UHG). By buying up companies involved in every aspect of health care delivery, UHG controls whether we are eligible for care, what care we’ll get, where we get it, how much we’ll be charged, what information we’ll receive about our care, and how our data is shared. UHG’s vertically integrated companies are rife with abuse. In 2025 alone, the American Economic Liberties Project identified 24 investigations and lawsuits pertaining to corrupt practices, denial of care, upcoding and overbilling, patient privacy violations, and anticompetitive steering of patients and providers. These egregious practices aren’t easy to spot. UHG has taken over more than 2700 entities, but retains their names and the appearance of separation. This month, my focus is on how UHG uses and abuses our health data. Invariably, UHG describes its data practices as being in customers’ interests, using words like “personalized," “customized," and “efficient.” It’s certainly the case that we expect our health care providers to have ongoing access to our personal medical history. We value it. We want Dr. A to know what Dr. B has prescribed and why. We also value the smooth interface between medical care and insurance and payment processing. But “personalization” has other implications, too. It limits the options you are offered; your data is sliced and diced to determine which goods and services to market to you. Every click you make provides UHG subsidiaries with information about your motivations and priorities. Your data is aggregated with that of other consumers and becomes a commodity to be bought and sold. You are monetized. Your data is also routinely shared to process transactions, an area of considerable vulnerability. In 2020, one takeover was especially significant. At that time, UnitedHealth Group was considering purchasing Change Healthcare, a company that provided the interface between insurers and health care providers to process insurance transactions. UHG turned to McKinsey and Company for advice. Pro Publica reports that McKinsey provided a sweeping vision for harvesting data: “UnitedHealth could 'utilize transactions intelligence' from Change’s claims data to 'optimize benefit design' for United Healthcare.” Most important, UHG would have access to claims data from other insurers. It could integrate that information into designing and positioning its own insurance offerings. An antitrust suit against the proposed purchase didn’t bear fruit. The presiding judge took the word of UHG that they wouldn’t use the data inappropriately: His 58-page opinion dismissed the McKinsey documents as “mere references to data and data rights” and concluded that United Health’s history of compliance with its own rules on maintaining data firewalls, along with the “convincing testimony from senior executives,” were persuasive. But in February, 2024, due to its failure to secure data, Change Healthcare experienced a massive data breach, affecting 192 million people and 45% of US health care transactions. Hospitals and medical practices were unable to bill patients, receive reimbursements from insurers, get paid, or confirm patients’ coverage. Patients could not fill prescriptions for weeks. UHG then offered loans to providers who were unable to get paid for patient visits. It stated that loans would not need to be repaid until all claims processed during the time of the breach had been paid. A year later, UHG is demanding payment from providers who are still trying to recover. Your data is also used to inform the predictive capability of artificial intelligence (AI). In 2023, UnitedHealth Group purchased NaviHealth, a company that utilizes artificial intelligence (AI) to deny medical care to seniors on Medicare Advantage. That didn’t go well. According to the American Economic Liberties Project, NaviHealth’s algorithm had a whopping 90% error rate in its denials. RVO Health is a UHG subsidiary with a different orientation to data usage: digital media and marketing. The Sunlight Report, which reviews and analyzes UHG’s acquisitions, reports that RVO Health “reaches 300 million people each month and manages more than 100 news and information sites.” One of its sites, Health Markets, purports to provide unbiased insurance information, despite its inherent conflict of interest because UHG is an insurance purveyor. Your data is also used for predictive analytics, in which your deidentified patient data is plugged into statistical models to identify what services and supports you might need. Yes, you read that right. Your data is aggregated with that of others, with the intent of then identifying you, individually, as a potential consumer for specific services. Here’s how UHG spins it: The new advocacy capability uses deidentified claims data from United Healthcare members to proactively identify who is most likely to need support with social determinants of health, such as access to nutritious food or aflordable housing. UnitedHealthcare call center advocates then use real-time interactions coupled with a curated database of community resources to help individuals dealing with challenging life events or circumstances. That all sounds great, but UHG’s embrace of supports for vulnerable community members is belied by its fierce cost-cutting initiatives, like the WISeR program, whose profits are predicated on maximizing denials of service, or UHG’s incentivizing nursing homes to ignore requests for hospitalization for its patients on Medicare Advantage. Efforts to hold UHG to account haven’t yet yielded results. The Interfaith Center on Corporate Responsibility recently sued UHG after UHG quashed a shareholder resolution to force disclosure of the impacts of UHG’s acquisition strategy. In January, Senators Warren (D-MA) and Wyden (D-OR) renewed their demands for UHG to produce data on the impacts of its acquisitions. Senator Warren and Senator Josh Hawley (R-MO) have introduced the Break Up Big Medicine Act to break up health care conglomerates. The PSARA Education Fund will work to integrate into our educational forums and written materials information about the dangers of vertical integration and the need to pass the Act. PSARA will join with local allies to advocate that our WA Senators and Representatives co-sponsor the legislation and work with national allies to position the legislation for passage after the 2028 election. Additionally, PSARA will work with state legislators and allies to reverse corporate control of medicine at the state level. Katie Harris is copy editor for the Retiree Advocate and a member of our editorial board. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents August 2025 PSARA Letter to the Washington State Congressional Delegation PSARA Board July 12, 2025 TO: Washington US Representatives and Washington Senators in the US Congress RE: The US National Climate Assessment Report The National Climate Assessment (NCA) is the US government’s preeminent report on climate change in the United States. It was set into law by the US Congress in 1990 and there have been five reports since then, released every four years. Although the National Climate Assessment is required by Congress, in April, the Trump administration announced it was canceling funding for the US Global Change Research Program, which coordinates the report. All the authors working on the upcoming Sixth National Climate Assessment, set for release in 2028, were also dismissed. The US Global Change Research Program's website was taken offline, along with all five editions of the National Climate Assessment and a wide range of information detailing how human- amplified climate change is impacting the United States. The most recent assessment, NCA5, was released in 2023. The report lays out the basic science of climate change, examines how climate change will affect 17 national-level topics, and includes 10 regional chapters covering the entire United States. The national reports are not only peer reviewed by other scientists, but examined for accuracy by the National Academy of Sciences, federal agencies, the staff and the public. The NCA gives close attention to current and future risks, how those risks can be reduced, and implications for society under different future scenarios. The most recent report, issued in 2023, included an interactive atlas that zoomed down to the county level. This lets Americans explore the impacts of climate change in their own back yards. Counties, cities, and states find it useful in planning future needs and in devel- oping budgets. Local officials say the report has helped them decide about upcoming needs - whether to raise roads, build seawalls and even move hospital generators from basements to roofs. Climate change is affecting people’s security, health and livelihoods in every corner of the country in different ways, with minority and Native American communities often disproportionately at risk. All of these reports have been taken offline by the Trump administration as of July 1. This is part of the cutback and cancellation of any work on climate change. The effect of this foolish ac- tion was brutally clear when over 100 people were swept away in the flash flood on Guadalupe River in Central Texas on July 4. Climate change will continue to make storms stronger and fires larger and faster moving. Thousands more will die from these catastrophic events. We need more resources focused on prevention and mitigation and we need them now! What specific actions are you taking to protect people and infra- structure from extreme weather events caused by climate change? We want to see public meetings and congressional hearings on this subject. It impacts the entire country. The hearings should include scientists and experts who provided the analysis for past NCA reports and those who used this critical data for planning and public health and safety at the state level. We are calling on you, our Washington State Representatives and Senators to the US Congress, to restore the National Climate Assessment as directed by congress in 1990. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents February 2025 The Alien Enemies Act of 1798 and Mass Deportation Anne Watanabe What comes to mind when you hear “alien enemies?” Hostile green creatures, Klingons threatening the Starship Enterprise, or – French people? Congress passed the Alien Enemies Act in 1798 during a US “quasi war” with France (naval hostilities that were never officially declared as war). Enacted during a time of fierce anti-French sentiment and fear of espionage and sabotage, the Act granted sweeping power to the president to detain and deport non-natives. This law, together with three other acts, formed the Alien and Sedition Acts. Even amidst 18th Century anti- French hysteria, the laws were controversial. Three of the four acts were quickly repealed or allowed to sunset. But the Alien Enemies Act remains in effect to this day. Why should we care? Because today anti-immigrant sentiment runs high, and incoming Presi- dent Trump campaigned on promises to use the Act to detain undocumented immigrants and carry out mass deportations. The Act states: “Whenever there is a declared war between the United States and any foreign nation or government, or any invasion or predatory incursion is perpetrated, attempted, or threatened against the territory of the United States by any foreign nation or government, and the President makes public proclamation of the event, all natives, citizens, denizens, or subjects of the hostile nation or government, being of the age of fourteen years and upward, who shall be within the United States and not actually naturalized, shall be liable to be apprehended, re- strained, secured, and removed as alien enemies.” The Alien Enemies Act has only been used three times. During the War of 1812, President Madison used it to require British nationals to report extensive information about themselves to the government. During World War I, President Wilson used the Act (newly amended to include women as well as men as “alien enemies”) to register hundreds of thousands of German nationals, and to place several thousand in internment camps – in some cases up to two years after fighting had ended. During WWII, President Roosevelt used the Act to detain and/or deport thou- sands of German, Italian, and Japanese nationals (Executive Order 9066 and military orders were used to incarcerate Japanese American US citizens). Despite lacking connection or loyalty to a former homeland (even German Jews who had fled Germany were included) noncitizens were treated as “alien enemies” based on national origin. If President Trump attempts to use the Alien Enemies Act to achieve mass deportations, he will of course face vigorous challenges. The Act refers to a “declared war” and has only been invoked during wartime. With its lack of procedural safeguards concerning detention or deportation, the 1798 Act runs counter to established principles of due process and equal protection, and it conflicts with modern immigration law. And yet… The Act also refers to an attempted or threatened “invasion or predatory incursion” by a foreign nation or government. The President has described undocumented immigration as an “invasion,” perhaps laying the ground- work to use the Act during peacetime. The state of Texas did this in its clash with the Biden Administration, arguing that unlawful immigration constitutes an “invasion” allowing the state to use extraordinary measures. Several judges declined to decide whether an “invasion” had occurred, viewing this as a “political question” for the executive branch, not the judicial branch, under the doctrine established by the US Supreme Court in Baker v. Carr (1962). The potential thus exists for the judiciary to stand down when a president creates a pretext for using the Alien Enemies Act. For a deeper dive into this issue, the Brennan Center for Justice has an excellent legal analysis on its website: The Alien Enemies Act | Bren- nan Center for Justice. The sweeping powers granted by the Act may appeal to politicians who wish to detain and remove immigrants while bypassing hearings or other legal protections. If people can be treated as foreign enemies based on national origin, then due process, habeas corpus and other protections under domestic and international laws may be denied in the name of national security. In 2023, Senator Mazie Hirano and Rep. Ilhan Omar reintroduced their “Neighbors Not Enemies” Act (SB 1747/ HR 3610) to repeal the Alien Enemies Act (as of this writing, three Washington representatives have signed on). Politicians will still have other deportation tools at their disposal, but repeal of the Alien Enemies Act will protect immigrants from the abusive power of an 18th Century law -- so that we remain a nation of neighbors, not enemies. Anne Watanabe is Chair of PSARA's Race and Gender Equity (RaGE) Commit- tee and a member of PSARA's Executive Board. < Back to Table of Contents

PSARA Board Members PSARA BOARD Steve Bauck has served as an officer of PSARA and is a co-chair of the Social Security Fiscal Commission Task Force. Claude Burfect is on the Executive Board of MLK Labor, representing the Coalition of Black Trade Unionists (CBTU); the Executive Committee of Seattle King County NAACP; the Board of RPEC (Retired Public Employees Council); and the Heath Care is a Human Right (HCHR) Steering Committee. Claude is a veteran activist, a former member of SNCC and CORE, and participated in the historic 1963 March on Washington. Maureen Bo has served as the Administrative Vice President of PSARA and is a retired member of Office Workers Union Local. Tim Burns Retired from Northwest Airlines after 39+ years.Served as Grievance Committee rep 26 years (12+ years as Chair), also as auditor and trustee (IAM LL 1040) and IAM DL 143 Vice President and contract negotiator. Currently on LL 2202 Legislative Committee and retiree rep and delegate to the State Machininsts Council, MLKCLC and WSLC. Former(6 years) Chair of the 30th Legislative District Democrats. Former Co-President of PSARA and former Chair of the Government Relations Committee (GRC). Current active member of GRC. Pamela Crone is a lawyer and PSARA’s former lobbyist. She represented clients in Olympia for 20 years. Her lobbying portfolio included advocating for the legal rights of women, LGBTQ persons, workers, people with disabilities, and people experiencing homelessness. Pamela developed a legislative and policy externship at the Seattle University School of Law where she was a Distinguished Policy Advocate in Residence. Prior to lobbying, Pam was the Attorney Director of the Unemployment Law Project where she mentored many new lawyers and law students. In retirement, Pam is active with PSARA and serves on the Board of Directors of the Cedar River Clinics. She loves spending time with her family, traveling and reading. Carlos de la Torre Originally from Southern California, Carlos has been a member of the Teamsters, Meat Cutters and United Cement, Gypsum & Lime Workers unions. After leaving the blue-collar world, Carlos returned to school and earned an accounting degree from California State University, San Bernardino. Upon graduation and relocation to the beautiful Pacific Northwest, Carlos worked in the private-sector financial arena spending more than 20 years in the chemical distribution industry. Evolving motivations and changing life perspectives have led Carlos to the non-profit world, where he has worked for an organization that addresses homelessness and formerly the accounting manager for WSLC. Carlos is on the Education Fund Board and is proud to be part of an organization that supports the struggle for fair wages and social justice. Barb Flye is a successful mosaic artist. Her art focuses on the beauty of the pacific northwest, and the issues facing our country and world. Prior to becoming a full time artist, Barb’s professional experience included over 30 years of community and coalition organizing on social, racial and economic justice. She is also the cartoonist for The Advocate. France Giddings was born in Canada and attended Reed College in Oregon where she lived for many years. She was on the board of Portland NOW and helped organize a large International Women's Day celebration and was a resource for women in crisis. She moved to Seattle in 1985 and joined the board of Seattle NOW until she adopted her daughter as a single parent. While her daughter was growing up she became active in the local Parent Teacher Student Association (PTSA) as the legislative liaison. She also worked with a coalition for years to get single payer health care in Washington. She also joined the Block Bork coalition and worked to protect the Supreme Court. France worked as an investigator for public defense. She spent time lobbying in Olympia for NOW, for the PTSA, for public defense, and more recently for the Washington Farms to Food Coalition. She currently serves on the Seattle NOW board and volunteers with Moms Demand Action and Save Shoreline Trees. Larry Gossett has been a civil rights activist in the Puget Sound region for more than 55 years. Larry served on the King County Council from 1994 to 2020. He was a long time member of the Seattle chapter of the Black Panther Party. The Seattle Civil Rights and Labor History Project describes him as having been one of Seattle’s best known black radicals. Larry served on the King County Council from 1994 to 2020. He is not only a voice for African Americans he continues to speak for civil rights, social and economic justice for all marginalized communities. Rhonda Gossett is a homemaker, caregiver, artist and a grandmother. She is blessed to be a cancer survivor and she researches cancer fighting foods, diabetic and kidney health nutrition to share useful information with family and friends to encourage good health and wellness. She serves as a medical advocate. For many years she volunteered to help with the local Food Bank and she continues to support the Food Bank. Jim Grayson Retired business owner. Previous boards: NW Regional VP of American Library Ass. Trustee Assn; King County Library System Trustee; President Washington State Library Trustee Association; Cities in Schools; Washington Women’s Employment and Education (WWEE). Steve Kofahl President of AFGE Local 3937, representing Social Security Administration employees throughout Alaska, Idaho, Oregon and Washington. Also active with JWJ, WSLC and MLKCLC. Susan Levy came to Seattle in 1970 and taught Economics and Labor relations at Shoreline CC for 30 years. She was an Activist and leader in American Federation of Teachers and the Washington State Labor Movement for20 years. Susan retired in 2000 and has continued her involvement with senior, labor, and other progressive issues. David Loud has been a peace and social justice activist since his first Ban the Bomb vigil in 1960 at age 15. After graduating from Harvard in 1968, he fell quite by accident into a 46-year career in health care in Seattle: Swedish Hospital laundry (1969-71), Yesler Terrace Free Clinic (1971-72), Veterans Administration Hospital ward clerk (1972-77), US Public Health Service Hospital/Pacific Medical Center Patient Advocate (1978-98), SEIU 1199NW organizer (1998-2005), Congressman McDermott’s Community Liaison for health care and Veterans (2005-2015). Since retiring in 2015, David has continued his activism for universal health care and social justice, currently serving as a Co-Chair of Health Care Is a Human Right WA. He is married to Thu-Van Nguyen, 1975 refugee from Vietnam, and has four grown sons. Bobby Righi is a retired community college instructor and is a co-chair of the PSARA Climate and Environmental Justice Committee. She was a Peace Corps volunteer in the mid 1960's and worked as a teacher and an organizer in the south of the U.S. in the 1970's. She is a member of AFT retiree chapter in Washington. Ronnie Shure has been an active member of PSARA since 2012; and he has been involved in the grassroots movement for universal health care since 1972. He worked as a pharmacist providing care to underserved populations in public health, behavioral health, and substance abuse programs for 42 years. Instead of retirement, he has transitioned to become an advocate for social justice in health care. He is President of Health Care for All - Washington, one of the CoChairs of the Steering Committee of the Health Care as a Human Right coalition, and participates in the work of many healthcare advocacy groups across the state and nation. Most importantly, his retirement transition allows him the joy of spending time with his wife and daughters and grandchildren. Sarajane Siegfriedt is the former King County Democrats Platform Committee Chair. She worked in human services and became a committed low-income housing advocate. As a member of the Washington Low-Income Housing Alliance Public Policy Committee, she shares their legislative priorities with PSARA and helps us advocate in Olympia. Sarajane was a lobbyist for nonprofits in Olympia. She served on the boards of Solid Ground, the Unitarian Housing Group and the Lake City Neighborhood Alliance. She helped organize the Seattle Coalition for Affordability, Livability and Equity. She's currently on the boards of Seattle Fair Growth, the Lake City Neighborhood Alliance and Northaven Senior Living. Robby Stern retired from the staff of the WA State Labor Council in 2008. He has been an active member of PSARA serving as president for nine years. He presently serves as the president of the PSARA Education Fund, Chairs the Social Security Works WA coalition, and is active in PSARA's Fund Raising, RAGE, and Climate Justice Committees. Anne Watanabe is the co-chair of PSARA's Race, Gender and Equity Committee. Anne is an attorney with a background in land use and environmental law, and formerly served as a hearing examiner for the City of Seattle and King County. Anne is a Seattle native and a third-generation Japanese American, and is grateful to be part of PSARA's work to achieve equity and social justice. Mike Warren started working for the state in 1967 and in 1968 was singled out for shop steward training. I was a shop steward for the next 25 years, I also spent time as an elected officer in my local and my bargaining team. After I retired, I was asked to be president of the Seattle RPEC Chapter, which I held for 10 years, until I was able to find a successor. I was elected to the board of the Puget Sound Council of Senior Citizens, There I stood and marched with Will and Louise Parry. I helped found the Washington State Alliance for Retired Americans and served as secretary, treasurer, Vice President and President. I spent 30 years as chair of an advocacy organization foe people of disability. Tim Wheeler served as a reporter and editor for the Worker in New York and later in Washington D.C. He has written more than 10,000 news reports, exposés, and commentaries. He is also an activist and an organizer. He grew up on a dairy farm in Sequim and lives on the family farm near Sequim. His books News from Rain Shadow Country and News for the 99% are selections of his writings over the last 50 years. Katie Wilson is a co-founder and the general secretary of the Transit Riders Union, a grassroots democratic membership organization that fights for transit and economic justice in King County. She has been involved in leading local fights for progressive taxation, affordable housing, renter protections, and affordable and accessible public transit.

The Retire Advocate < Back to Table of Contents June 2026 Resolution to the WA Democratic Party Convention, June 21: Divest from Fossil Fuels to Mitigate Climate Change while Strengthening Pension Funds Resolution to the WA Democratic Party Convention, June 21: Divest from Fossil Fuels to Mitigate Climate Change while Strengthening Pension Funds WHEREAS the scientific consensus is clear that the climate crisis poses an imminent and existential threat to human health, global ecosystems, and economic stability ((WMO), 2025); WHEREAS rising greenhouse gas emissions, primarily from the burning of fossil fuels, are the leading cause of global warming and extreme weather events, and the impacts such as heatwaves, droughts, wildfires, floods, sea level rise, and loss of biodiversity—disproportionately affect vulnerable communities and future generations; WHEREAS immediate and sustained action is necessary to limit global temperature rise to 1.5°C above pre-industrial levels, as outlined in the Paris Agreement (United Nations - The Paris Agreement, 2025); WHEREAS state and public pension investments in fossil fuel companies perpetuate reliance on nonrenewable energy sources and undermine efforts to transition toward a sustainable, low-carbon economy; and WHEREAS at this time when the Trump administration is removing incentives for renewable energy and making deals with Chevron and other oil companies, divesting from fossil fuels and reinvesting public funds in renewable energy, energy efficiency, and other Green New Deal projects, creating a state bank that invests in large-scale commercial, industrial, public, and residential building energy retrofits, building and expanding electrified mass transit, and climate mitigation infrastructure, clean air and water and other natural resources for public use, can accelerate the transition to a renewable energy future, create green jobs, and drive innovation. THEREFORE BE IT RESOLVED we call for all affiliated institutions, partners, and shareholders, including the WA State Investment Board, to identify and divest all direct and indirect holdings from fossil fuel companies within the next five years, including but not limited to coal, oil, and natural gas producers, suppliers, and their subsidiaries. THEREFORE BE IT FURTHER RESOLVED we call for prioritizing reinvestment of divested funds into socially responsible and sustainable sectors - including renewable energy, energy efficiency measures, energy storage, clean technology, and climate adaptation and mitigation projects - with clear environmental, economic, and social benchmarks, including emissions reductions, community benefits, job creation and local hire, public health outcomes, and equitable investment in disproportionately impacted communities. THEREFORE BE IT FINALLY RESOLVED this resolution be adopted by the Washington State Democratic Party and that this resolution be distributed to Governor Bob Ferguson and all of our elected representatives of the Washington State Legislature as a statement of our support and call to action. Submitted by Sharon Abreu, State Committee Member for San Juan County, to the 40th LD Democrats for consideration at the June 21st Washington State Democrats Convention. Sources: “Protecting Our Assets, Protecting Our Asses: Public and Pension Investments in a World of Climate Crisis” by Jeff Johnson, President Emeritus of the Washington State Labor Council and Board Member, Labor Network for Sustainability (with Introduction by Rep. Pramila Jayapal). psara.org “Washington Unions Say: Divest from Fossil Fuels to Protect State’s Assets” by Jeff Johnson. labor4sustainability.org < Back to Table of Contents

The Fiscal Commission Is a "Death Panel" for Medicare and Social Security (This is a reprint from PSARA’s March 2024 Advocate) By Jaisri Lingappa and Robby Stern Jaisri Lingappa Robby Stern Republicans and a few “business” Democrats in Congress are determined to set up a fast-track process to cut Social Security and Medicare. They know from experience that they can’t do this out in the open – their previous attempts resulted in massive public outcries. Indeed, polling from Data for Progress last month showed that 70 percent of voters, including 71 percent of Republican voters, oppose the idea of cutting Social Security and Medicare. Instead, the GOP is using a backdoor approach to achieve their goal by demanding a bipartisan fiscal commission to examine potential cuts to Social Security and Medicare as a means of reducing the debt. The House Budget Committee voted on Jan 18, 2024, to advance this fiscal commission (HR 5779) to the floor of the House. The legislation provides that the commission will develop its recommendations behind closed doors. Four non-voting members of this 16-member commission would be from outside of Congress. Thus, the discussions that will decide the fate of these critical social insurance programs will be held in secret with a small number of unelected individuals influencing the outcome. The favorable vote of two of the Democrats appointed to the commission is all that it will take to forward the proposal to Congress. The commission’s voting process is designed to make it likely that the recommendation will be to cut earned benefits, a stated goal of the Republican Party. The legislation also sets up a fast-track vote by Congress on the commission’s recommendations, with a limit of a two hour debate, no amendments permitted, followed by an up or down vote in each chamber. Removing the vote from the democratic process provided by “regular order” means our elected representatives will be prevented from proposing changes to the commission recommendations. Initially, the GOP intended to insert this bill into one of the two budget bills that need to be passed to keep the government running. As of this writing, one of those bills remains to be voted on and could still be linked to the fiscal commission bill. But even if the budget passes without this bill, there will be many other opportunities for the fiscal commission legislation to be pushed through, including during the lame-duck session after the election. So voters will need to stay vigilant. The White House has called the commission a “death panel for Medicare and Social Security.” Biden likely had the fiscal commission in mind when he said during his March 7 State of the Union speech: “If anyone here tries to cut Social Security or Medicare or raise the retirement age, I will stop them.” He went on to say “I will protect and strengthen Social Security and make the wealthy pay their fair share!” Currently the wealthy pay into Social Security only for their first $168,000 in wages annually. The White House wants to raise that cap. Moreover, in a March 7, 2024, fact sheet, the White House proposed to “modestly increase the Medicare tax rate on income above $400,000” and close loopholes in existing Medicare taxes. These proposals would go a long way in funding Social Security and Medicare without increasing the debt or increasing the tax burden on lower- and middle-income earners. Even though President Biden appears to be on our side, it would not be wise to count on a Presidential veto in the event that Congress passes the fiscal commission legislation as part of another piece of “must pass” legislation. Shortly after President Biden’s State of the Union speech, former President Trump showed his willingness to consider cuts to Social Security and Medicare in a CNBC interview. This is no surprise. The GOP has long prioritized cuts to Social Security and Medicare, with strategies such as raising the eligibility age, reducing cost-of-living adjustments, and reducing benefit amounts. We should not take any chances. We must prevent the bill enacting the fiscal commission from passing the full House of Representatives, since it would then have a high likelihood of being passed in the Senate. And we shouldn’t stop at just preserving Social Security and Medicare. A big part of what is needed is to make these programs work better. Excellent legislative proposals exist that would fix the Social Security funding gap and even expand benefits for the first time in 50 years. And to fix Medicare, we need to “Level the Playing Field” between the Medicare Advantage plans offered by the for-profit insurance industry and Traditional Medicare, which is currently hamstrung by rules limiting what it can offer. PSARA will try to keep you as up-to-date as we can on the attacks that are being mounted on Social Security and Medicare and what we can do to deny success to those who attack the programs while cynically saying they are saving them. Jaisri Lingappa is a University of Washington Professor Emeritus of Global Health and a member of PSARA's Jefferson County Organizing Committee. Robby Stern is President of the PSARA Education Fund and a member of PSARA's Executive Board

The Retire Advocate < Back to Table of Contents December 2025 AARP, United Health Group, and WISeR Robby Stern 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.” Robby Stern is President of the PSARA Education Fund and a member of PSARA's Executive Board. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents December 2025 ICE Considers Raiding the Local Sandwich Shop The Barbed Wire < Back to Table of Contents

PSARA Oral Histories Project PSARA members have a wealth of experience in their respective professions and communities including their roles in labor, social justice, racial justice and environmental movements. Angela Bartels has been collecting the oral histories of PSARA members and documenting those interviews in PSARA’s monthly publication the Retiree Advocate. Those interviews are now recapped in the Oral Histories section of our website. The written summaries of the interviews are provided here and in some cases video of the interview are included. Bob Barnes Swimming Against the Current: making hard choices during the Vietnam War. Bob Barns talks about facing life changing challenges during the Vietnam war. View Story Frankie Manning "Before we integrated hospitals, the majority of Black people who died in the hospital died because the Black hospitals and wards were not well equipped..." View Story Lou Truskoff Lou Truskoff talks about his early years, his love of Music and integrating music into the labor movement. View Story Larry Gossett A Story of the Great Migration North, Housing discrimination in Seattle and how Black Power Captured Larry Gossett’s Soul While in VISTA . View Story Frieda Takamura Frieda Takamura has been and activist on a range of issues most importantly fighting for social Justice Listen to Frieda's Story Frank Irrigon Mud on their hands: Frank Irigon talks about his time in the military and working with Seattle's Asian Student Coalition protesting the construction of the King Dome. View Story Thursten Muskelly Thursten Muskelly discusses his work in the labor movement and particularly with the American Federation of Government Employees Local 1170 organizing in Seattle. View Story Tony Lee Friends of Tony Lee, Peter Costantini and Tom Berry, recount their work creating the Team Tony Lee during the 2022 election helping to flip the third WA State Congressional District View Story Gary Owens Gary Owens recounts his time with the labor movemet and the Black Panthers. View Story

The Retire Advocate < Back to Table of Contents January 2026 Fossil Fuels Have Put Us in an Existential Fix Jefl Johnson “The Oil and gas industry makes $3 billion a day in pure profit. Generates over $4.3 trillion dollars a year in revenue. It is the seventh largest industry in the world ranked above food production, automobile production, coal mining, and at $1.4 trillion, the pharmaceutical industry doesn’t even crack the top ten. The industries listed above oil and gas are completely dependent on oil and gas. The more they grow, the more we grow. That’s the scale, that’s the size of this thing.” This is the opening monologue by the independent oilman character, Tommy Norris, played by Billy Bob Thornton, in the Taylor Sheridan‘s TV production, “Landman”. Exact numbers or not, they are staggering. And the amount of climate and species damage caused by fossil fuels is even more staggering. Since the signing of the Paris Climate Accord in 2016, the world’s major banks have lent approximately $7.9 trillion dollars to the fossil fuel industry, 20 percent of which has gone toward fossil fuel exploration and expansion. These numbers are real and are also staggering. In December 2024, one month prior to Trump’s second inauguration, six major U.S. banks (JP Morgan Chase, Citigroup, Bank of America, Morgan Stanley, Wells Fargo, and Goldman Sachs) withdrew from the United Nations sponsored net zero banking alliance. This gives new meaning to Trump’s expression “burn, baby burn.” As our planet gets hotter every year, the interest on our credit card payments, our checking and savings accounts, and our pension funds are financing climate disaster. Can we do something about this? Yes. Should we do something about it? Absolutely! Easy first steps are to bank on the community level. We can do our banking and get our credit cards from credit unions, financial companies that don’t loan money or buy the debt of fossil fuel companies. But if we really want to make a difference, we can organize around getting our private and public pension funds to stop investing our pension dollars in fossil fuel assets. We can organize around getting the Washington State Investment Board (WSIB) to stop investing the 18 pension funds they oversee in fossil fuel assets. While the WSIB makes it difficult to precisely identify how much of their assets are invested in fossil fuels, a reasonable estimate is $6-8 billion directly invested in fossil fuels and at least as much in indexed funds that contain fossil fuel investments. All told, somewhere in the neighborhood of 5-7% of the WSIB portfolio. Why is it so important to divest, or to use a less pejorative financial term "rebalance," WSIB assets out of fossil fuels? Right out of the chute, fossil fuel assets continue to underperform the overall stock market. Since the end of the last bear market, October 2022, the Standard and Poor index of funds grew by 92 percent, while fossil fuels pulled up the rear at 17 percent. You don’t need to be a math major to understand that our pension assets would earn more money if they weren’t invested in fossil fuels. But given the real and palpable urgency of reducing carbon emissions and slowing down and reversing climate disaster, if a well-respected fund like the WSIB rebalanced their portfolio out of fossil fuels it would send a clear message to other institutional investors that you can earn great returns while also protecting our planet. Not too shabby of a rationale. As a species, humans are great at making excuses not to do something. Particularly when billionaires and their representatives tell us there is a better way. Engage, they say, don’t divest. A cursory reading of the history of the corporate response to asbestos and cigarettes should be fair warning. Simply engaging corporations in a discussion around lowering carbon emissions will kill us on a grander scale than anything we have known before. Climate disaster is the greatest existential crisis there is. The situation that we are in right now recalls for me two sayings I am quite fond of. The first by our dear friend Michael Righi, recently passed, who used to say “every billionaire is a policy failure.” We have to stop taking our advice from people who benefited the most from extractive industries and who will be the least impacted by climate disaster. The second is by humorist and social commentator Will Rogers. Rogers used to say, “If you find yourself in a hole, stop digging.” Acknowledging that fossil fuel investments have put us in an existential fix is a first step. Now it’s time to stop making it worse, time to stop digging! Over the next several months I will continue to research and write about ending the financing of climate change. In the meantime, if you are persuaded by this article or the group of essays I wrote last year, “Protecting our Assets, Protecting Our Asses”(visit our website at psara.org and click the image on our homepage) then please write letters, emails, or postcards to our political leaders (Governor, Lt. Governor, State Treasurer, Director of Labor and Industries) and to our union leaders and tell them it is time to act. Jeff Johnson is Co-President of PSARA and a retired President of the Washington State Labor Council < Back to Table of Contents

The Retire Advocate < Back to Table of Contents January 2026 Book Review: The Trees are Speaking: Dispatches from the Salmon Forests, by Lynda V. Mapes Lisa Dekker Recent efforts in Clallam County, and elsewhere, to protect our remaining legacy forests from logging, led me to this recently published book. Per Stephen Kropp, founder of the Center for Responsible Forestry, coined the term, ‘legacy forest’ means a “naturally regrown, mature forest that preserves the biological, functional, and structural legacies of the forests they replaced.” Although not everyone respects this relatively new term, we know that there are other legacy forests scattered throughout the publicly-owned lands in Washington, managed by the Department of Natural Resources. In fact, these legacy forests already have great value as they cool the air, hold carbon, and harbor wildlife. Precisely why these forests matter is eloquently described in the first part of Mapes’ book as she travels to regions in Washington, Oregon, and British Columbia. Through interviews on site and forest walks with luminaries like Dr. Jerry Franklin, often called the "father of modern forestry" through his work at the University of Washington, we learn how research has radically changed our understanding in the space of just 60 years. Likely due to their dark understories with little sun, older forests with big trees went from once being described as “biological deserts,” to currently being recognized as the complex, life-giving, carbon-capturing, watershed- preserving treasures we know them to be today. In the chapter titled “Salmon Forests,” she travels for a week among both the remaining healthy forests and the desolate clearcuts of Vancouver Island, with Teresa Ryan (traditional name Sm’hayetsk) an indigenous knowledge and natural science lecturer at the University of British Columbia (UBC), and Susan Simard, an eminent forest ecologist, also at UBC. Both Ryan and Simard are part of the Mother Tree Project, a crew of researchers looking at the changes in soils, especially the decline in the amount of carbon in soils of areas that have been clearcut. Simard has also led the project’s deep dive into examining the richly complex soils of the uncut forests, bringing insight into how the trees connect via the mycorrhizal fungi network between them. Also evidence of the value of older forests are the proven, "sustainable" traditions of the Tribes, stewards of these lands and forests for centuries before colonization. Their practices and protocols recognized that care for the forests meant that the forests would care for them. New evidence for this appeared in a paper published in 2022, based on an archeologic study done in the land of the Nuun-chah-nulth peoples of British Columbia, (whose family ties and culture extend down to the Makah reservation in northwest Clallam County.) Botanists and archaeologists found that “old growth trees [still there] are witnesses” to the fact that these people were more than hunter-gatherers and that they “took care of and managed…forest gardens abundant with crab apples, berry patches, and wild rice root crops.” At the same time, because they stripped off only narrow pieces of cedar bark for shelter and clothing, these same cedar trees lived on for centuries. In the preface, Mapes declares that “The need for a paradigm shift is readily apparent.” After presenting data and real-world accounts to justify that shift, she ends with examples of successful restoration projects, new ideas for community solutions, and a belief in the potential for people to change their way of thinking. This should encourage the reader to hope, as does the author, for a “new ethos of conservation, based on reciprocity and respect in our relations with one another, and with nature.” < Back to Table of Contents

The Retire Advocate < Back to Table of Contents September 2025 What Do People in the US think About Climate Change? Peter Harris What do people in the US think about climate change? The large majority of people in the US see global warming and want the government to act. This holds across the country, in all states, even those run by Republicans. This has been shown for years in surveys conducted by the Climate Change Communication program at George Mason University and Yale, easily found online. This holds everywhere. A globe- spanning survey by the 89% Project of international newsrooms showed that the very large majority of people in all nations want their governments to do more to fight global warming. The 74% in the US is a lower percentage than almost every other nation. How much are people aware of these opinions? Why does this matter? People who care about global warming tend to think others don’t care. This is part of what prevents climate action. People are more willing to act when they see that others care. Per the 89% Project: “We’re sitting on an enormous potential climate movement...It’s latent. It hasn’t been activated or catalyzed. But when you break through these perception gaps, you help people under- stand that they’re not alone...Making people aware of this would help a lot and bring hope. [A lot] of people are self-censoring and not fighting or voting [for climate action] because they think that their ideas are not in the zeitgeist.” The same holds for politicians. Elected officials greatly underestimate the number of constituents who care about global warming. “You might think their political antennas are finely tuned to public opinion, but they are not – sometimes wildly underestimating public views. . . If we can make politicians more aware of what the people in their country want, they mightactually act on people’s preferences.” Why does reducing climate change have a low political priority? The lack of awareness of public opinion is one reason. Another is the misinformation skillfully produced by the fossil fuel industry. A third reason may be that the environmental impacts of climate change are often confused with environmental problems we’ve addressed before. These have mainly been things we directly created and try to directly solve, often successfully. The problems can be big or small, but they are addressed case by case. In contrast, the climate change caused by humans is an indirect result of greenhouse gas emissions and is global in its impacts. The impacts are new and growing fast and have the potential to damage life on earth. There can only be a global cure. It is easy to see this as outside the scope of government action and beyond our choices in voting. The solution may be recognizing that a global cure will come from hundreds of local actions, from individuals reducing power consumption, to states and nations replacing fossil fuels with solar and wind power. State actions can be popular. The strong political support in Washington for the Climate Commitment Act is a good example. The CCA was protected by voters in soundly rejecting I-2117. It was protected again by the state legislature in a tough bud- get process. How much are people aware of these opinions? Why does this matter? First, we can share our views with friends, neighbors and colleagues. Ask them what they think about global warming. If they care, tell them you care too, and that most others agree. Second, we can share this information with all of our elected officials. This will back up the good positions many have taken, encourage more of the same, and at least stimulate some thought by those who have not supported climate action. Third, we can move from the general to here and now. When a political issue directly or indirectly affecting the climate is on the table, tell the decision makers how many of their constituents want action on global warming. Use the data. Fourth, we can repeat this in next year’s elections. Tell all state and federal candidates the majority view of their constituents and ask for their positions on any climate actions at hand. Publish their responses or non-responses. In all this, do not be discouraged by the federal government’s insane denial of climate change. Trump and the billionaires he serves care more about putting money into their already stuffed pockets than protecting a livable world for their own grandchildren. But the public is opening its eyes. Opinions are the result of the occasions for expressing them. Every day, each of us can add a little weight. Peter Harris is a member of PSARA's Climate and Environmental Justice Committee. < Back to Table of Contents