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Private insurers often require a cumbersome review process that frequently results in the denial or delay of essential treatments that are readily covered by traditional Medicare. The new model relies on an additional set of private companies for traditional Medicare that have a very clear incentive to deny care.

Private plans under Medicare Advantage have become increasingly popular, with a little more than half of older Americans and people with disabilities eligible for the program and some 34 million enrolled. But many are willing to forgo some of the additional benefits the private plans offer, like dental checkups and gym memberships, to avoid having to jump through numerous administrative hoops to get care.

How insurers make their decisions remains opaque. A spokesman for Health and Human Services, which oversees the Medicare agency, declined to identify which companies had submitted applications for the contract.

People enrolled in traditional Medicare who live in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington State will be included in the pilot experiment, which is expected to start in January and last for six years.

As many of you know, for the past year, I've been drinking like a fish, a whole bottle of rum every day for much of the year and sometimes more. I did this because I felt depressed and stuck, unable to move, and wanted an escape. Many of you tried to help me, to which I didn't listen. However, I hit rock bottom when my liver function test was done on May 19, 2025. My ALT levels were 373, and AST was 319. Both of these are more than 6 times the acceptable levels of 50 or less. Indicating very severe liver damage. This explained why I managed to drink so much, yet not feel drunk, my liver was doing a death rattle, and I would be, soon, if I didn't stop. For the first time in a while, i felt scared to lose my life, I looked back and saw what a coward I'd been. I felt a deep sense of regret, all the people I pushed away, all the problems I avoided, and now it might be too late. I bought a bottle of rum, 1 liter. I poured out 700ml of it and drank the rest. That was 80 days ago, and I haven't had one single drop since. My doctors had given up, not even bothering to schedule an appointment as they knew my cowardly behavior would simply cancel, so I didn't have to face them. After 38 days of absolute sobriety, I messaged my doctor informing her that i took her advice to heart and have removed alcohol from my life, I wanted to come in and get bloodwork done. On July 14th, it came back. ALT levels are 64, AST is 42. My liver healed faster than I ever thought possible, crushing my foolish excuse from before that I was too far gone to heal. With this, I was able to go back on Trikafta, improving my lung function greatly. I got another liver function test done on August 13th, ALT levels are 49, AST is 25. My liver is now healthier than it was a year before I started drinking. I wasn't sure I believed in God, but I prayed for my life to be spared, and I do believe he listened. I'm not sure how I want to celebrate, but you can bet it will involve a lot of family and no alcohol