The Department of Justice is intervening in a second whistleblower lawsuit that alleges UnitedHealth Group, the largest health insurance and services company in the country, has defrauded the Medicare Advantage insurance program by exaggerating people's medical diagnoses to obtain more federal dollars.
Why this matters: These lawsuits have some explosive allegations and threaten a company that dominates a growing and lucrative Medicare industry. In addition, the Center for Public Integrity and a federal watchdog agency have reported numerous instances of insurers manipulating a Medicare patient's "risk score" to get more money.
The bottom line: This will be one of the most closely watched federal court cases in health care considering billions of taxpayer dollars are on the line.
Oscar Health Insurance lost $25.8 million in the first quarter of this year, based on its financial documents filed in California, New York and Texas on Tuesday. That was an improvement over the $48.5 million loss from the same period last year.
Our thought bubble: Oscar was able to slow the financial bleeding after exiting several Affordable Care Act individual markets last year and decreasing its membership to 90,000. But Oscar is still hemorrhaging a lot of money — more than most people expected from a startup that attracts a younger and potentially healthier member base, and a company that has promised to change how health insurance works through its technology.
More numbers to chew on: Oscar, an investor-backed startup that uses a narrow network of doctors, now has lost more than $350 million since 2015. The insurer also continues to struggle with high administrative costs, ranging from 25% to 56% of revenue.
Senate Majority Leader Mitch McConnell told Bloomberg's Kevin Cirilli Tuesday morning that a border adjustment tax "probably wouldn't pass the senate," but said Congress is trying to reach an agreement that will serve as a starting point. "We haven't reached that agreement yet, but we will at some point."
Part of the GOP case for repealing the Affordable Care Act is that it has made insurance more expensive or even unaffordable for many people.
"In some cases, insurance premiums and out-of-pocket expenses have become families' most significant expenses," White House Press Secretary Sean Spicer told reporters last week.
