Category: Healthcare

In the high-stakes world of American healthcare, where billions of dollars in federal funds hang in the balance, UnitedHealth Group Inc. UNH -2.45% ▼ is pulling out all the stops to navigate a storm of regulatory scrutiny and policy shifts under the Trump administration. The nation’s largest health insurer, grappling with criminal investigations into its lucrative Medicare Advantage business and looming threats to its billing practices, has turned to a time-tested Washington strategy: leveraging connections to former President Donald Trump’s inner circle. From high-level meetings with Justice Department officials to dinners with Medicare overseers and a surge in lobbying expenditures, UnitedHealth is working overtime to plead its case directly with the powers that be.

This aggressive outreach comes at a pivotal moment for the Minnetonka, Minnesota-based giant. UnitedHealth’s Medicare Advantage segment, which generated over $100 billion in revenue in 2023 according to Medicare data, has long been the crown jewel of its operations. These private plans, which manage federal benefits for seniors and disabled individuals, have been a boon for insurers, offering higher reimbursements than traditional fee-for-service Medicare. But recent changes to federal payment rules under the Biden administration, coupled with ongoing probes, have eroded profitability and wiped out nearly 40% of the company’s market value since April.

The company’s troubles intensified in May when The Wall Street Journal first reported that the Justice Department’s criminal fraud unit had launched an investigation into UnitedHealth’s Medicare practices. Shortly thereafter, UnitedHealth secured an unusual meeting with senior Justice Department officials, including Chad Mizelle, the attorney general’s chief of staff. According to people familiar with the meeting, the discussion touched on the probes targeting the company—a move that former prosecutors described as atypical for a firm in the early stages of a criminal inquiry.

“You don’t typically see companies under investigation getting face time with top brass like that,” said Barbara McQuade, a former U.S. attorney for the Eastern District of Michigan and a legal analyst who has followed similar cases. “The goal in investigations is to maintain independence and avoid any perception of favoritism or leaks. This kind of access raises eyebrows.”

UnitedHealth’s CEO, Stephen Hemsley, who returned to the role in May after serving as chairman and previously as CEO, has been at the forefront of these efforts. Hemsley, a veteran of the company since the 1990s, recently met with White House Chief of Staff Susie Wiles to discuss Medicare policy and other healthcare issues, though government investigations were not on the agenda, according to a White House official. Earlier in the summer, Hemsley dined with Chris Klomp, the official overseeing Medicare at the Centers for Medicare & Medicaid Services (CMS), where they delved into topics like Medicare-plan billing policies and the supplemental benefits offered through private plans, sources familiar with the matter said.

These engagements underscore a broader playbook in Washington: direct access to decision-makers. UnitedHealth has also sought meetings with President Trump himself, though it has not yet secured one, according to people close to the discussions. The company is particularly focused on resolving the ongoing investigations, which include not only the criminal probe but also civil and antitrust inquiries.

The backdrop to these maneuvers is a company in recovery mode. UnitedHealth’s stock has shown some tentative signs of stabilization since Hemsley’s return, but the Washington overhang persists. The insurer was already reeling from the tragic public murder of Brian Thompson, CEO of its UnitedHealthcare insurance unit, in December 2024—an event that shocked the industry and added to operational disruptions. Amid this, Hemsley has outlined a recovery plan emphasizing cost controls, operational efficiencies, and advocacy in policy circles.

Financially, the hits have been hard. Changes to Medicare billing rules implemented by the Biden administration began impacting results in earnest this year, squeezing margins in the Medicare Advantage business. Investors are now laser-focused on how the Trump administration will handle these practices. Mehmet Oz, Trump’s nominee for CMS administrator and a high-profile television personality turned public health advocate, has vowed a crackdown on certain insurer tactics, including those employed by UnitedHealth. “We’re going to root out waste, fraud, and abuse in Medicare,” Oz said during his confirmation hearings earlier this year, signaling potential further reimbursement cuts or stricter oversight.

To counter these threats, UnitedHealth has ramped up its Washington presence dramatically. In the first half of 2025, the company spent $7.7 million on lobbying—roughly double the amount from the same period in 2024, according to its own disclosure filings with the Senate. This surge outpaced rivals: Humana Inc. and Cigna Group saw only modest increases in their lobbying budgets during the same timeframe.

A key part of this strategy involves hiring influencers with deep Trump ties. UnitedHealth brought on Brian Ballard, a prominent fundraiser for the president and founder of Ballard Partners, as its top outside lobbyist. Ballard’s firm, which started representing UnitedHealth in 2024, has become the company’s highest-paid external advocacy group, per disclosure records. Ballard, known for his access to the White House and Capitol Hill, has been instrumental in facilitating connections.

The company also enlisted Jesse Panuccio, a former senior Justice Department official from Trump’s first term who now partners at Boies Schiller Flexner LLP. Panuccio played a role in arranging the meeting with Justice Department officials, including Mizelle, sources said. Additionally, in a shareholder lawsuit filed against the company, UnitedHealth in July replaced its legal team from WilmerHale—a firm criticized by Trump—with Robert Giuffra, the president’s personal lawyer and a securities litigator at Sullivan & Cromwell, along with his colleagues.

This shift in legal representation highlights the personalized nature of influence-peddling in the Trump era. “Lobbying spending often ticks up year over year, but 2025 is on track to shatter records,” said Anna Massoglia, a researcher at OpenSecrets.org, a nonpartisan group that tracks money in politics. “With the administration’s inner circle so accessible, companies are going all-in on direct relationships. It’s more nuanced now—you can court the president, his family, and allies outright.”

UnitedHealth’s disclosures paint a picture of an all-hands-on-deck approach. The company has increased its roster of lobbyists and lawyers with Trump-era credentials, aiming to shape policies on Medicare payments, supplemental benefits, and regulatory relief. In a statement to reporters, UnitedHealth emphasized its proactive stance: “Public policy shapes healthcare across America, and it’s our responsibility to engage with the administration and Congress at all levels to improve patient access and affordability,” a spokesman said. “This is especially true now as critical decisions are being made.” The spokesman added that lobbying expenditures fluctuate annually based on needs.

Executives have been candid with Wall Street about these efforts. In a recent earnings call, Hemsley told analysts that the company has been “engaged and collaborative with the administration,” providing management with “a seat at the table,” according to notes from a Morgan Stanley investor briefing last week. This engagement yielded a tangible win in August, when the Justice Department cleared UnitedHealth’s long-stalled $3.3 billion acquisition of home-health provider Amedisys Inc. after the company agreed to divestitures. The deal, first announced in 2023, had been bogged down in antitrust reviews.

The White House has downplayed any special treatment. “The Administration routinely meets with insurers to deliver on the President’s mandate of improving healthcare and lowering costs for everyday Americans,” said Kush Desai, a White House spokesman, in response to inquiries about UnitedHealth’s outreach.

Yet, the investigations remain a thorn in UnitedHealth’s side. When the Journal broke the story of the criminal probe in May, the company initially stated it had not been formally notified and robustly defended its Medicare Advantage integrity. “We have full confidence in our practices,” a spokesman said at the time. But by July 24, in a securities filing with the U.S. Securities and Exchange Commission, UnitedHealth disclosed that it had proactively reached out to the Justice Department and was complying with formal criminal and civil requests. The filing reiterated the company’s commitment to cooperation.

The probe, led by the Justice Department’s criminal fraud unit, is examining potential overbilling and other practices in Medicare Advantage, sources familiar with the matter confirmed. It remains active, with no resolution in sight. Civil investigations by the Department of Health and Human Services and antitrust scrutiny of mergers add layers of complexity.

Former Justice officials like McQuade stress the rarity of such high-level interventions. “You don’t want to give anyone a heads-up,” she said, referring to the risks of discussing active cases. Panuccio, who helped orchestrate the meeting, did not respond to requests for comment.

For UnitedHealth, the stakes couldn’t be higher. Medicare Advantage accounts for a significant portion of its $371 billion in total 2024 revenue, and any adverse policy changes could derail its growth trajectory. The company serves about 8 million enrollees in these plans, making it the market leader with a roughly 30% share. Rivals like Humana, which derives even more of its business from Medicare Advantage, are watching closely, though their lobbying increases have been more measured.

Broader industry dynamics are at play. The Trump administration has promised to overhaul healthcare, with Oz’s CMS nomination signaling a focus on efficiency and fraud reduction. Insurers fear this could mean clawbacks on prior payments or caps on supplemental benefits like dental and vision coverage, which have driven enrollment surges. Enrollment in Medicare Advantage plans hit 33 million in 2025, up from 29 million the prior year, per CMS data.

UnitedHealth’s pivot to Trump allies reflects a sea change in corporate advocacy. In Trump’s first term, industries from tech to energy hired former administration officials to navigate deregulation. Now, with a second term underway, the trend is accelerating. “Companies are figuring out how to win over the new guard,” Massoglia said. “It’s not just about money—it’s about relationships.”

As UnitedHealth pushes forward, the outcomes of these efforts will shape not only its fortunes but the future of privatized Medicare. For now, Hemsley and his team are betting on personal diplomacy to turn the tide. Whether it pays off remains to be seen, but in Washington, access is everything.