Eight major health care corporations were able to avoid $34 billion in taxes thanks to the Tax Cuts and Jobs Act, while increasing costs, denying care to customers and cutting staff, according to a new report.
The report, released Wednesday by the advocacy groups Americans for Tax Fairness and Community Catalyst, discusses how insurers like Centene, Cigna, CVS Health (which owns Aetna), Elevance (formerly known as Anthem), Humana, UnitedHealth, and hospital chains HCA Healthcare and Universal Health Services leveraged tax breaks to benefit shareholders and executives instead of investing in patient care and improved health outcomes. Since the TCJA passed in 2017, their profits surged 75%, while care denials rose, staffing dropped, and patient costs increased.
The report found Centene increased Medicare Advantage prior authorization denials by 14%; while other companies cut nursing staff at hospitals while safety violations mounted; raised premiums and out-of-pocket costs for patients. Centene on average repurchased 20 times more shares in the years following enactment of the law as it did in the four years preceding it, buying back over $3 billion worth of stock in 2024 alone. In 2023, Elevance’s Anthem Medicare Advantage plans tied with Humana’s for the highest number of prior authorization determinations per enrollee.
The One Big Beautiful Bill Act that was signed into law in July extended and increased the tax breaks for the health care companies from the TCJA, while removing the premium tax credit from the Affordable Care Act that helps patients pay for health insurance and imposing steep Medicaid cuts, requiring patients to continually prove their eligibility.
“The bill makes a huge cut in Medicaid,” said David Kass, executive director of Americans for Tax Fairness, during a press briefing Wednesday in answer to a question from Accounting Today. “They didn’t raise the corporate rate. They didn’t do anything about the stock options loophole. They didn’t do anything about the foreign earnings loophole.”
An estimated 15 million people are expected to lose their health care under the OBBBA, noted Mona Shah, senior director of policy and strategy at Community Catalyst, as people lose coverage in the ACA’s health insurance marketplaces.
