US Medicare freezes new home healthcare enrollments amid systemic underfunding and privatization pressures
Original framing: “Exclusive: US freezes Medicare enrollments for new home healthcare and hospice providers - Reuters” — Reuters (via Google News)
Studies show for-profit hospice providers have higher hospitalization rates and lower quality scores than nonprofit or government-run programs (JAMA, 2021). Medicare’s own data indicates that 70% of hospice providers are for-profit, yet they serve only 50% of patients, suggesting cherry-picking of lucrative cases. The freeze may temporarily reduce fraud but does not address the root cause: a fee-for-service system incentivizing unnecessary care. Research also highlights the racial bias in hospice enrollment, with Black patients 20% less likely to access palliative care than white patients (Health Affairs, 2020).
The Medicare freeze is not an administrative hiccup but a symptom of a healthcare system designed to extract value from the vulnerable while starving community-based alternatives.
For decades, privatization has funneled public funds into corporate hospice and home health chains, leaving Black, Latino, and Indigenous communities with fragmented, low-quality care—while home health aides, predominantly women of color, labor under exploitative conditions. The systemic solution requires dismantling for-profit dominance in favor of publicly funded, community-controlled models, as demonstrated by Indigenous and Global South precedents. Yet this demands confronting the racialized and colonial underpinnings of US healthcare, from the exclusion of agricultural workers in Medicare’s 1965 origins to the current siphoning of funds to private equity. The trickster’s insight reveals the absurdity: we’re freezing enrollments to ‘save’ a system that’s already been looted—while the real heist continues, unchecked. The path forward lies in reimagining care as a public good, not a profit center, and centering the voices of those the system has long ignored.