John McGing couldn’t reach a human. That might be business-as-usual in this economy, but it wasn’t business; he had called the Social Security Administration, where the questions often aren’t generic and the callers tend to be older, disabled, or otherwise vulnerable Americans.

McGing, calling on behalf of his son, had an in-the-weeds question: how to prevent overpayments that the federal government might later claw back. His call was intercepted by an artificial intelligence-powered chatbot.

No matter what he said, the bot parroted canned answers to generic questions, not McGing’s obscure query. “If you do a key press, it didn’t do anything,” he said. Eventually, the bot “glitched or whatever” and got him to an agent.

It was a small but revealing incident. Unbeknownst to McGing, a former Social Security employee in Maryland, he had encountered a technological tool recently introduced by the agency. Former officials and longtime observers of the agency say the Trump administration rolled out a product that was tested but deemed not yet ready during the Biden administration.

“With the new administration, they’re just kind of like, let’s go fast and fix it later, which I don’t agree with, because you are going to generate a lot of confusion,” said Marcela Escobar-Alava, who served as Social Security’s chief information officer under President Joe Biden.

Some 74 million people receive Social Security benefits; 11 million of those receive disability payments. In a survey conducted last fall, more than a third of recipients said they wouldn’t be able to afford such necessities as food, clothing, or housing without it. And yet the agency has been shedding the employees who serve them: Some 6,200 have left the agency, its commissioner told lawmakers in June, and critics in Congress and elsewhere say that’s led to worse customer service, despite the agency’s efforts to build up new technology.

Take the new phone bot. At least some beneficiaries don’t like it: Social Security’s Facebook page is, from time to time, pockmarked with negative reviews of the uncooperative bot, as the agency said in July that nearly 41% of calls are handled by the bot.

Lawmakers and former agency employees worry it foreshadows a less human Social Security, in which rushed-out AI takes the place of pushed-out, experienced employees.

Anxieties Across Party Lines

Concern over the direction of the agency is bipartisan. In May, a group of House Republicans wrote to the Social Security Administration expressing support for government efficiency, but cautioning that their constituents had criticized the agency for “inadequate customer service” and suggesting that some measures may be “overly burdensome.”

The agency’s commissioner, Frank Bisignano, a former Wall Street executive, is a tech enthusiast. He has a laundry list of initiatives on which to spend the $600 million in new tech money in the Trump administration’s fiscal 2026 budget request. He’s gotten testy when asked whether his plans mean he’ll be replacing human staff with AI.

“You referred to SSA being on an all-time staffing low; it’s also at an all-time technological high,” he snapped at one Democrat in a House hearing in late June.

But former Social Security officials are more ambivalent. In interviews with KFF Health News, people who left the agency — some speaking on the condition of anonymity for fear of retribution from the Trump administration and its supporters — said they believe the new administration simply rushed out technologies developed, but deemed not yet ready, by the Biden administration. They also said the agency’s firing of thousands of employees resulted in the loss of experienced technologists who are best equipped to roll out these initiatives and address their weaknesses.

“Social Security’s new AI phone tool is making it even harder for people to get help over the phone — and near impossible if someone needs an American Sign Language interpreter or translator,” Sen. Elizabeth Warren (D-Mass.) told KFF Health News. “We should be making it as easy as possible for people to get the Social Security they’ve earned.”

Spokespeople for the agency did not reply to questions from KFF Health News.

Using AI to automate customer service is one of the buzziest businesses in Silicon Valley. In theory, the new breed of artificial intelligence technologies can smoothly respond, in a human-like voice, to just about any question. That’s not how the Social Security Administration’s bot seems to work, with users reporting canned, unrelated responses.

The Trump administration has eliminated some online statistics that obscure its true performance, said Kathleen Romig, a former agency official who is now director of Social Security and disability policy at the left-leaning Center on Budget and Policy Priorities. The old website showed that most callers waited two hours for an answer. Now, the website doesn’t show waiting times, either for phone inquiries (once callback wait time is accounted for) or appointment scheduling.

While statistics are being posted that show beneficiaries receive help — that is, using the AI bot or the agency’s website to accomplish tasks like getting a replacement card — Romig said she thinks it’s a “very distorted view” overall. Reviews of the AI bot are often poor, she said.

Agency leaders and employees who first worked on the AI product during the Biden administration anticipated those types of difficulties. Escobar-Alava said they had worked on such a bot, but wanted to clean up the policy and regulation data it was relying on first.

“We wanted to ensure the automation produced consistent and accurate answers, which was going to take more time,” she said. Instead, it seems the Trump administration opted to introduce the bot first and troubleshoot later, Escobar-Alava said.

Romig said one former executive told her that the agency had used canned FAQs without modifications or nuances to accommodate individual situations and was monitoring the technology to see how well it performed. Escobar-Alava said she has heard similarly.

Could Automation Help?

To Bisignano, automation and web services are the most efficient ways to assist the program’s beneficiaries. In a letter to Warren, he said that agency leaders “are transforming SSA into a digital-first agency that meets customers where they want to be met,” making changes that allow the vast majority of calls to be handled either in an automated fashion or by having a human return the customer’s call.

Using these methods also relieves burdens on otherwise beleaguered field offices, Bisignano wrote.

Altering the phone experience is not the end of Bisignano’s tech dreams. The agency asked Congress for some $600 million in additional funding for investments, which he intends to use for online scheduling, detecting fraud, and much more, according to a list submitted to the House in late June.

But outside experts and former employees said Bisignano overstated the novelty of the ideas he presented to Congress. The agency has been updating its technology for years, but that does not necessarily mean thousands of its workers are suddenly obsolete, Romig said. It’s not bad that the upgrades are continuing, she said, but progress has been more incremental than revolutionary.

Some changes focus on spiffing up the agency’s public face. Bisignano told House lawmakers that he oversaw a redesign of the agency’s performance-statistics page to emphasize the number of automated calls and deemphasize statistics about call wait times. He called the latter stats “discouraging” and suggested that displaying them online might dissuade beneficiaries from calling.

Warren said Bisignano has since told her privately that he would allow an “inspector general audit” of their customer-service quality data and pledged to make a list of performance information publicly available. The agency has since updated its performance statistics page.

Other changes would come at greater cost and effort. In April, the agency rolled out a security authentication program for direct deposit changes, requiring beneficiaries to verify their identity in person if what the agency described in regulatory documents as an “automated” analysis system detects anomalies.

According to documents accompanying the proposal, the agency estimated about 5.8 million beneficiaries would be affected — and that it would cost the federal government nearly $1.2 billion, mostly driven by staff time devoted to assisting claimants. The agency is asking for nearly $7.7 billion in the upcoming fiscal year for payroll overall.

Christopher Hensley, a financial adviser in Houston, said one of his clients called him in May after her bank changed its routing number and Social Security stopped paying her, forcing her to borrow money from her family.

It turned out that the agency had flagged her account for fraud. Hensley said she had to travel 30 minutes to the nearest Social Security office to verify her identity and correct the problem.

Rennie Glasgow, who has served 15 years at the Social Security Administration, is seeing something new on the job: dead people.

They’re not really dead, of course. In four instances over the past few weeks, he told KFF Health News, his Schenectady, New York, office has seen people come in for whom “there is no information on the record, just that they are dead.” So employees have to “resurrect” them — affirm that they’re living, so they can receive their benefits.

Revivals were “sporadic” before, and there’s been an uptick in such cases across upstate New York, said Glasgow. He is also an official with the American Federation of Government Employees, the union that represented 42,000 Social Security employees just before the start of President Donald Trump’s second term.

Martin O’Malley, who led the Social Security Administration toward the end of the Joe Biden administration, said in an interview that he had heard similar stories during a recent town hall in Racine, Wisconsin. “In that room of 200 people, two people raised their hands and said they each had a friend who was wrongly marked as deceased when they’re very much alive,” he said.

It’s more than just an inconvenience, because other institutions rely on Social Security numbers to do business, Glasgow said. Being declared dead “impacts their bank account. This impacts their insurance. This impacts their ability to work. This impacts their ability to get anything done in society.”

“They are terminating people’s financial lives,” O’Malley said.

Though it’s just one of the things advocates and lawyers worry about, these erroneous deaths come after a pair of initiatives from new leadership at the SSA to alter or update its databases of the living and the dead.

Holders of millions of Social Security numbers have been marked as deceased. Separately, according to The Washington Post and The New York Times, thousands of numbers belonging to immigrants have been purged, cutting them off from banks and commerce, in an effort to encourage these people to “self-deport.”

Glasgow said SSA employees received an agency email in April about the purge, instructing them how to resurrect beneficiaries wrongly marked dead. “Why don’t you just do due diligence to make sure what you’re doing in the first place is correct?” he said.

The incorrectly marked deaths are just a piece of the Trump administration’s crash program purporting to root out fraud, modernize technology, and secure the program’s future.

But KFF Health News’ interviews with more than a dozen beneficiaries, advocates, lawyers, current and former employees, and lawmakers suggest the overhaul is making the agency worse at its primary job: sending checks to seniors, orphans, widows, and those with disabilities.

Philadelphian Lisa Seda, who has cancer, has been struggling for weeks to sort out her 24-year-old niece’s difficulties with Social Security’s disability insurance program. There are two problems: first, trying to change her niece’s address; second, trying to figure out why the program is deducting roughly $400 a month for Medicare premiums, when her disability lawyer — whose firm has a policy against speaking on the record — believes they could be zero.

Since March, sometimes Social Security has direct-deposited payments to her niece’s bank account and other times mailed checks to her old address. Attempting to sort that out has been a morass of long phone calls on hold and in-person trips seeking an appointment.

Before 2025, getting the agency to process changes was usually straightforward, her lawyer said. Not anymore.

The need is dire. If the agency halts the niece’s disability payments, “then she will be homeless,” Seda recalled telling an agency employee. “I don’t know if I’m going to survive this cancer or not, but there is nobody else to help her.”

Some of the problems are technological. According to whistleblower information provided to Democrats on the House Oversight Committee, the agency’s efforts to process certain data have been failing more frequently. When that happens, “it can delay or even stop payments to Social Security recipients,” the committee recently told the agency’s inspector general.

While tech experts and former Social Security officials warn about the potential for a complete system crash, day-to-day decay can be an insidious and serious problem, said Kathleen Romig, formerly of the Social Security Administration and its advisory board and currently the director of Social Security and disability policy at the Center on Budget and Policy Priorities. Beneficiaries could struggle to get appointments or the money they’re owed, she said.

For its more than 70 million beneficiaries nationwide, Social Security is crucial. More than a third of recipients said they wouldn’t be able to afford necessities if the checks stopped coming, according to National Academy of Social Insurance survey results published in January.

Advocates and lawyers say lately Social Security is failing to deliver, to a degree that’s nearly unprecedented in their experience.

Carolyn Villers, executive director of the Massachusetts Senior Action Council, said two of her members’ March payments were several days late. “For one member that meant not being able to pay rent on time,” she said. “The delayed payment is not something I’ve heard in the last 20 years.”

When KFF Health News presented the agency with questions, Social Security officials passed them off to the White House. White House spokesperson Elizabeth Huston referred to Trump’s “resounding mandate” to make government more efficient.

“He has promised to protect social security, and every recipient will continue to receive their benefits,” Huston said in an email. She did not provide specific, on-the-record responses to questions.

Complaints about missed payments are mushrooming. The Arizona attorney general’s office had received approximately 40 complaints related to delayed or disrupted payments by early April, spokesperson Richie Taylor told KFF Health News.

A Connecticut agency assisting people on Medicare said complaints related to Social Security — which often helps administer payments and enroll patients in the government insurance program primarily for those over age 65 — had nearly doubled in March compared with last year.

Lawyers representing beneficiaries say that, while the historically underfunded agency has always had its share of errors and inefficiencies, it’s getting worse as experienced employees have been let go.

“We’re seeing more mistakes being made,” said James Ratchford, a lawyer in West Virginia with 17 years’ experience representing Social Security beneficiaries. “We’re seeing more things get dropped.”

What gets dropped, sometimes, are records of basic transactions. Kim Beavers of Independence, Missouri, tried to complete a periodic ritual in February: filling out a disability update form saying she remains unable to work. But her scheduled payments in March and April didn’t show.

She got an in-person appointment to untangle the problem — only to be told there was no record of her submission, despite her showing printouts of the relevant documents to the agency representative. Beavers has a new appointment scheduled for May, she said.

Social Security employees frequently cite missing records to explain their inability to solve problems when they meet with lawyers and beneficiaries. A disability lawyer whose firm’s policy does not allow them to be named had a particularly puzzling case: One client, a longtime Social Security disability recipient, had her benefits reassessed. After winning on appeal, the lawyer went back to the agency to have the payments restored — the recipient had been going without since February. But there was nothing there.

“To be told they’ve never been paid benefits before is just chaos, right? Unconditional chaos,” the lawyer said.

Researchers and lawyers say they have a suspicion about what’s behind the problems at Social Security: the Elon Musk-led effort to revamp the agency.

Some 7,000 SSA employees have reportedly been let go; O’Malley has estimated that 3,000 more would leave the agency. “As the workloads go up, the demoralization becomes deeper, and people burn out and leave,” he predicted in an April hearing held by House Democrats. “It’s going to mean that if you go to a field office, you’re going to see a heck of a lot more empty, closed windows.”

The departures have hit the agency’s regional payment centers hard. These centers help process and adjudicate some cases. It’s the type of behind-the-scenes work in which “the problems surface first,” Romig said. But if the staff doesn’t have enough time, “those things languish.”

Languishing can mean, in some cases, getting dropped by important programs like Medicare. Social Security often automatically deducts premiums, or otherwise administers payments, for the health program.

Lately, Melanie Lambert, a senior advocate at the Center for Medicare Advocacy, has seen an increasing number of cases in which the agency determines beneficiaries owe money to Medicare. The cash is sent to the payment centers, she said. And the checks “just sit there.”

Beneficiaries lose Medicare, and “those terminations also tend to happen sooner than they should, based on Social Security’s own rules,” putting people into a bureaucratic maze, Lambert said.

Employees’ technology is more often on the fritz. “There’s issues every single day with our system. Every day, at a certain time, our system would go down automatically,” said Glasgow, of Social Security’s Schenectady office. Those problems began in mid-March, he said.

The new problems leave Glasgow suspecting the worst. “It’s more work for less bodies, which will eventually hype up the inefficiency of our job and make us, make the agency, look as though it’s underperforming, and then a closer step to the privatization of the agency,” he said.

Jodie Fleischer of Cox Media Group contributed to this report.

Subscribe to KFF Health News' free Morning Briefing.

This article first appeared on KFF Health News and is republished here under a Creative Commons license.

President Donald Trump’s health officials want you to take your vitamins.

Mehmet Oz, the nominee to lead the Centers for Medicare & Medicaid Services, has fed calves on camera to tout the health wonders of bovine colostrum on behalf of one purveyor in which he has a financial stake. Janette Nesheiwat, the potential surgeon general, sells her own line of supplements.

Robert F. Kennedy Jr., the secretary of Health and Human Services, said he takes more vitamins than he can count — and has suggested he’ll ease restrictions on vitamins, muscle-building peptides, and more.

Their affection for supplements might lead to tangible consequences for Americans’ health regimens. Late in the 2024 campaign, Kennedy claimed the federal government was waging a “war on public health” by suppressing a vast array of alternative therapies — many of them supplements, like nutraceuticals and peptides.

In February, Trump announced the “President’s Make America Healthy Again Commission” with Kennedy at the helm, calling for “fresh thinking” on nutrition, “healthy lifestyles,” and other pathways toward combating chronic disease. Spokespeople for Kennedy did not reply to multiple requests for comment.

Supplements can be beneficial, particularly in aiding fetal development or warding off anemia, said Pieter Cohen, a general internist at the Cambridge Health Alliance, who researches supplements. “I recommend supplements routinely,” he said.

Still, “the majority of use is not necessary to improve or maintain health,” and due to only light regulations, supplement makers may make claims about their benefits without sufficient evidence, Cohen said. “No supplement needs to get tested or vetted by the FDA before it’s sold.”

Consumer watchdogs, regulators, and researchers have reported cases of finding traces of lead and other toxins in supplements. And a 2015 analysis from a team of federal health researchers attributed about 23,000 emergency department visits annually to supplement use. (The Council for Responsible Nutrition, the industry’s lobbying group, challenged the findings, arguing some visits were due to over-the-counter and homeopathic medicines that should not have been included.)

Nevertheless, many Americans are ready to buy in. Internet forums populated by biohackers, weight lifters, and enthusiasts of alternative medicine, along with supplement producers, applauded Kennedy’s elevation to health secretary. Many express hopes that he’ll loosen what they perceive as unwarranted restrictions on these products.

The Natural Products Association saluted Trump’s health nominees as a victory for “health freedom.”

“For the first time in our industry’s history, the top healthcare political appointees think it is important that Americans have the right to use nutritional supplements,” wrote Kyle Turk, the association’s vice president for government affairs.

The worlds of supplement users and the Trump team overlap substantially when it comes to being skeptical of the traditional health system.

Supplement use is part of “a broadening sort of health populist movement,” said Callum Hood, the head of research at the Center for Countering Digital Hate, a nonprofit that researches online disinformation, pointing to influencers who criticize conventional public health measures and offer alternatives like supplements, powders, or peptides.

To many supplement enthusiasts, Kennedy’s views align with theirs — particularly his dislike for Big Pharma and Big Food, which he characterizes as corrupt, profiting from Americans’ ill health.

Kennedy promotes supplements as a key part of good health. In a prerecorded interview aired this month, amid a growing measles outbreak that started in West Texas, he said doctors had had “very, very good results” by treating those patients with cod liver oil, which can be delivered in pill form, along with a steroid and an antibiotic. (Separately, he wrote in a Fox News op-ed that parents should discuss the vaccine with their doctors, adding, “The decision to vaccinate is a personal one.”)

“What we’re trying to do is really to restore faith in government and to make sure that we are there to help them with their needs and not particularly to dictate what they ought to be doing,” Kennedy said in a Fox News interview.

Kennedy spoke of federal officials delivering vitamin A to affected communities — a treatment he pushed in past remarks as chairman of the anti-vaccine group Children’s Health Defense.

“What is the cure for measles?” he told an audience in 2021 at an Amish country fair in Pennsylvania. “Chicken soup and vitamin A. And neither of those things can be patented.”

The World Health Organization advises people who contract measles to take vitamin A, which can prevent blindness and death — but it also strongly urges all children be vaccinated against the disease.

While the image of natural wellness has long evoked organic supermarket-patronizing, liberal types, supplement use is bipartisan — and now slightly more popular with Republicans. A December poll from Ipsos and Axios found that 63% of Republicans take supplements daily or most days, versus 58% of independents and 52% of Democrats.

Supplement companies sometimes explicitly court right-wing customers. In the days before Trump’s inauguration, the brand Nugenix posted an ad on the social platform X for its testosterone supplement with the president’s trademark red hat perched on the bottle, bearing the slogan “Make Your T-Levels Great Again.” (Adaptive Health, Nugenix’s parent company, did not respond to requests for comment.)

Some industry observers think the shift rightward happened during the pandemic. “During the covid era, Democrats became the party of science and establishment,” said John Roulac, a California-based supplements entrepreneur. In his telling, the party and especially its elected officials were more likely to trust the FDA and other big institutions — and to discount any potential contribution to health from supplements.

“Under RFK, you have people associated less with pharmaceutical drugs and more with healthier lifestyle choices, whether that’s eating organic food or using herbs or taking vitamins,” Roulac said.

Kennedy and others in Trump’s orbit have found a particularly warm reception among some of the biggest supplement evangelists: influencers, who often promote personal responsibility, in the form of vitamins and other products, as the key to health — and have provided plenty of airtime in recent years for Trump’s newly minted health officials.

On popular podcast host Lex Fridman’s show in 2023, Kennedy accepted praise for being in “great shape” and attributed it, in part, to his vitamin regimen. “I take a lot of vitamins,” he said. “I can’t even list them to you here because I couldn’t even remember them at all.”

In November, Oz endorsed Kennedy’s nomination on his TikTok channel — and then, in his next post, told viewers they need “an alphabet soup” of vitamins to protect their brains and power their organs.

Oz, who at the time had not yet been named to lead CMS, pointed viewers to a “trusted source” of vitamins: iHerb.

Federal ethics rules generally bar public officials from using their office for financial gain. Last month, in a letter to the health agency’s ethics official, Oz disclosed that he is an adviser to iHerb and holds a financial stake in the company. He wrote that, if he is confirmed, he plans to resign and divest from iHerb, as well as recuse himself from policy matters directly involving the company “until I have divested.”

Oz’s Senate confirmation hearing is scheduled for March 14. A spokesperson for Oz did not reply to multiple requests for comment.

Nesheiwat, Trump’s pick for surgeon general, has touted BC Boost, a combination of vitamins promising to toughen one’s immune system and rev energy. The supplement — which advertising claims was formulated by Nesheiwat herself — bears her name and portrait on the package.

“After years of educating my patients, now I made it a little easier to get all the nutrition you need to live strong and stay healthy,” reads a marketing quote attributed to Nesheiwat.

The surgeon general, considered “the nation’s doctor,” does not set policy but rather acts as a spokesperson for public health. During the Biden administration, Surgeon General Vivek Murthy outlined the ills from alcohol, loneliness, and social media.

Nesheiwat, whose financial disclosures are not yet public, did not reply to an inquiry to her website, nor did an HHS spokesperson reply to a request for comment.

It’s unclear what moves the administration might take to boost supplements. Industry officials say they hope the government will make it easier for everyday consumers to use health savings accounts to buy vitamins and other products. The FDA could also decide to allow manufacturers to make more aggressive claims about their wares’ health benefits.

Contrary to Kennedy’s claim of a “war on public health,” in recent years the supplements industry has seen its fortunes grow, and attempts to increase regulations have fallen short amid pressure from supplement makers.

According to the Nutrition Business Journal, revenues for the supplement industry surged during the pandemic, as customers became “more invested in their health,” said Journal analyst Erika Craft. Revenues have continued to increase since then, outpacing earlier industry expectations and boosting product sales to some $70 billion per year, she told KFF Health News.

One FDA attempt to put more stringent regulations — like registration — on businesses, during the 1990s, was defeated soundly after the industry and its clients lobbied Congress.

“It was one of the largest campaigns to Congress imaginable,” David Kessler, the FDA commissioner at the time, said in an oral history.

Grace Sparks, a survey analyst at KFF, the health policy research, polling, and news organization that includes KFF Health News, provided research assistance for the Ipsos-Axios poll.

Subscribe to KFF Health News' free Morning Briefing.

This article first appeared on KFF Health News and is republished here under a Creative Commons license.

President-elect Donald Trump’s choice to run the sprawling government agency that administers Medicare, Medicaid, and the Affordable Care Act marketplace — celebrity doctor Mehmet Oz — recently held broad investments in health care, tech, and food companies that would pose significant conflicts of interest.

Oz’s holdings, some shared with family, included a stake in UnitedHealth Group worth as much as $600,000, as well as shares of pharmaceutical firms and tech companies with business in the health care sector, such as Amazon. Collectively, Oz’s investments total tens of millions of dollars, according to financial disclosures he filed during his failed 2022 run for a Pennsylvania U.S. Senate seat.

Trump said Tuesday he would nominate Oz as administrator of the Centers for Medicare & Medicaid Services. The agency’s scope is huge: CMS oversees coverage for more than 160 million Americans, nearly half the population. Medicare alone accounts for approximately $1 trillion in annual spending, with over 67 million enrollees.

UnitedHealth Group is one of the largest health care companies in the nation and arguably the most important business partner of CMS, through which it is the leading provider of commercial health plans available to Medicare beneficiaries.

UnitedHealth also offers managed-care plans under Medicaid, the joint state-federal program for low-income people, and sells plans on government-run marketplaces set up via the Affordable Care Act. Oz also had smaller stakes in CVS Health, which now includes the insurer Aetna, and in the insurer Cigna.

It’s not clear if Oz, a heart surgeon by training, still holds investments in health care companies, or if he would divest his shares or otherwise seek to mitigate conflicts of interest should he be confirmed by the Senate. Reached by phone on Wednesday, he said he was in a Zoom meeting and declined to comment. An assistant did not reply to an email message with detailed questions.

“It’s obvious that over the years he’s cultivated an interest in the pharmaceutical industry and the insurance industry,” said Peter Lurie, president of the Center for Science in the Public Interest, a watchdog group. “That raises a question of whether he can be trusted to act on behalf of the American people.” (The publisher of KFF Health News, David Rousseau, is on the CSPI board.)

Oz used his TikTok page on multiple occasions in November to praise Trump and Robert F. Kennedy Jr., including their efforts to take on the “illness-industrial complex,” and he slammed “so-called experts like the big medical societies” for dishing out what he called bad nutritional advice. Oz’s positions on health policy have been chameleonic; in 2010, he cut an ad urging Californians to sign up for insurance under President Barack Obama’s Affordable Care Act, telling viewers they had a “historic opportunity.”

Oz’s 2022 financial disclosures show that the television star invested a substantial part of his wealth in health care and food firms. Were he confirmed to run CMS, his job would involve interacting with giants of the industry that have contributed to his wealth.

Given the breadth of his investments, it would be difficult for Oz to recuse himself from matters affecting his assets, if he still holds them. “He could spend his time in a rocking chair” if that happened, Lurie said.

In the past, nominees for government positions with similar potential conflicts of interest have chosen to sell the assets or otherwise divest themselves. For instance, Treasury Secretary Janet Yellen and Attorney General Merrick Garland agreed to divest their holdings in relevant, publicly traded companies when they joined the Biden administration.

Trump, however, declined in his first term to relinquish control of his own companies and other assets while in office, and he isn’t expected to do so in his second term. He has not publicly indicated concern about his subordinates’ financial holdings.

CMS’ main job is to administer Medicare. About half of new enrollees now choose Medicare Advantage, in which commercial insurers provide their health coverage, instead of the traditional, government-run program, according to an analysis from KFF, a health information nonprofit that includes KFF Health News.

Proponents of Medicare Advantage say the private plans offer more compelling services than the government and better manage the costs of care. Critics note that Medicare Advantage plans have a long history of costing taxpayers more than the traditional program.

UnitedHealth, CVS, and Cigna are all substantial players in the Medicare Advantage market. It’s not always a good relationship with the government. The Department of Justice filed a 2017 complaint against UnitedHealth alleging the company used false information to inflate charges to the government. The case is ongoing.

Oz is an enthusiastic proponent of Medicare Advantage. In 2020, he proposed offering Medicare Advantage to all; during his Senate run, he offered a more general pledge to expand those plans. After Trump announced Oz’s nomination for CMS, Jeffrey Singer, a senior fellow at the libertarian-leaning Cato Institute, said he was “uncertain about Dr. Oz’s familiarity with health care financing and economics.”

Singer said Oz’s Medicare Advantage proposal could require large new taxes — perhaps a 20% payroll tax — to implement.

Oz has gotten a mixed reception from elsewhere in Washington. Pennsylvania Sen. John Fetterman, the Democrat who defeated Oz in 2022, signaled he’d potentially support his appointment to CMS. “If Dr. Oz is about protecting and preserving Medicare and Medicaid, I’m voting for the dude,” he said on the social platform X.

Oz’s investments in companies doing business with the federal government don’t end with big insurers. He and his family also hold hospital stocks, according to his 2022 disclosure, as well as a stake in Amazon worth as much as nearly $2.4 million. (Candidates for federal office are required to disclose a broad range of values for their holdings, not a specific figure.)

Amazon operates an internet pharmacy, and the company announced in June that its subscription service is available to Medicare enrollees. It also owns a primary care service, One Medical, that accepts Medicare and “select” Medicare Advantage plans.

Oz was also directly invested in several large pharmaceutical companies and, through investments in venture capital funds, indirectly invested in other biotech and vaccine firms. Big Pharma has been a frequent target of criticism and sometimes conspiracy theories from Trump and his allies. Kennedy, whom Trump has said he’ll nominate to be Health and Human Services secretary, is a longtime anti-vaccine activist.

During the Biden administration, Congress gave Medicare authority to negotiate with drug companies over their prices. CMS initially selected 10 drugs. Those drugs collectively accounted for $50.5 billion in spending between June 1, 2022, and May 31, 2023, under Medicare’s Part D prescription drug benefit.

At least four of those 10 medications are manufactured by companies in which Oz held stock, worth as much as about $50,000.

Oz may gain or lose financially from other Trump administration proposals.

For example, as of 2022, Oz held investments worth as much as $6 million in fertility treatment providers. To counter fears that politicians who oppose abortion would ban in vitro fertilization, Trump floated during his campaign making in vitro fertilization treatment free. It’s unclear whether the government would pay for the services.

In his TikTok videos from earlier in November, Oz echoed attacks on the food industry by Kennedy and other figures in his “Make America Healthy Again” movement. They blame processed foods and underregulation of the industry for the poor health of many Americans, concerns shared by many Democrats and more mainstream experts.

But in 2022, Oz owned stakes worth as much as $80,000 in Domino’s Pizza, Pepsi, and US Foods, as well as more substantial investments in other parts of the food chain, including cattle; Oz reported investments worth as much as $5.5 million in a farm and livestock, as well as a stake in a dairy-free milk startup. He was also indirectly invested in the restaurant chain Epic Burger.

One of his largest investments was in the Pennsylvania-based convenience store chain Wawa, which sells fast food and all manner of ultra-processed snacks. Oz and his wife reported a stake in the company, beloved by many Pennsylvanians, worth as much as $30 million.

Subscribe to KFF Health News' free Morning Briefing.

This article first appeared on KFF Health News and is republished here under a Creative Commons license.