Democratic lawmakers are expressing concern over President-elect Donald Trump’s choice of Dr. Mehmet Oz to head the U.S. Centers for Medicare and Medicaid Services (CMS). Specifically, lawmakers are focused on Oz’s advocacy for the elimination of traditional Medicare, and what they call his “deep financial ties” to private health insurers.

In a recent letter — penned by Sens. Elizabeth Warren (D-Mass), Ron Wyden (D-Ore) and Dick Durbin (D-Ill.) — the lawmakers questioned Oz’s qualifications for the role of administrator.

“The CMS Administrator oversees Medicare, Medicaid, and Affordable Care Act coverage,

setting the rules for and managing programs that provide health care coverage for 160 million

Americans,” the lawmakers wrote. “We have questions about your lack of qualifications for this job: although you were a renowned heart surgeon, you have no management experience relevant to running these critical health care programs.”

Oz is also a former TV personality who hosted the series The Dr. Oz Show for 13 seasons.

Lawmakers raised concern, specifically, around Oz’s previous advocacy efforts around the privatization of Medicare.

“In June 2020, ahead of your campaign for the U.S. Senate in Pennsylvania, you outlined your vision for the Medicare program,” the lawmakers wrote. “Your plan advocated for covering every senior that is not on Medicaid ‘through the Medicare Advantage program,’ the private Medicare program run by for-profit insurers. This plan would entirely eliminate Traditional Medicare – a program you have criticized as ‘highly dysfunctional,’ but which provides more accessible and less expensive care than private insurers in Medicare Advantage. Indeed, private insurers that run the Medicare Advantage program drastically overcharge for care.”

The letter cited MedPAC’s projection that in 2024 alone, private insurers will overcharge CMS by $83 billion relative to traditional Medicare.

Lawmakers also noted private insurers often delay and deny vital and medically necessary care, and place burdensome utilization management requirements on providers. They believe that Oz’s efforts against traditional Medicare ignores these issues.

Medicare Advantage has largely been a tricky landscape for home health providers.

Over the years, providers have navigated receiving meager pay for their services, and increased administrative burden in their dealings with Medicare Advantage plans.

Some home health companies anticipated that the upcoming Trump administration would mean an environment more friendly to Medicare Advantage plans.

“It seems that the Trump administration has talked more favorably about the Medicare Advantage players, which could affect home health,” Addus CEO Dirk Allison said in November. “Managed care, they don’t pay quite what fee-for-service does.”

In addition to the harm lawmakers believe will come as a result of the elimination of traditional Medicare, the letter calls into question Oz’s financial conflicts of interest.

“Your advocacy for eliminating the traditional Medicare program and replacing it with Medicare

Advantage also raises questions about your own financial conflicts of interest,” the lawmakers wrote. “In your financial disclosures from your 2022 Senate run, you reported owning over $550,000 of stock in UnitedHealth, the largest private insurer in Medicare Advantage and largest employer of physicians in the nation. The company is currently under a sprawling antitrust investigation by the Department of Justice – including for its role in aggressively upcoding Medicare Advantage enrollees to secure higher payments from CMS – and has been sued on multiple occasions for Medicare fraud.”

Lawmakers pointed out that, under Oz’s plan, UnitedHealth’s revenue from Medicare Advantage would increase to $274 billion annually.

Oz will still need to be confirmed before stepping into the role of CMS administrator.