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The Shift from Private to Public: How Big Insurance is Capitalizing on Government Programs

In the past 12 years, the landscape of the American health insurance industry has shifted significantly, with the six largest insurers—Anthem, Centene, Cigna, CVS/Aetna, Humana, and UnitedHealth—moving away from private commercial health plans and increasingly focusing on government-funded programs. Between 2010 and 2021, commercial health plan enrollments grew only modestly from 84.9 million to 91.3 million, a mere 7.6% increase. In stark contrast, enrollments in government-funded programs such as Medicare Advantage, Medicaid, and Medicare supplement plans surged by 373%, rising from 16.9 million to 63 million. This shift was fueled by the ACA’s expansion of Medicaid and subsidies for private insurance, leading these insurers to rely heavily on public funds. Nearly 90% of their enrollment growth since 2010 has come from these taxpayer-funded sources, raising concerns about the long-term sustainability and fairness of the healthcare system, as more of their revenue now depends on public dollars rather than private premiums .

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Why Ownership Matters:

At Haven Home Health and Hospice, we are proud to be the last locally-owned, independent, and clinician-led provider of home-based care in our region. While that may sound like a simple fact, it’s actually a defining difference—one that matters deeply to the quality of care our patients receive every day. In recent years, private equity firms and large corporate healthcare chains have rapidly bought out home health and hospice providers across the country, including right here in our community. What we’ve seen in the aftermath is troubling: rapid turnover of staff, shrinking time spent with patients, and decisions driven more by profit margins than by compassion, dignity, and clinical excellence. 

When ownership shifts from caregivers to corporations, priorities shift too. 

We believe healthcare should never be treated like a commodity. That’s why we’ve remained committed to local, clinician-led ownership—because we answer to patients, not shareholders. Our leadership is hands-on, involved, and invested in every life we touch. We believe that meaningful care takes time, intention, and heart—and it starts with the people who make the decisions. As owners who are also licensed clinicians, we understand the weight of the responsibility we carry. Our patients are not numbers in a spreadsheet. They are parents, grandparents, neighbors, and friends. And we believe they deserve the kind of care we’d want for our own families. We will continue to stand against the corporatization of healthcare, and we invite you to stand with us. Whether you’re a patient, a referral partner, or a member of the community, your trust makes it possible for us to preserve something rare and essential in today’s healthcare system: personalized, human-centered care. Because in the end, ownership isn’t just about who signs the papers—it’s about who shows up when it matters most.

– John Ray, Founder

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