Health insurance giants Aetna, Elevance (formerly Anthem), and Humana — along with three major broker firms — are facing a federal lawsuit accusing them of funneling illegal kickbacks to boost Medicare Advantage enrollments, all while steering vulnerable seniors into unsuitable plans.
Key Facts:
- The DOJ filed a False Claims Act lawsuit against Aetna, Elevance, Humana, eHealth, GoHealth, and SelectQuote.
- The alleged kickback scheme took place from 2016 through at least 2021.
- Insurers allegedly paid brokers hundreds of millions in exchange for Medicare Advantage plan enrollments.
- Brokers are accused of steering seniors into plans based on kickbacks, not suitability.
- Aetna and Humana allegedly conspired to avoid enrolling disabled beneficiaries viewed as less profitable.
The Rest of The Story:
The federal government alleges that some of the biggest names in health insurance conspired with brokers to rig the Medicare Advantage enrollment system.
According to the DOJ, brokers created teams that sold only the most lucrative plans and even refused to offer products from companies that didn’t pay up.
In a disturbing twist, Aetna and Humana are accused of trying to exclude disabled individuals from coverage by withholding broker payments if too many disabled patients were enrolled.
The lawsuit stems from a whistleblower complaint and is now being handled by the Department of Justice.
If found guilty, the companies could face triple damages under the False Claims Act, as well as steep penalties.
The United States Files False Claims Act Complaint Against Three National Health Insurance Companies and Three Brokers Alleging Unlawful Kickbacks and Discrimination Against Disabled Americans
🔗: https://t.co/DcHbIL0jZY pic.twitter.com/x3ohEkcPwD
— DOJ Civil Division (@DOJCivil) May 1, 2025
Commentary:
What this case reveals is appalling.
At a time when seniors rely on Medicare Advantage to navigate complex healthcare needs, major insurance companies and brokers allegedly put profit ahead of integrity.
Instead of guiding seniors toward the most beneficial plans, these brokers allegedly herded them into whichever plans brought in the biggest commission checks.
The role of a broker is to act as an advocate for the client — especially when dealing with elderly or disabled Americans who may not fully understand the fine print.
But according to the DOJ, these brokers betrayed that trust, acting more like salespeople for corporate giants than patient allies.
Even worse, Aetna and Humana are accused of discriminating against disabled Americans.
They reportedly discouraged agents from signing up individuals with disabilities — those who need the most help — simply because they might require more care and cost the company more.
That’s not just unethical; it’s cruel.
This conduct reflects a disturbing pattern in corporate healthcare: prioritizing bottom lines over human lives.
Instead of investing in better services or lowering premiums, these companies allegedly spent hundreds of millions ensuring a stream of new customers.
The focus was not on care, but cash.
With the DOJ now stepping in, it’s clear that such exploitation is no longer going unchecked.
The Trump-era emphasis on rooting out fraud in public programs appears to be yielding results, and this lawsuit could signal a turning point.
The days of backroom deals and broker kickbacks may finally be numbered.
The Bottom Line:
Top U.S. health insurers and brokers face serious allegations of defrauding taxpayers and exploiting Medicare beneficiaries.
As federal prosecutors pursue justice, this lawsuit sends a clear message: public trust, especially in healthcare, is not for sale.
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