By Alice Embree / The Rag Blog / June 11, 2026
This article appeared in Alice Embree’s Substack on May 18, 2026. An interview with James Russell, mentioned below, will air on Rag Radio 91.7 FM, 2-3 p.m. Central, Friday, June 12, 2026.
President Lyndon Johnson signed Medicare into law in 1965, the same year Johnson signed the Voting Rights Act into law. While most people know the civil rights movement prompted the Voting Rights Act, few people know the significant role African American doctors played in advocating for Medicare. Even fewer know that Medicare led to desegregation of hospitals. For that history, see the excellent documentary, The Power to Heal.
I didn’t pay much attention to Medicare until I qualified for it. When “Medicare for All” became shorthand for universal healthcare, a lot of more people took note – including younger people inspired by Senator Bernie Sanders’ presidential campaign.
But cynicism is a powerful drug right in today’s world. Many people younger than I am – that’s almost everybody – think Medicare will be gone by the time they qualify. Meanwhile, private insurance has barreled into the Medicare arena, lobbying for Congressional favors and inundating airwaves with ads pushing Medicare Advantage.
Many Medicare recipients find out that Medicare Advantage is a Disadvantage when they encounter serious illness. That’s what a friend, James W. Russell, found out.
James W. Russell
Jim Russell is a civil rights veteran who participated in Tulsa sit-ins after graduating from high school. He was a member, as I was, of Students for a Democratic Society (SDS). It’s through the SDS connection that I’ve kept up with him.
Rusell has published ten books, including The Labor Guide to Retirement Plans: For Union Organizers and Employees, Social Insecurity: 401(k)s and the Retirement Crisis; Double Standard: Social Policy in Europe and the United States; and Escape from Texas: A Novel of Slavery and the Texas War of Independence.
Russell has taught at universities in the U.S. and as a Fulbright professor in Mexico and the Czech Republic. It was his stint teaching at Eastern Connecticut State University that brought him into Connecticut retirement system and their health care benefits. As a retiree, he had only one option, Medicare Advantage.
A serious illness revealed the disadvantages of his Medicare Advantage plan. Russell’s most recent book, published in 2025, is Recovering From Serious Illness Late in Life. It is about his personal recovery journey. It is a fascinating read for anyone facing life-threatening illnesses. It is also a cautionary tale about barriers to coverage for needed treatments. Russell’s experience with Medicare Advantage prompted him to launch an organizing effort. It was successful.
Jim Russell provided this background to me:
Until 2017, we had a union-negotiated very generous traditional Medicare plus supplemental insurance retiree benefit. Then the state, to save money, switched us involuntarily to Medicare Advantage and the unions went along. They assured us –and may have genuinely believed — that we would be able to see all providers that accepted traditional Medicare, which turned out to be grossly wrong.
In 2024, we started the Connecticut State Employees for Medicare Choice, as the problems with our MA plan became apparent.
Organizing Works
Robert Kuttner tells the story in his article, Rolling Back Medicare Advantage, published in The American Prospect on May 13, 2026. I encourage you to read the entire article. Kuttner writes:
Connecticut public employees have just won a major victory over Medicare Advantage, the brand name for private-insurer HMO products for seniors. In 2017, in order to save money, Connecticut shifted all state retirees, some 65,000 of them, to Medicare Advantage and denied them the freedom to stay on traditional public Medicare. But now, thanks to rank-and-file protest and organizing, that policy has just been reversed.
Kuttner describes the strategies Medicare Advantage uses to maximize profits before turning to their lobbying efforts:
Worse, lobbying by insurers has led to a formula in which traditional Medicare payers subsidize these private Medicare Advantage plans to the tune of $82 billionover ten years, giving them an artificial price advantage. The plans appear to be great deals—until you get seriously ill.
Kuttner describes Russell’s Medicare Advantage challenges, saying that he was fortunate compared to another retiree, Gary Bent, who was denied intensive rehabilitation after brain surgery and subsequently died.
Russell contacted Bent’s widow, Gloria, and the two founded Connecticut State Employees for Medicare Choice. Their rank and file efforts paid off. Kuttner writes:
The shift to Medicare Advantage had been projected to save the state of Connecticut money. To achieve a legislative solution, retirees made a cost-sharing deal. Kuttner reports:
“Our strategy was to meet the state halfway,” Russell said.
Final numbers are still being worked out. But the deal will allow any Connecticut retiree who wants traditional Medicare to get it.
In the context of steady market share gains by Medicare Advantage, which now has over half of all people eligible for Medicare, this rare rollback is a major victory. Russell, Gloria Bent, and their group are now in touch with others around the country who want to resist and reverse the insurance industry takeover of America’s most important island of single-payer public health insurance.
Stop WISeR / Vote SMARTER!
Unfortunately, we now see the intrusion of AI-powered “pre-approval” schemes into traditional Medicare.
The Alliance for Retired Americans is sounding the alarm on a pilot program to use AI in traditional Medicare. The Wasteful and Inappropriate Service Reduction (WISeR) Model is being implemented in six states: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington.
The WISeR program is being implemented by the Centers for Medicare and Medicaid Services (CMS). Dr. Oz is the Medicare & Medicare Services administrator under HHS Secretary Robert Kennedy, Jr. The implementation will inject AI between you and your doctor AND the AI company will be paid for denying medical claims.
The Texas Alliance for Retired Americans (TARA) is sounding the alarm. So is the California Alliance for Retired Americans (CARA). CARA is launching a statewide campaign aimed at stopping WISeR with SMARTER. The Smarter Act (HR 5940 and S 3480) will prohibit implementation of the WISeR model under the Medicare program. Tell your representatives in the US Congress to vote SMARTER.
The Texas Medical Association identified services and procedures that are affected. Refer to my previous Substack for that listing.
Breaking News from the Texas Alliance for Retired Americans:
Senior Solidarity: Some good news on WISeR!
The Texas Alliance for Retired Americans opposes CMS’s WISeR Model, which expands AI-generated prior authorization to Traditional Medicare for selected services in 6 states. Contracted AI companies are compensated on a share of the claims denied.
In an amendment added to the broader appropriations bill for the Department of Health and Human Services after a unanimous vote, the House Appropriations Committee determined (this week) that “none of the funds made available in this Act or any other Act” should be used to implement the Wasteful and Inappropriate Services Reduction (WISeR) model, or another model that would add prior authorization to traditional Medicare.
This is not a done deal. The HHS appropriations bill must clear more hurdles, including passing the House and being reconciled with the Senate’s pending version of the spending package, before the WISeR provisions would become law. But a powerful committee endorsing a policy that would effectively end WISeR signals growing opposition to the WISeR program.
Now that we know that a bipartisan group in Congress shares our concerns about WISeR let’s keep up the pressure to take action. Another effort to get rid of WISeR has been introduced in the Senate. Senate Joint Resolution 192 provides congressional disapproval of WISeR. JR 192 has 20 votes and requires only 10 more Senators to co-sponsor to go to a floor vote. We only have until July 11 to make this happen! More info HERE.
Call Senator Cornyn at 202-224-3121. Ask him to “co-sponsor Senate Joint Resolution 192 – Providing for congressional disapproval of the rule by CMS and DHS relating to WISeR.”
Script: My name is ____________. I live in Texas and I oppose WISeR, a CMS model that expands AI-generated prior authorization to Traditional Medicare in 6 states through AI companies compensated on the number of denied claims.·Texas is one of the 6 target states. Senate Joint Resolution 192 provides congressional disapproval of the rule by CMS relating to WISeR.·This is an urgent matter that must be voted on soon! I urge you to co-sponsor Senate Joint Resolution 192.
