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Democrats in Washington have been negotiating the terms of President Joe Biden’s economic, health care, and climate bill for seven months, and most Americans have no idea what’s in it — or which popular provisions conservative Democrats are helping their corporate donors try to kill.

Sen. Bernie Sanders, Ind-Vt., has laid some of the blame for that on news coverage, arguing that “the mainstream media has done an exceptionally poor job in covering what actually is in the legislation,” and asserting that while there has been endless coverage of Capitol Hill gossip, there has been “very limited coverage as to what the provisions of the bill are and the crises for working people that they address.”

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The Vermont senator’s assertions are backed up by a series of studies from Media Matters documenting how corporate media has often written the climate crisis out of its coverage of the legislative battle, and how that coverage has decontextualized the bill’s topline price tag.

The corporate press corps seems so busy celebrating West Virginia Democratic Sen. Joe Manchin’s temper tantrums and prognosticating about Arizona Democratic Sen. Kyrsten Sinema’s style, it isn’t bothering to consistently tell America how Manchin’s climate denial may doom the planet, and how Sinema’s corruption would let seniors continue being fleeced by drugmakers.

The big question is: why?

To answer it, you have to do the thing fewer and fewer media outlets ever do: follow the money, and follow it all the way down to the bedrock of the political media ecosystem — the Washington gossip rags that are quite literally “presented by” a rogues gallery of corporate villains trying to buy politicians and kill the reconciliation bill.

The Corporate Newsletter At The Bottom Of The News Ecosystem

In general, corporate news outlets aren’t aggressively covering what’s in the reconciliation legislation and are instead focusing on meaningless numbers, useless palace intrigue, and vapid debates about personalities. One reason is because they have a vested financial interest in preserving the status quo. Same thing for their advertisers like Big Pharma and Big Oil, which are lobbying against the legislation as they spend huge sums sponsoring news content.

As a result, it is common to see a corporate newspaper turn Sinema’s obstruction of anti-poverty and health care initiatives into a tale about her sartorial choices, and for a Comcast-owned TV outlet to publish a story about mailers touting her “iconoclast image” in Arizona without even mentioning that the flyers were sent out by a pharmaceutical industry front group that wants her to kill the bill’s drug pricing provisions.

These kinds of editorial choices are being made so frequently, they aren’t even conscious decisions anymore — they are media culture. While it’s not accurate to say there is an explicit newsroom quid pro quo in such editorial focus, it’s also ridiculous to presume that all that cash from corporate sponsors has no influence at all.

That corporate influence, though, does not necessarily begin in the stratosphere of elite newspapers and TV outlets — it starts all the way down in the muck, where corporate newsletters storify the granular details of the legislative process and hollow out all its substance.

This new foundation of political news was originally constructed by now-disgraced Washington gossip Mark Halperin and his ABC News email called The Note — a publication founded in January 2002 as an internal staff memo proudly boasting that it only cared about the so-called “Gang Of 500” people in Washington who allegedly matter.

Today’s copycats like Politico, Punchbowl, and Axios have made this arrangement even more explicit: Their innovation was baking corporate ideology directly into their news via snarky voice and so-called “native advertising.” In practice, their primary raison d’etre is not to publish accountability reporting, but to instead play tone policeman and frame the parameters of the policy discourse so that it best guarantees outcomes that corporate sponsors want.

These publications aren’t shy about their business model. Politico pioneered the “native advertising” model, where the news arrives in your inbox with a special message from big corporations or their lobbying groups. As the outlet itself puts it, Politico says: “We imagine and deliver intelligence-led brand content solutions that earn clients a seat at the table in Washington and in power centers across the globe.”

Axios, launched in 2017, promises corporate sponsors that its “team of writers, illustrators, and producers break through the noise, distilling your brand’s message into its most effective form.” And the email newsletter Punchbowl News, which was launched earlier this year by veteran writers from Politico, says it is “a news community about power.” The outlet brags that its members “include some of the most important political figures in Washington,” including several congressional staffers-turned-corporate consultants and lobbyists.

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In the rip-and-read world of news and politics, these newsletters are the talking points torn out by pundits, TV bookers and lobbyists and then turned into newspaper columns, to-camera diatribes and pitches to lawmakers. They are, in other words, the prefabricated scripts distributed throughout news industry superstructure, wrapped in the veneer of objectivity, and then blasted out to the general population under the banner of corporate media mastheads.

Indeed, take a look at even the so-called liberal media: MSNBC and CNN are owned by the telecom giants Comcast and AT&T and provide these corporate pamphleteers recurring television guest slots to tell the masses how to properly interpret what’s happening in Washington. They have sources, and you don’t.

But, of course, these newsletters aren’t written for you. They are written for an audience of business insiders and influence peddlers. These publications sell corporate advertisers on their position as the agitprop everyone in power reads, and they focus on pleasing those sponsors, who they brag their newsletters are quite literally “presented by.”

And they aim to coddle — rather than hold accountable — the bankrolled politicians who give them scoops about the various ways they are trying to protect big businesses.

As Talking Points Memo publisher Josh Marshall notes: “The highly influential insider newsletter publications — Politico, Axios, Punchbowl et al. — have become what amounts to a cheering section for the two holdouts” on the Democrats’ reconciliation bill, Sinema and Manchin.

“The more or less open cheerleading for this duo is so enthusiastic it almost starts to seem like part of the background noise of the moment — so obvious and so taken for granted that it starts to seem unremarkable,” Marshall writes.

Politico co-congressional bureau chief Burgess Everett, who is often handed insidery Sinema and Manchin scoops, put a really fine point on the situation on Wednesday, cheering a new report that Manchin could leave the Democratic Party if he doesn’t get his way.

“Hell yeah time for a Manchin party switch news cycle,” Everett tweeted — to enthusiastic applause from other Capitol Hill reporters.

Manchin is denying the report, but leaving the party could flip control of the Senate, make Mitch McConnell the majority leader again, and doom any chance of climate legislation amid a climate emergency. Celebrating this is pure nihilism, and Everett soon doubled down, transforming from reporter into de facto Manchin press secretary demanding Democrats stop pressuring the West Virginia lawmaker to allow his own compromise voting rights bill to pass the Senate.

“Not sure it makes sense to simultaneously pivot to whipping (Manchin) on changing the Senate rules that he's ruled out countless times,” Everett tweeted.

Democrats’ To-Do List, “Presented By ExxonMobil”

The best way to see how this corporate blood sausage gets made on a day-to-day basis is to take a close look at the email newsletter Punchbowl.

Each day, Punchbowl’s missive is sponsored by fossil fuel giants like ExxonMobil or Chevron, an investor-owned hospital behemoth like HCA Healthcare, the drug lobbying group Pharmaceutical Research and Manufacturers of America (PhRMA), or tech companies like Facebook and Uber — as all of those companies are actively trying to sway and manufacture the discourse parameters for the legislation Punchbowl is covering.

Sponsors get to tell Punchbowl’s audience of lobbyists, pundits, and television bookers any self-serving lie they want. For instance, as international scientists have been begging lawmakers to shut down the fossil fuel industry before it incinerates the ecosystem that supports all human life, ExxonMobil was just permitted to tell Punchbowl readers that “ExxonMobil is working to advance climate solutions.” Meanwhile, Chevron said: “At Chevron, we’re taking steps toward a lower carbon future. Because it’s only human to help power a better tomorrow.”

And under those big corporate sponsorship logos, Punchbowl is often spinning and framing the news in exactly the way that corporate lobbyists want it presented.

On Monday, Punchbowl’s morning email was headlined, “The Democratic leadership's to-do list,” and “presented by ExxonMobil.” The email noted that West Virginia’s coal-mogul-turned-senator Joe Manchin opposes including a “Clean Electricity Performance Program” in Democrats’ reconciliation bill. The proposed measure was designed to push electric utilities to transition to renewable energy sources.

Punchbowl didn’t mention Manchin’s ties to the fossil fuel industry in general, or his specific links to its newsletter sponsor, ExxonMobil. Instead, it described Manchin’s move as “a blow to both President Joe Biden... as well as advocates who want to use the reconciliation package to push the United States into taking a leadership role on global warming.”

To be clear, the development is actually a blow to mankind. Scientists warn that we will all face catastrophic weather-related consequences if politicians don’t swiftly move to decarbonize the planet within the next several years. Worst-case scenarios suggest big chunks of the D.C. metro area could be underwater by 2100. Oh, and Manchin’s own home state is the nation’s most threatened by climate-intensified floods. But none of these inconvenient facts got a mention.

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Tuesday’s Punchbowl newsletter was somehow worse. The email, headlined “Try believing Joe Manchin,” was yet again sponsored by ExxonMobil, the oil company whose lobbyist recently accidentally admitted he talks to Manchin’s “office every week.”

Punchbowl actively revised history in a way that no doubt pleased ExxonMobil, declaring that “if you have listened to Manchin and you’re still surprised by or enraged at his positions, that may be because you’re irrationally hopeful he will change his beliefs, or you’re engaging in wishful and likely unrealistic thinking.”

But, in January, Manchin said lawmakers should spend as much as $4 trillion on infrastructure. In August, he voted to advance Democrats’s $3.5 trillion infrastructure reconciliation legislation despite expressing concerns. He’s now insisting on $1.5 trillion max.

Marshall, of Talking Points Memo, points out: “What is actually most consistent about Manchin has been the fluidity and imprecision of his positions.”

And yet, Punchbowl continued: “Here’s what you have to understand about Manchin: He says what he means. When he gets heavy pressure from the left, it helps him back home.”

But Manchin has faced very little actual pressure from the left. You won’t find any sustained advertising campaign targeting Manchin for working to deny dental, vision, and hearing benefits to seniors through Medicare, even though seniors in his state desperately need the help.

On the other hand, if you live in West Virginia, you may have seen ads from a health insurance industry front group claiming “Manchin has fought for seniors,” by which they mean that Manchin wants to make sure private health insurers keep making huge profits from the Medicare Advantage program.

Nor has Manchin faced significant pressure from the Biden White House. Earlier this month, in a call with progressives, Biden laid out a $1.9- to $2.2-trillion range for a reconciliation compromise — not even trying to land halfway between the $3.5 trillion and the $1.5 trillion the West Virginia senator has demanded.

Among the only pushback Manchin has faced was a single op-ed by Sanders published in a West Virginia newspaper calling on him to support the party’s reconciliation bill — a piece that prompted a public meltdown from the Wolf of West Virginia.

But the most insulting part was Punchbowl writing, “Here’s the reality: Joe Manchin is a filibuster-supporting conservative Democrat who is also an ardent supporter of coal, skeptical of big government, and massive spending packages.”

Manchin is not just an ardent coal supporter — he is a literal coal baron. He makes more money every year from his family’s coal brokerage, for doing no work at all, than he does as a U.S. senator. Punchbowl did not mention Manchin’s coal interests in either newsletter.

Another recent Punchbowl email blast was sponsored by Chevron six days after the oil giant’s chief critic, Steven Donziger, was sentenced to jail for the alleged crime of helping a poor community win an environmental lawsuit against the company.

In this missive, Punchbowl expressed alarm that Democrats might eliminate or reform the legislative filibuster in a way that could give environmental activists a slim chance to pass legislation that could block Chevron from boiling the Earth’s climate.

“Once the door is opened, it'll be hard to close it again,” Punchbowl warned. “If you allow an exception for the debt limit, why not voting rights? Or guns? Or health care? Or climate change?”

In the real world, legislation to protect voting rights, strengthen gun safety, expand health care and rescue humanity from ecocidal extinction are wildly popular and considered necessary — but corporate media’s rip-and-read machine and its sponsors don’t want that fact getting out.

“Ambitions Slam Into Reality,” Presented By PhRMA

We don’t mean to single out Punchbowl. It is no anomaly — it embodies a capital city where many reporters are paid to cover the news as if it were a sports story. CNN president Jeff Zucker admitted that's exactly how corporate media views events in Washington – in 2017, he told The New York Times: “The idea that politics is sport is undeniable."

Politico takes that ethos to heart. On Wednesday, Politico Playbook decided to publish a literal scorecard of winners and losers so far on the Biden reconciliation plan. “ON CLIMATE… Winner: Manchin; Loser: Environmentalists,” they wrote. “The entire climate agenda of the Biden administration is in question right now thanks to one man — and it’s unclear if this dynamic will change, given the positions of the senator from coal-mining West Virginia.”

That newsletter was mercifully only sponsored today by tech giant Google. But sponsors’ interests can explicitly overlap with the news content.

Earlier this month, Politico Pulse — the Beltway outlet’s health care newsletter — sent out an email headlined: “Democrats’ domestic ambitions slam into reality.”

The newsletter was sponsored by PhRMA, the powerful Washington drug lobby that is working to kill Democrats’ plan to allow Medicare to negotiate lower drug prices. PhRMA, the $500-million-a-year lobbying colossus, is the “reality” that Democrats’ drug pricing ambitions are slamming into.

Politico previously put together sponsored content for PhRMA touting how the organization had demonstrated its “groundbreaking commitment to improve health equity when it announced the first-ever industry-wide principles on enhancing clinical trial diversity.”

In the Politico Pulse post, the authors wrote: “Top Democrats dreamed of making generational progress this year on health coverage, drug pricing, family leave, and all manner of other big priorities — and doing it in a single masterful stroke. But if that dream isn’t dead after this week, it’s barely breathing."

The newsletter added that “​​drug pricing is on the chopping block, despite the fact it would potentially save significant money.”

The post ended with a message from PhRMA: “Some in Congress are considering a plan that would tie medicine prices in Medicare to those in the U.S. Department of Veterans Affairs.”

“This misguided approach is just the latest in a series of government price-setting proposals that threaten patients’ access to medicines and future innovation,” it read.

Politico was recently purchased by German publisher Axel Springer. The company’s CEO, Mathias Döpfner, told the Wall Street Journal last week that Politico staffers will now be required to adhere to a very particular set of principles, including supporting Israel and a free-market economy.

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Axios, another outlet built around the native advertising model, published an ostensibly objective news piece that same day framing Sinema as a powerful, unconventional “force to be reckoned with.” The piece noted, “Sinema’s political allies have some free advice for anyone trying to bully the wine-drinking triathlete into supporting President Biden's $3.5 trillion budget bill: She doesn’t play by Washington’s rules — and she's prepared to walk away.”

While Sinema previously campaigned on the need to lower drug prices, she has recently emerged as one of the chief roadblocks in the Senate to Democrats’ drug pricing plan.

The ads on Axios stories rotate, but for a moment the banner at the top of the article contained a message warning: “Treatments and cures for rare disease patients are under threat from Congress.”

That message was sponsored by the Rare Access Action Project, a dark money group bankrolled by PhRMA.

“It’s Blame-The-Media O'clock”

These are but a few emblematic grains of bullshit from the mountain of misinformation to which corporate media is now anchored. Since these Beltway outlets have now scaled up to produce metric tons of such bullshit every day, there is now a perpetual dust storm of propaganda “presented by” industry sponsors and enveloping the entire political conversation — as intended, and as promised to influence-seeking corporate advertisers.

You can see that immersion a few levels up the mountain, when outlets like The New York Times use their news pages to cast progressives defending Biden’s agenda as supposedly complicating his agenda; or when a CNN anchor demands that progressives back off even the most minimal climate and health care policies that might help people; or when NBC News publishes a story declaring as fact that “progressives have to give a lot to get a little,” and insisting that it’s not clear “they will gain anything at all” by trying to deliver on their popular campaign promises.

There are, of course, exceptions to all of this: Politico has periodically mentioned Sinema’s pharma cash haul. Axios helpfully broke the news about Manchin’s Dr. Evil-esque plan to slash the child tax credit (though the outlet cast it as merely a political problem for Biden rather than a real-world problem for the millions of people who could be thrown into poverty).

The Washington Post’s Greg Sargent, meanwhile, pointed out that Manchin’s demands on the child tax credit — work requirements and means testing — could result in 190,000 children in his home state losing out on the benefit. And Post reporter Jeff Stein has consistently framed the political discussions about what items could get from the reconciliation bill in human terms, enraging conservatives.

The Times, to its credit, published a hard-hitting story about how Manchin’s behavior imperils his flood-threatened state. (The dispatch is an example of how the best reporting from that newspaper is usually far away from its political desk.)

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But these are the outliers and not the norm, which is why independent non-corporate media have been growing of late. Put simply, more and more Americans can see that when it comes to the day-to-day coverage of Washington, the bullshit, spin, and Orwellian talking points are so interwoven into the news coverage that propaganda isn’t the momentarily bad weather of the news cycle. It is now the news atmosphere all around us — and a cable TV diatribe this week made clear that corporate media plans to defend rather than fix that atmosphere.

The screed from CNN’s Brianna Keilar came in response to Sanders lamenting the press corps’ refusal to consistently cover the details of the reconciliation bill. Keilar upbraided Sanders for having “trolled” Manchin by publishing his West Virginia op-ed politely outlining the details of the legislation. CNN briefly flashed a few rare stories on the screen as alleged proof that corporate media had consistently reported on the bill’s provisions. Promoting her televised tirade like a practiced social media influencer, Keilar tweeted that “it’s blame-the-media o'clock and Sen. Bernie Sanders is right on time.”

The video was four minutes of precious television airtime defending corporate media — four minutes that could have instead been used to inform viewers about the landmark legislation.

But that’s not what the “corporate” in corporate media wants.

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As Medicare Advantage continues to drive profits for the nation’s major health insurance companies, the industry is lobbying against a provision in the reconciliation bill that could save the government nearly $150 billion over the next decade on a much-needed expansion of the country’s Medicare program and prevent even more money from being funneled to private health insurance companies.

Medicare Advantage — the privatized version of the national health insurance program for people over the age of 65 and people with disability status — has become a cash cow for private health insurers. As small- and medium-sized employers struggle to keep up with the skyrocketing costs of health care, private insurers are increasingly expanding into the Medicare Advantage market to buffer their profits.

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A provision being considered as part of the reconciliation bill would add dental, vision, and hearing benefits to Medicare without including those benefits in the calculation of the rate at which the federal government reimburses Medicare Advantage plans. Doing so could cut the cost of expanding Medicare benefits by 41 percent, according to an analysis by the Brookings Institution.

The vast majority of Medicare Advantage plans already provide dental, hearing, and vision benefits. But that hasn’t stopped private insurers and their front group, the Better Medicare Alliance (BMA), from demanding more money from Congress and spending $3 million on advertising campaigns since September to try to ensure their reimbursement rates go up if those benefits are also added to traditional Medicare plans.

Some of the BMA ads misleadingly thank conservative Democratic Sens. Kyrsten Sinema of Arizona and Joe Manchin of West Virginia, claiming the two main opponents to expanding Medicare have actually “fought for seniors.” The Sinema ad says: "We need her now more than ever, because Washington listens to her.”

Meanwhile, BMA sent a letter last month to House Speaker Nancy Pelosi, D-Calif., and Senate Majority Leader Chuck Schumer, D-N.Y., urging them to “to ensure additional benefits are structured in a way that fully reflect the cost of adding dental, vision, and hearing to Medicare in the benchmark calculation.”

Increasing that benchmark calculation would mean private insurers get additional reimbursement for services they already provide — it would amount to a taxpayer-funded windfall for insurance companies that are already raking in money off of Medicare Advantage.

“The insurance companies that participate in Medicare Advantage are making huge, huge profits off of taxpayers in that program, and they absolutely could afford to give up the overpayments that Congress is making to keep the program going at its current level,” said Wendell Potter, a former Cigna executive who became a whistleblower and is now a Medicare for All advocate.

Gaming The Medicare Advantage System

While Medicare has contracted with private insurance companies since the national health insurance program was formed as part of the Social Security Act in 1965, the current iteration of Medicare Advantage has only existed since 2003. Similar in policy design to charter schools, Medicare Advantage offers people the choice of private insurance plans instead of traditional Medicare. Medicare Advantage plans offer baseline benefits, and insurers are paid to provide them by the government.

Utilization of Medicare Advantage has grown steadily since it was launched. According to health policy experts, that’s largely because private insurers invest in marketing tactics to draw people to their plans, highlighting perks like extra benefits that aren’t covered by Medicare and an annual cap on out-of-pocket costs. More than 40 percent of Medicare recipients now receive their coverage through Medicare Advantage.

For insurers, meanwhile, the business is increasingly lucrative.

“One of the reasons why they are so focused on Medicare Advantage is they are finding that the commercial insurance market, private side, is not growing,” said Potter, the former insurance executive. “It hasn't been growing for years. The unsustainable increase in premiums year after year and their constant shifting of out-of-pocket costs, is making health insurance unaffordable for businesses, so there is no growth there.”

Ahead of the current open enrollment period for Medicare plans, which began on October 15, major insurers including UnitedHealth Group, Humana, and Aetna announced new expansions into the Medicare Advantage space.

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Profits come from the generous reimbursement structure for Medicare Advantage. The federal government calculates a “benchmark” rate for benefits, based on what it spends on those services under traditional Medicare coverage.

Private insurers submit estimates as to how much it will cost them to provide the average Medicare Advantage customer with the benefits of traditional Medicare, and the federal government reimburses them at a rate that is slightly higher than that estimate but below the benchmark.

This calculation results in considerable profits. In 2019, when the most recent data is available, private insurers averaged 4.5 percent profit margins on their Medicare Advantage plans. Between 2016 and 2018, Medicare Advantage plans reported nearly double the profit margins per customer compared to individual and employer plans.

The returns are so high in part because Medicare Advantage providers have devised ways to spend less on their customers than traditional Medicare. “They've figured out how to game the system in ways that enable them to make outsized profits,” said Potter.

One stratagem is that Medicare Advantage, unlike traditional Medicare, is allowed to require prior authorization for procedures. And high denial rates can deter people from seeking care in the first place, which saves insurers money. The federal Health and Human Services Department has found that “there are persistent problems related to denials of care and payment in Medicare Advantage,” and that in most cases when denials are appealed, insurers overturn their own denials.

At the same time, taxpayers spend more per person for Medicare Advantage plans than they do on traditional Medicare plans. A recent analysis by the Kaiser Family Foundation found that in 2019, the federal government spent $321 more per Medicare Advantage enrollee than traditional Medicare enrollee.

Another method insurers utilize is a shady practice known as “upcoding,” in which they manipulate the government’s system for coding diagnoses in order to get larger reimbursements from the government. The Department of Justice has brought lawsuits against multiple insurers in recent months for upcoding.

In some cases, insurers simply illegally underspend on their customers, for which they face few consequences. Last month, UnitedHealthcare was penalized by the Centers for Medicare and Medicaid Services (CMS) for having spent too small a percentage of premiums on providing benefits for three years in a row. In response, the company has been banned from enrolling new subscribers in certain plans in a handful of states, which represent a small fraction of the insurers’ overall enrollment.

Hundreds Of Billions In Savings

Adding dental, hearing, and vision benefits to traditional Medicare through the reconciliation bill could make Medicare Advantage plans less attractive to consumers, cutting into private insurers’ profits. Such an expansion of the national insurance program would likely cost the federal government more than $350 billion over the next ten years.

However, a proposal to include those benefits in Medicare without increasing the rate at which the government reimburses Medicare Advantage plans could cut that cost by 41 percent, according to a recent analysis by Matthew Fiedler, an economist at the USC-Brookings Schaeffer Initiative for Health Policy and former chief economist on President Barack Obama’s Council of Economic Advisors. With corporate Democrats demanding a smaller reconciliation bill, such a drastic cost savings should, in theory, be a very attractive move.

“Most of the federal savings from excluding the cost from the benchmark would be coming out of reduced plan profits,” Fiedler told The Daily Poster.

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More than 98 percent of Medicare Advantage plans already offer dental, vision, and hearing benefits. While some of those plans could be required to improve their dental, vision, and hearing benefits to meet the new proposed standards for traditional Medicare, and a few would be required to expand their coverage to include those benefits, the plans can afford to do so without the government increasing the benchmark, Fiedler explained.

If the new benefits were included in a new Medicare Advantage benchmark calculation, it would contribute to already high profits for private insurers — with very little of that funding going to people on the plans. Past research has found that when Medicare Advantage increases its reimbursement rate, only one in every eight dollars of reimbursements is passed along to customers in the form of savings or better coverage. A larger share is passed to insurers in the form of profits.

On the other hand, said Fiedler, expanding Medicare benefits without changing the benchmark calculation would only lead to modestly lower profits for insurance companies.

Misleading Ads And Mounting Industry Opposition

In August, Politico reported that an insurance industry source said proposals to add benefits to Medicare had insurers “freaking out,” because they “worry that seniors will drop their private plans en masse and migrate to traditional Medicare once the new benefits are in place.” Politico added that their source “said the industry is mindful of the optics of publicly opposing coverage of eyeglasses, dental care and hearing aids, and is largely lobbying behind the scenes.”

To do so, the insurance industry has turned to the BMA, a dark money group representing insurers and business groups. Health insurance giant Humana and CVS Health, which owns Aetna, each donated $2 million to the organization last year, according to company disclosures.

The BMA has spent nearly $3 million on TV and radio ads since the beginning of September, according to data from AdImpact.

Those ads included paid spots on cable news in Arizona this month that featured the faces of elderly people who, according to a voiceover, are among the more than 625,000 people in the state who “have come to rely on something vital: Medicare Advantage.”

The raspy masculine voice warns, “Now there’s talk in Washington of cutting Medicare Advantage and raising our premiums.” But, the voiceover says, “Sen. Kyrsten Sinema has fought for seniors and Medicare Advantage.” The advertisement ends with an image of the senator’s face alongside the phone number for her office, encouraging viewers to thank Sinema “for fighting for us.”

In West Virginia, viewers are seeing a similar ad, featuring Manchin.

Since September, BMA has spent $516,000 on ads in Arizona and $266,000 in West Virginia, as well as nearly $550,000 in the Washington, D.C. area. They have also targeted conservative Democrats in the House, including Reps. Stephanie Murphy (Fla.), Jared Golden (Maine), Kurt Schrader (Ore.), and Cindy Axne (Iowa).

In reality, there is no proposal in Congress to “cut Medicare Advantage” or raise premiums, and moreover, no evidence that Sinema or Manchin have “fought for seniors.”

Instead, the BMA is running ads thanking Manchin and Sinema because they have become the most prominent obstacles to passing Democrats’ social safety net legislation — and because they do not support the party’s plan to expand Medicare to cover dental, vision, and hearing benefits.

As a supposed fiscal hawk, Manchin might be expected to welcome the cost savings that would come with expanding Medicare benefits without changing the reimbursement rate going to private insurers — but instead, he appears to be parroting the talking points of his corporate allies, who don’t want the benefits expanded at all, much less without scoring a better reimbursement rate.

Manchin has said he thinks Democrats need to shore up Medicare’s finances before expanding the program, and he also wants any new benefits to be means tested and only help poorer Americans — an idea that would undermine Medicare’s draw as a universal program.

Sinema, meanwhile, refuses to say anything about Democrats’ plans publicly, but Axios recently reported that she is “less interested in offering new dental and vision benefits in Medicare.”

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Sinema does appear interested in protecting the Medicare Advantage payouts to private insurers, however. On Oct. 15, she sent a letter, co-signed by Manchin, to CMS “to express our support for the Medicare Advantage (MA) program.” The letter continued, “To ensure this continuum of care, we stand ready to protect MA from payments cuts, which could lead to higher costs and premiums, reduce vital benefits, and undermine advances made to improve health outcomes and health equity for MA enrollees.”

The BMA subsequently issued a press release thanking the signatories for their “unwavering leadership.”

In addition to the BMA advertisements, the health insurance lobbying group America’s Health Insurance Plans (AHIP), the right-wing think tank American Action Forum, and UnitedHealth Group’s employee lobbying arm have been mobilizing to ensure that taxpayer dollars continue to prop up the Medicare Advantage program.

AHIP commissioned a study that showed that adding dental, vision, and hearing to Medicare without including them in the benchmark calculation would leave Medicare Advantage with fewer rebate dollars to be spent on supplemental benefits.

The American Action Forum — a think tank affiliated with the American Action Network, a dark money group that bankrolls House Republicans — has opposed adding new benefits to Medicare on the grounds that Medicare Advantage already provides those benefits.

“If Democrats are really looking for pain-free ways to cut back on their $3.5 trillion spending spree, scrapping the dental, vision, and hearing additions to Medicare would be a good place to start, because the benefits are already available through Medicare Advantage. Perhaps advocates for enhanced Medicare coverage should instead focus on bolstering MA, which already provides a range of tailored benefits to the Medicare population,” wrote the organization’s health policy analyst in a blog post earlier this month.

At the same time, UnitedHealth Group has pushed its employees to call Congress and ask them “not to cut Medicare Advantage” through its internal political engagement platform, called United For Action.

“While action is entirely voluntary, consider lending your voice to protect seniors in Medicare Advantage,” noted a September 16 email sent to employees by management of the company, which was found to have been spending too little on seniors’ care for years.

“Policymakers are currently debating and considering proposals that may impact the Medicare Program and other health policies,” the email said. “To protect Americans enrolled in Medicare Advantage, ask Congress to ensure any reforms to Medicare maintain stability for the 27 million seniors currently served by Medicare Advantage.”

On an earnings call last week, the company announced that it had surpassed $4 billion in profits last quarter, $1 billion more than the same quarter last year. UnitedHealth Group’s chief financial officer John Rex pointed to Medicare Advantage as a source of ongoing growth, and said the company plans to bring on 900,000 more customers through Medicare Advantage this upcoming year.

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Ports are overflowing with shipping containers, manufacturers are scrambling to find materials, stores are running low on goods, and banking experts predict spiraling inflation as the world grapples with the so-called “Great Supply Chain Disruption” of 2021. Are the global shortages simply the effect of pandemic-related shutdowns, or is the planet’s production system in need of a massive overhaul? In this edition of Weekend Reader, we highlight several stories that delve deep into the supply chain woes spreading across the globe — and explore how part of the blame can be traced back to corporate monopolies and neoliberal outsourcing policies.

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Pharmaceutical interests have been flooding in donations to Sen. Kyrsten Sinema, D-Ariz., who has emerged as the chief roadblock to Democrats’ plan to allow Medicare to negotiate lower drug prices.

Between July and September, Sinema raised at least $100,000 from the pharmaceutical industry and donors at a private equity firm in the business of outsourcing pharmaceutical research and development, according to her campaign finance report filed Friday.

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While Sinema previously campaigned on lowering drug prices, Politico reported last month that Sinema had informed President Joe Biden that she opposes the party’s signature drug pricing initiative, which would finally allow Medicare to use its bulk purchasing power to lower prices.

Democratic leaders have planned to include the drug pricing measure, which would save the government hundreds of billions of dollars over 10 years, in the party’s $3.5 trillion reconciliation bill, as a way to finance other portions of Biden’s economic, health care, and climate agenda.

According to a recent Politico newsletter, “Democrats would be lucky if they managed to convince Sinema to support a version of drug pricing reform that raises even $200 billion.”

News of Sinema’s opposition to the drug pricing legislation arrived shortly after a pharmaceutical industry front group launched a TV and radio ad campaign in Arizona praising the freshman senator for her “independence,” calling her “a bipartisan leader” in the mold of the late Sen. John McCain.

Sinema’s new federal election filing shows she raised roughly $55,000 in the third quarter from drug industry executives and political action committees.

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The donors included PACs for drugmakers Abbvie, Alexion Pharmaceuticals, Astellas, Eisai, Eli Lilly, EMD Serono, Horizon Pharma, Lundbeck, Sunovion Pharmaceuticals, and Takeda Pharmaceuticals.

She also received donations from executives at Abbvie, Bristol-Myers Squibb, Eli Lilly, Genentech, Gilead Sciences, Lundbeck, Merck, Otsuka, and Sage Therapeutics, and the powerful drug lobby Pharmaceutical Research and Manufacturers of America (PhRMA).

Sinema additionally received about $47,000 from executives at Welsh, Carson, Anderson & Stowe. The private equity firm owns a big stake in Abzena, a company it describes as an “outsourced research, development and manufacturing services provider to biopharmaceutical companies.”

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