Study reveals private healthcare lobby's disinformation campaign against UHC

The private health industry lobby group "Partnership for America's Health Care Future" engages in marketing and publicity strategies similar to Big Tobacco and other unhealthy commodity industry groups to shape public perception of universal health care policies as negative in the United States, according to a study published July 16, 2025 in the open-access journal PLOS Global Public Health by Kendra Chow from the London School of Hygiene and Tropical Medicine, United Kingdom, and colleagues.

The United States remains the only high-income country without universal health insurance coverage, with approximately 31.6 million Americans uninsured and an overall healthcare system ranking of last place compared to other high-income countries in terms of access to care, efficiency, equity, and health outcomes (in spite of spending the most money overall and per person). However, private, profit-driven health care companies would incur losses under a move to universal health care (UHC) in the US. In 2019, the Partnership for America's Health Care Future (PAHCF), a private health industry lobby group, launched a campaign across Meta platforms Facebook and Instagram to generate opposition to universal health care policies in the United States. Chow and her co-authors investigated PAHCF's campaign and how it was designed to affect public conversation and perceptions around universal healthcare policies.

The authors analyzed 1675 paid advertisements and associated metadata shown to Meta platform users from May 2018-September 2021.

The PAHCF campaign received between 32,596,000 and 40,706,329 views from Meta users over the time period studied. There were 5 major themes throughout the advertisements, with multiple themes often present in one ad to encourage American audiences to focus on how implementing UHC policies could harm them: 1) the negative impacts of UHC policies on health care in the US (the most frequent claim promoted, arguing that UHC policies would force Americans to "pay more to wait longer for worse care"); 2) infringement on individual choice and rule by the state; 3) misrepresentation of legislative intent; 4) promoting partnerships and fixing the current system; and 5) appealing to audience interests. The ads also targeted specific appeal groups by including visual representations of specific individuals (e.g. mothers with children, senior citizens, people speaking Spanish).

The authors note the communications strategies seen in this campaign mirror strategies undertaken by unhealthy commodity industries (e.g. tobacco, alcohol, and ultra-processed food) to manufacture doubt, fear, and uncertainty about policy reform efforts. Meta does not publicly provide the number of impressions and other data for all advertisements, such as demographic targeting; however, the authors hope to further investigate the interplay between social media as a relatively new advertising platform and the well-known communications strategies of industries seeking to protect profits at the expense of public health.

The authors note: "With the new budget bill that has just been passed in the US, close to 12 million Americans could lose their access to healthcare. Campaigns like Partnership for America's Healthcare Future that use Meta's advertising tools to target people and affect their voting behaviours around policy reforms like Medicaid are extremely important to pay attention to."

They add: "With Meta rolling back its fact-checking policies in the US earlier this year, along with the continued lack of transparency around political ad targeting, their platforms offer health-harming industries large-scale opportunities engage in tactics that protect their profits at the expense of public health. And by not regulating content on their platforms, while collecting huge amounts in ad revenue, Meta is also engaging with the same style of tactics."