John Oliver returned to Last Week Tonight following a month-long hiatus to examine UnitedHealth Group, the parent company of UnitedHealthcare, the largest insurance company in the US serving over 50 million people. The segment aired as the company faced renewed public scrutiny ahead of Luigi Mangione’s sentencing after he pleaded guilty to killing UnitedHealthcare CEO Brian Thompson in December 2024. A poll conducted after the shooting indicated that 69% of respondents in some part blamed insurance coverage denials for the killing.
Oliver noted that UnitedHealth Group generated $447 billion in revenue in 2025, making it the third-highest company by revenue in the US behind Walmart and Amazon. The host highlighted the company’s extensive reach across the healthcare system through approximately 2,700 subsidiaries, including primary care clinics, surgical centers, urgent care facilities, home health agencies, hospice care operations, pharmacies, and even its own bank. Oliver characterized the company’s business model as creating a “massive data-sharing panopticon” that generates substantial revenue through vertical integration.
The segment examined documented cases of claim denials that Oliver characterized as misaligned with medical advice. These included instances involving medical equipment coverage, cancer treatment authorization, and pharmacy benefit management decisions. Oliver noted that while UnitedHealthcare’s insurance arm is required by the Affordable Care Act to spend 80% to 85% of collected premiums, much of this spending flows to other UnitedHealth Group entities, potentially benefiting the parent company across billions of dollars in transactions.
Oliver presented the case of Cole Schmidtknecht, a 22-year-old in Wisconsin whose asthma medication coverage was abruptly changed by OptumRx, UnitedHealth Group’s pharmacy benefit manager. The change resulted in his preventative inhaler cost increasing from $66 to over $539. According to reporting, Schmidtknecht died from a severe asthma attack after deciding he could not afford the medication that night. Oliver characterized the death as preventable and resulting directly from the coverage change.
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