Part II: The Contractor State: Who Actually Runs Medicare, How CMS Spends Its $8 Billion a Year, Why a South Carolina Blue Plan Quietly Banks $700 Million, and How AI Vendors Now Get Paid to Deny Care

CMS moves $1.5 trillion a year with 6,000 employees. It does almost none of the actual work. A contractor market of $7-8.5B a year does it for them.

Maximus leads five-year contract totals at nearly $4B. But the most surprising #2: a nonprofit Blue plan in South Carolina, through three affiliated entities, pulling $718M in fiscal 2025 alone.

The entire Me…