By JEFF GOLDSMITH
It has happened at least a dozen times. I mention John Arnold and am greeted by knowledgeable healthcare colleagues with a blank stare. Houston billionaire John Arnold is the most powerful man in US healthcare that nobody has ever heard of. An investing savant, Arnold made $50k in high school trading collectors’ hockey cards over the Internet. He became the star natural gas trader at Enron in his early twenties. Arnold, who played no role whatever in Enron’s storied collapse, left the company in 2001 with an $8 million bonus. In 2002, at age 28, Arnold founded a hedge fund, Centaurus Advisors, focusing on energy investing, and reeled off a decade of 100% annual returns.
Bored with investing and by then a multi-billionaire, Arnold shut down Centaurus in 2012, and decided to change the world. With his Yale trained attorney wife Laura, John created a family foundation. and funded it with a large share of their personal wealth. For reasons we will explore more fully below, in 2019, Arnold converted their foundation to a ”for-profit charity” known as Arnold Ventures. At nearly $4.7 billion in assets in 2024, Arnold Ventures was about a third of the size of the lions in foundation world, Robert Wood Johnson ($14.7 billion in 2023) and Ford ($13.7 billion in 2024). Arnold Ventures 501c3 grantmaking subsidiary gave away a cool $194 million in 2024 to a bewildering array of grantees from American Enterprise Institute to Families USA.
But Arnold’s business model is fundamentally different than these legacy charitable foundations.
Arnold Ventures, the parent, is a for-profit enterprise with limited financial disclosure requirements. It has two main subsidiaries, the Laura and John Arnold Foundation, a traditional 501c3 and the Action Now Initiative, a 501c4 non-profit, which funds community- based policy advocacy. Arnold’s for-profit parent makes political campaign contributions and funds class action lawsuits against policy targets, which funding is not disclosed as to targets or amounts. Thus, Arnold Ventures is actually closer to a diversified political action committee/public interest lobbyist with a focused policy research agenda than it is to a traditional foundation. As Arnold himself said in defense of the flexibility their structure creates: “If we want to attack an issue, we will do whatever it takes.”
Arnold Ventures has an audacious policy agenda spanning a broad range of domestic issues: criminal justice, housing, nutrition, infrastructure development (e.g. pipelines and the electrical grid), substance abuse, tax policy, education, retirement policy and healthcare. Some of its earliest advocacy was on behalf of charter schools, but also research integrity, through the Reproducibility Project and the Center for Open Science, seeking to determine if research findings are actually real, or whether commercial interests have filtered what reaches the public from the laboratory bench.
It is difficult to pin Arnold’s agenda down on the ideological spectrum. Arnold was a major donor to both Obama campaigns and has seemingly gone to ground during the Trump era. While Arnold’s agenda is broadly progressive, advocating for heightened government activism, Arnold’ advocacy has also funded projects at American Enterprise Institute, Oren Cass’s libertarian project American Compass and Brian Blase’s Paragon Health Institute. You can find all of Arnold Ventures 990s listing their research funding activities here courtesy of ProPublica.
However, its sprawling healthcare agenda appears to consume a large fraction of its project funding. In 2017, Arnold hired Mark Miller, who was for fifteen years Executive Director of MedPac, the Congressional policy advisory body overseeing the Medicare program. Miller brought with him what used to be called a primo Rolodex of contacts in the health services research community, and has dedicated the last eight years to showering his colleagues with Arnold Ventures funding. The biggest beneficiaries of Arnold’s health policy funding reside, not surprisingly, at the nation’s elite Universities.
ARNOLD VENTURES HEALTH POLICY GRANT ACTIVITY AT SELECT UNIVERSITIES 2020-2025
Source: ProPublica Non-Profit Explorer, 2026
The short list of health policy experts Arnold has funded is star-studded: Michael Chernew (Harvard University and current MedPac Chair) , David Cutler, (also Harvard), Jamie Robinson, (UC Berkeley), Paul Ginsberg and Glenn Melnick (USC), Larry Casalino (Cornell), Amy Finkelstein (MIT), Gerard Anderson and Ge Bai (Johns Hopkins), Roslyn Murray and Chris Whaley (Brown), and Zack Cooper (Yale). As one of these distinguished researchers said to me when asked about what Arnold was looking for, “If you want to make war on the medical-industrial complex, Arnold is your man”.
A longer list runs into dozens of younger and less well known health research scholars that represent the next generation of movers and shakers in health policy. Arnold’s reach is broad enough to exert a pervasive influence on the pool of peer reviewers of health policy papers for major journals such as JAMA, New England Journal of Medicine and Health Affairs. As a refugee from academia, I can tell you that you have to work hard to name leaders in health services research who has not been funded by Arnold.
In the spirit of vertical integration, Arnold has also generously funded an impressive array of healthcare foundations, non-profits and media outlets that publicize Arnold funded findings: Health Affairs, Kaiser Health News and the Kaiser Family Foundation, Academy Health, ProPublica, Third Way, the Rand Corporation, the National Bureau of Economic Research, the National Association of State Health Policy, Altarum Institute, Brookings Institution, the Health Care Cost Institute, the National Conference of State Legislatures and the Lown Institute.
These organizations are key parts of the Arnold policy “ecosystem”, because they both amplify and legitimize the writings of Arnold Ventures grantees and/or organize conferences where Arnold funded experts gain access to general media. You pretty much have to have been hiding under rock to avoid being showered with Arnold Ventures-funded content, often without attribution, in the well-orchestrated post-publication media coverage!
In referring to his early work on scientific integrity a decade ago, Arnold posted on X, “’A new study shows’ . . . are the four most dangerous words.” Yet in its own policy agenda, Arnold seems keenly aware that “A New Study by .. . elite University scholar name goes here . . .” is an almost irresistible publicity magnet. By attaching elite university investigators’ brands to its policy agenda, it has followed the classic progressive playbook.
We take a closer look at how this process works in Part II of this Report.
Jeff Goldsmith is a veteran health care futurist, President of Health Futures Inc and regular THCB Contributor. This comes from his personal substack
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