A House member has an idea for making employer-sponsored health coverage cheaper and more flexible: Exempt the plans from the Affordable Care Act essential health benefits rules. The bill would, in effect, give small employers with fully insured group health plans a choice about whether to cover prescription drugs, maternity care or surgery, and it ...

Specialty drug trend remains high, although it decreased from 11.2% to 10.8% on a gross cost basis in Pharmacy Strategies Group’s 2026 State of Specialty Spend and Trend Report. Claim utilization is now the dominant driver of specialty drug trend as the percentage of members using specialty drugs rose to 5.5%. “For a decade, this ...

A federal appeals court has ruled that pharmaceutical manufacturers cannot unilaterally replace upfront discounts under the 340B Drug Pricing Program with after-the-fact rebates, affirming the federal government’s authority to approve how those price reductions are provided. The U.S. Court of Appeals for the District of Columbia Circuit upheld lower court judgments against Novartis, Bristol Myers Squibb, ...

U.S. hospitals are now treating fewer patients with health insurance purchased through an ACA exchange. Hospitals are also seeing more uninsured patients and patients with skimpy commercial coverage. The patients with high-deductible commercial coverage seem to be waiting until later in the year, when they have met their deductibles, to have elective surgical procedures. Executives ...

A tiny federal agency tasked with protecting the public from injuries caused by lawn mowers and coffeemakers is demanding that some of the nation’s biggest health systems turn over detailed, personally identifiable medical records of all patients who seek help at their emergency rooms. The Consumer Product Safety Commission, responsible for tracking and issuing recalls ...

Figuring out who’s offering the best deal on heart surgeries or routine physicals isn’t the most pressing issue for everyday Americans. That hasn’t stopped lawmakers on Capitol Hill from trying to turn that kind of price transparency into their marquee bipartisan health care goal this year. Republican and Democratic lawmakers who advanced bills on the ...