Dems Accept Shutdown Deal Without ACA Guarantee

Enough Senate Democrats are poised to accept a deal to reopen the government without a concrete agreement to extend Affordable Care Act subsidies — but with the promise of a showdown vote on the assistance next month. Why it matters: If a bill to temporarily fund the government passes this week, it would be a relief ...

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CMS Grants Temporary Flexibility For Telehealth Coverage In Medicare Advantage During The Government Shutdown

The Centers for Medicare & Medicaid Services (CMS) has issued new guidance allowing Medicare Advantage plans to maintain coverage of certain telehealth services that technically expired when federal telehealth authorities lapsed on October 1, 2025. Under the announcement, CMS will temporarily waive the prohibition on mid-year benefit changes to permit plans to continue offering these ...

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Fixing The Unintended Consequences Of High-Deductible Health Plans

High-deductible health plans were introduced to curb rising health care premiums and costs with the aim of giving employees more control over spending and driving a consumer-driven approach to care. Yet over time, HDHPs have shifted from being a strategic choice to a default option for millions of Americans: today, 58% of privately insured individuals are enrolled, ...

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Even A 15-Minute Walk May Help Boost Your Longevity

Walking for at least 10 or 15 minutes at a time might do more for your health and longevity than spreading your steps out into shorter walks throughout the day, a large-scale study suggests. The study, published in October, looked at the effects of how people gather their steps each day, as well as how many ...

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‘It’s insane’: This Calif. Couple is a Facing an 800% Hike in Health Care Costs

David Delfiner and Lisa Parsons received a shocking letter from their health insurance provider when they checked their mail last week. Their monthly health insurance cost will increase from $350 a month this year to $2,221 starting in 2026. “It’s insane. It’s unbelievable,” said Parsons, a 59-year-old retiree living in South Lake Tahoe. The couple is not ...

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ACA Premiums Stabilize, Nearly Mirroring Employer-Sponsored Coverage Costs

After several volatile years after the Affordable Care Act was first implemented, individual Marketplace premiums have become more similar to employer-sponsored coverage. “When insurers entered the ACA Marketplaces in 2014, they were operating with virtually no experience participating in an individual market like this,” according to a Peterson-KFF Health System Tracker report. “Insurers must submit premiums almost a year in advance ...

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Medical Inflation Is Top Priority For Employers As They Wrestle With Health Costs

Executives at Aon and Arthur J. Gallagher say that the U.S. labor market still looks strong, but that big increases in U.S. health coverage costs are definitely getting employers’ attention. At Aon, the health solutions unit increased revenue 6%. “This is a 20%-plus segment of the U.S. economy, and costs are growing at 9% to 10% a year,” ...

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How Insurers Are Leveraging AI Agents

In June, Becker’s predicted that 2025 would shape up to be the year of AI agents in healthcare. While AI agents are nothing new, more insurers are getting on the bandwagon. AI agents complete tasks autonomously to achieve specific goals. More broadly, though, AI use in health insurance has been contentious. CMS released AI guidance for Medicare Advantage plans in an effort ...

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Medicare Finalizes Controversial Cut To Specialty Care Next Year

Medicare has locked in a controversial pay cut for specialty doctors next year, normalizing reimbursement between specialists and primary care doctors and curbing the influence of a powerful physician association in setting rates. The CMS finalized the 2026 Medicare physician fee schedule on Friday. The massive payment rule includes a so-called “efficiency adjustment,” which reduces ...

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Managed Care Plans Offer Recommendations To CMS On Rollout Of Medicaid Work Requirements

Two leading organizations representing Medicaid managed care plans are offering several key suggestions to the Trump administration for managing the rollout of work requirements in the program. In the letter (PDF), experts at Medicaid Health Plans of America (MHPA) and the Association for Community-Affiliated Plans (ACAP) urged the Centers for Medicare & Medicaid Services (CMS) to allow ...

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