As Democrats Bicker Over Massive Spending Plan, Here’s What’s at Stake for Medicaid

Hours after the Supreme Court in 2012 narrowly upheld the Affordable Care Act but rejected making Medicaid expansion mandatory for states, Obama administration officials laughed when asked whether that would pose a problem. In a White House briefing, top advisers to President Barack Obama told reporters states would be foolish to turn away billions in ...

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AMA: 73% Of Health Insurance Markets Are Highly Concentrated

Nearly three-quarters of metropolitan statistical areas are concentrated health insurance markets, according to a new study from the American Medical Association (AMA). The analysis (PDF) found that 73% of MSAs are highly concentrated, based on Department of Justice and Federal Trade Commission horizontal merger guidelines. In 91% of markets, a single insurer had a market share of ...

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Lots Of People Say They’ll Quit Over Vaccine Mandates, But Research Shows Few Do

Surveys have shown that as many as half of unvaccinated workers say they will leave their jobs if they’re forced to get the COVID-19 shot, but in reality few of them actually quit. That’s according to an article in The Conversation, a nonprofit news organization that covers academic research. Researchers looked at companies that have vaccine ...

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Democrats Grapple With Cuts To Health Care Priorities

Top House Democrats are voicing a new willingness to pare down their ambitious health care proposals within the sweeping $3.5 trillion social spending bill as they scramble to build consensus ahead of a potential vote this week.

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California Continues To Have Lowest COVID Rates In The Country

California continues to have the lowest levels of coronavirus transmission in the country, according to the U.S. Centers for Disease Control and Prevention.

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Medical Loss Ratio (MLR) Carrier Update

The Affordable Care Act (ACA) requires health insurance issuers to provide information on the proportion of premium revenues spent on clinical services and quality improvement, also known as the Medical Loss Ratio (MLR).

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5 Changes Health Plans Need to Make to Adapt to an Ever-Shifting Industry

Health insurance is a constantly evolving and complicated industry that continues to change with the needs of the people, and it's only getting more complicated by the day. With new regulations and guidelines, new technology for data management, and emerging preferences for user experiences, it's easy to feel lost as you navigate this evolving landscape with your business.

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Federal Judge Requires Vaccines For California Prison Staff

A federal judge on Monday ordered that all employees entering California prisons be vaccinated or have a religious or medical exemption, as he tries to head off another coronavirus outbreak like the one that killed 28 inmates and a correctional officer at San Quentin State Prison last year. Inmates who want in-person visits or who ...

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Healthcare 2025: Health Plans Look Ahead To Emerging Business Opportunities

In the past 18 months, the healthcare industry has been defined by a time of sustained innovation and continuing technology investment. Health plans recognize the opportunity to collaborate with providers to deliver more patient-centric care and remove cost from the system. As government regulations and market forces converge around these initiatives, now is the time ...

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Dentists’ Organization Fights Plan To Cover Dental Benefits Under Medicare Expansion

The American Dental Association is mobilizing its 162,000 members to fight a proposal to include dental coverage for all Medicare recipients, opposition that could prove pivotal as Democrats look to make cuts in their $3.5 trillion domestic policy agenda. Giving dental, vision and hearing benefits to the 60 million older and disabled Americans covered by Medicare will provide ...

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