IRA Round 2 Begins As Drugmakers Sign On To Price Negotiation Process With CMS

Spring has sprung, and round two of the Inflation Reduction Act's (IRA's) negotiation period has begun. Each of the drugmakers that make the fifteen medicines selected for 2027 price cuts have officially signed on to the process, giving the go-ahead for the price talks to begin.

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Cigna Closes $3.3B Sale Of Medicare Plans To HCSC

Cigna has officially sealed the deal on the $3.3 billion sale of its Medicare business to Health Care Service Corporation. HCSC acquired Cigna’s Medicare Advantage, Part D, supplemental benefits and CareAllies units as part of the deal. While it will no longer operate the Medicare unit directly, Cigna said it will continue to provide pharmacy ...

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Congress Extends Medicare Telehealth Flexibilities For 6 Months

Telehealth groups celebrated the extension, but added that the short-term reprieve means continued uncertainty for providers.

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Newsom’s Office Seeks Another $2.8B To Plug Medicaid Gap

The request comes on top of a $3.44 billion loan proposed last week, with costs for undocumented residents running higher than expected.

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California Lawmakers Demand Answers On Medicaid Shortfall

The $3.44 billion loan, first floated to lawmakers Wednesday, will cover obligations for Medi-Cal, through March, but it’s raising questions about a bigger budget hole that may need to be filled later on. Lawmakers said they were caught off guard by the news and still don’t understand the extent of the shortfall.

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Actual Small-Group Health Premiums Rise 6.1%

Small-group health insurance premiums are still going up at about the same rate as before, and the enrollee count continues to fall. The average monthly premium increased 6.1% in 2024, to $659. The rate of increase was down, slightly, from 6.2% in 2023.

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GLP-1 Drugs Need Price Cuts To Be Financially Viable, Researchers Say

The new-generation weight-loss drugs work very well at preventing obesity, diabetes and death, but they are still much too expensive to be a good financial value for employer plans or other payers, researchers report in a new paper published by JAMA Health Forum. Semaglutide, the GLP-1 agonist drug that powers Wegovy, could cost less than $100,000 per ...

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Congress Must Reject Taxing Employer-Provided Health Care Coverage

As the new Congress and administration are settling in, all eyes in Washington are focused on the trillion-dollar question: whether and how to pay for the expiring provisions of the 2017 Tax Cuts & Jobs Act (TCJA), signed into law in President Trump’s first term. Among the various revenue-generating proposals emerging from GOP circles — ...

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ACA Changes Could Impact Employer Plans, Individual Coverage Reimbursements

Managers of the Affordable Care Act public exchange system want HealthCare.gov and the state-based exchanges to tighten up. The Centers for Medicaid and Medicaid Services, the federal agency that oversees the ACA exchange system, hopes to make all ACA public exchanges start their annual open enrollment periods Nov. 1 and end the open enrollment periods ...

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No Data, Higher Premiums: Insurance Industry Braces For Fallout From Government Cuts

The insurance industry relies on a steady flow of publicly available data to predict losses, price policies, and mitigate financial exposure. What happens when those data streams dry up? We’re on the verge of finding out. Recent governmental workforce reductions, agency closures and “streamlining” initiatives fostered by President Donald Trump, his unelected advisor, Elon Musk, ...

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