Industry Updates
This broad category includes articles concerning health insurance costs, carrier and health plan news, changing benefits technology, and surveys by the Kaiser Family Foundation and others on employee benefits.
Editor’s Note: Covered California is a State-Based Marketplace (SBM). For details on how these new rules will impact Covered California and other SBMs we recommend the following Princeton University linked report: (Broker rule changes appear at the bottom of the Princeton analysis.) https://shvs.org/wp-content/uploads/2025/06/SHVS_2025-Final-Marketplace-Integrity-Rule.pdf. The Trump administration on Friday finalized a major rule reshaping the ...
Enrollment in the Affordable Care Act continues to erode as some customers struggle to make premium payments, with the declining numbers churning market uncertainty for insurers. In response, insurers are likely to raise rates again next year, following this year’s larger-than-typical hikes. Sign-ups were already down in January by about 1.2 million from last year’s record enrollment. For ...
The Trump administration on Monday said it is adding generic medications to its direct-to-consumer drug sales website, TrumpRx, in a bid to expand a platform that is key to his administration’s efforts to lower prescription drug costs in the U.S. The administration is adding more than 600 generic drugs to the site, President Donald Trump said at an event ...
The US Supreme Court on Monday rejected a series of appeals from several of the nation’s largest drugmakers challenging a program that is expected to save taxpayers and the federal government billions of dollars by requiring the companies to negotiate with Medicare on the prices for some of their most popular drugs. The court’s decision to deny ...
The Department of Health and Human Services (HHS) on Monday withdrew its amended charter for a highly influential vaccine advisory committee that would have loosened eligibility requirements, citing administrative errors. In a notice set to be officially published in the Federal Register, HHS formally withdrew its proposed amendment to the charter for the Advisory Committee ...
Two of the most powerful lobbies in the country are turning on a third in the hopes of deflecting Washington’s wrath and securing bigger shares of the $5 trillion Americans spend on health care each year. Drugmakers and insurers are aiming to take advantage of lawmakers’ worries about affordability to convince them it’s the hospitals ...
Physicians remain skeptical that health insurers’ pledges to ease prior authorization hassles will result in any meaningful action, an American Medical Association (AMA) survey found. In June 2025, a group of about 60 insurers said that they would standardize electronic prior authorization by the end of 2026 to help speed up the process. They also said they would reduce ...
In April, the Centers for Medicare & Medicaid Services began enforcing the strongest hospital price transparency rules in the program’s history. The Calendar Year 2026 Outpatient Prospective Payment System final rule eliminates the “estimated allowed amount” placeholder that hospitals used to game disclosure, requires three new data elements based on 12 to 15 months of actual claims ...
When Gavin Newsom ran for California governor in 2018, his support for a state-run single-payer healthcare system was considered a risky move and earned him hefty labor endorsements. Today, leading Democrats in the wide-open race to succeed Newsom have embraced single-payer as a political necessity, an answer to voters fed up with rising premiums and other spiraling healthcare ...
State Obamacare marketplaces are starting to feel tremors from the GOP-controlled Congress’s ending of enhanced subsidies, as millions of Americans are dropping coverage. Experts and state officials say the impact varies from state to state, but enrollment decline is expected to grow this year and beyond, as policies from the One Big Beautiful Bill Act and potential Trump ...