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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.

Real-Time Drug Pricing Access Rule To Take Effect

A federal rule enabling real-time access to prescription drug pricing, coverage details and prior authorization requirements is set to take effect Oct. 1.

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Key House Committee Lays Groundwork For Health Extenders

Committee could extend telehealth flexibilities in Medicare coverage, expiring provisions in pandemic preparedness law

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As Insurers Struggle With GLP-1 Drug Costs, Some Seek To Wean Patients Off

Lots of research suggests such medications must be used indefinitely to maintain weight loss and related health benefits. But with list prices of roughly $1,000 a month, public and private payers are struggling to keep up with ballooning demand for GLP-1 weight loss drugs and in some cases are eliminating or restricting their coverage as a result.

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Pharmacy Costs Drive Health Care Trend To Nearly 10%

Accurate trend projections are critical for effective renewal planning and budget forecasting, and according to HUB International’s 2026 Trend study, health care costs will only continue to rise throughout 2026. Key regional observations for 2025 reveal that the east region consistently shows the highest medical trends across all plan types, with Med/Rx combined at 10.04%, ...

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Covered CA Price Spikes In 2026: Inland Empire Projected To Be Hit Hard

The average rate increase is expected to be higher in Riverside and San Bernardino counties compared to most of the state.

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Setting the Record Straight: Separating Fact from Fiction on Health Insurance Marketplace Fraud

The Paragon Health Institute has published a series of new reports once again alleging large-scale “fraud” in health care. This time their target is enrollment in the Insurance Marketplace. They then use these allegations as rationale for a set of policy recommendations, including allowing the enhanced premium tax credits to expire at the end of ...

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Employers Face Vaccine Coverage Chaos As FDA Sets New Rules For COVID Vaccines

For employers, covering COVID-19 shots and other vaccinations is now a lot more complicated. Officials at the U.S. Food and Drug Administration took vaccinations off the auto-pilot list Wednesday, by withdrawing emergency use rules for COVID vaccinations like Novavax’s Nuvaxovid vaccine and tightening access rules for other COVID vaccinations. A team at the Pandemic Mitigation Collaborative says wastewater ...

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Study Suggests No Surprises Act Protections Are Reducing Patients’ Out-Of-Pocket Costs

While data released earlier this week raised questions about the administrative costs associated with No Surprises Act (NSA) arbitrations, a second study suggests the legislation is working to reduce out-of-pocket costs for members. Researchers at Harvard University and Mass General Brigham examined a sample of 17,351 privately insured adults, 8,204 of which lived in states that gained ...

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Trump Says CDC Is ‘Being Ripped Apart’ Over Covid Products, Calls For Drugmakers To Prove Their Benefits

President appears divided between RFK Jr. and detractors, despite clear evidence favoring vaccines

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Who Is Jim O’Neill, Trump’s New CDC Director

The White House quickly named a new leader of the Centers for Disease Control and Prevention (CDC) after Health and Human Services Secretary Robert F. Kennedy Jr. pushed out Director Susan Monarez this week. Jim O’Neill, a senior Department of Health and Human Services (HHS) official with deep ties to President Trump donor Peter Thiel, will take over the agency amid ...

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