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.
Robert F Kennedy Jr, the US health secretary, on Sunday told American parents that they should get their children vaccinated against measles, as the surge in infections has reached numbers not seen in the past 35 years. Kennedy, a leading vaccination skeptic who has spent years amplifying misinformation about vaccines, including the shot that protects against measles, mumps ...
As care continues to move beyond the hospital, pharmacy has become an increasingly important enterprise capability that influences patient access, financial performance and long-term growth. This evolution is driven not only by drug acquisition costs but also by utilization growth, reimbursement complexity, payer-driven site-of-care restrictions, specialty pharmacy access and advanced therapies. “For health system leaders, ...
Vanessa Barahona received a call this past spring from Angelica at Kern Family Health Care in Bakersfield, California, telling her it was time to renew her coverage under Medi-Cal, the state’s version of Medicaid. Angelica helped Barahona, 41, schedule an appointment to complete her paperwork in person at Kern Family’s offices before she submitted it ...
Employer benefits are under more pressure and scrutiny than they have been in years. “Cost volatility, more complex workforce needs, tighter regulatory requirements and emerging technologies such as AI are pushing organizations beyond incremental adjustments toward more disciplined benefit management,” according to the latest Benefits Benchmarks report from Gallagher. The report focused on five key ...
Democratic attorneys general are making a renewed push to challenge the latest regulation governing the Affordable Care Act’s marketplaces. In a lawsuit filed Friday, the AGs of 21 states, as well as Pennsylvania Gov. Josh Shapiro, argue that the rule, which establishes key policies for the 2027 plan year, will make ACA plans more expensive ...
California House Republicans are asking the Trump administration to prevent Democratic state leaders from implementing a new tax on health insurers. Six House members, including Reps. Kevin Kiley, I-Rocklin, and James Gallagher, R-Yuba City, sent a letter Friday to U.S. Department of Health and Human Services Secretary Robert F. Kennedy, Jr. and Centers for Medicare ...
Health plan cost trends for employer-sponsored benefits are approaching their highest levels in 15 years, fueled by inflationary pressure, AI implementation, a broken No Surprises Act dispute resolution process and market consolidation. “We have seen elevated medical trends for several years, but costs now feel like they’re reaching a breaking point,” said Edward Kaplan, national ...
The Trump administration is withholding more than $1 billion in Medicaid funding to California and Minnesota over what it deems suspect claims. Tuesday’s funding suspension is the latest action by the Centers for Medicare and Medicaid Services to target Medicaid funding in the two states. More than $2.5 billion has been deferred from them due ...
The No Surprises Act’s arbitration process awarded close to $15 billion to providers in 2025, according to a Wall Street Journal analysis of federal data. Payouts through the independent dispute resolution process reached $14.85 billion in 2025, up from just $4.08 billion in 2024, the Journal reported. Arbitration firms collected about $1.3 billion in fees last year. “This law ...
A House member has an idea for making employer-sponsored health coverage cheaper and more flexible: Exempt the plans from the Affordable Care Act essential health benefits rules. The bill would, in effect, give small employers with fully insured group health plans a choice about whether to cover prescription drugs, maternity care or surgery, and it ...