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.
Centene pulled back its guidance for the year after receiving an actuarial report suggesting its growth in the Affordable Care Act marketplaces will be lower than expected. The insurer said an analysis from Wakely predicted that market growth in 22 of its states will fall short of expectations, and “aggregate market mobility” in those regions ...
A new report from federal actuaries estimates national health spending will increase by 7.1% in 2025, with spending growth set to outpace growth in the U.S. gross domestic product. The Centers for Medicare & Medicaid Services Office of the Actuary released its annual look at spending projections last week, and it estimates that from 2026 ...
Doctors for America, the Main Street Alliance and three cities have sued the Centers for Medicare & Medicaid Services (CMS) over a recent Affordable Care Act (ACA) final rule the agency said will help counter improper enrollments. The plaintiff cities named in the lawsuit are Baltimore, Chicago and Columbus. The groups and cities say the ...
House fiscal hawks are looking at the math underlying Senate Republicans’ sprawling domestic policy legislation, and they don’t like what they see.
California Gov. Gavin Newsom signed on Friday a budget that pares back a number of progressive priorities, including a landmark health care expansion for low-income adult immigrants without legal status, to close a $12 billion deficit. It’s the third year in a row the nation’s most populous state has been forced to slash funding or stop some ...
The Affordable Care Act (ACA) established the Patient-Centered Outcomes Research Institute (PCORI) to fund research into the effectiveness, benefits, and harms of various medical treatments and interventions. This research is funded in part by the PCORI fee – an annual fee paid by: Health insurance carriers on fully insured medical plans, and Employers that sponsor self-funded medical plans (including ...
Effective July 1, 2025, Optum Rx is removing reauthorization for more than 60 drugs that treat chronic conditions. The newly added medications include treatments for seven chronic conditions, such as behavioral health, HIV, dry eye disease, high cholesterol and hypertension. “Chronic conditions affect about 60% of Americans and are the leading cause of death in ...
The Supreme Court upheld a key preventive services task force in a 6-3 ruling issued Friday morning. The high court determined that members of the U.S. Preventive Services Task Force, which makes recommendations for coverage requirements under the Affordable Care Act, are selected within the bounds of the Constitution. In the case, Braidwood Management, an ...
In 2025, nearly 4 in 10 people said they worried about being able to afford their medications, up significantly from 27% in 2024.
US health officials met with with Walmart Inc., Amazon.com Inc. and other retailers this week as part of an effort to help Americans get their medicines more directly from companies that make them, according to people familiar with the talks. The conversations between the Trump administration and experts from the nascent straight-to-consumer drug industry are ...