Employers Shifting To Self-Insurance Will Still Face Soaring Costs, Voya Says

Voya has bad news for employers with fully insured health plans that want to avoid big cost increases by shifting to self-insured plans: Rates for stop-loss insurance will also go up. A lot.

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Bay Area County Could Raise Taxes To Offset Trump Medicaid Cuts

In response to recent federal legislation that cuts billions of dollars to Medicaid, Santa Clara County supervisors on Thursday unanimously voted to add a ballot measure to November’s special election that would increase local sales tax by five-eighths of a cent (0.625%) for five years to try to backfill some of the projected lost federal ...

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Kaiser Permanente Notches 3.2% Operating Margin, $3.3B Net Income In Q2 2025

Kaiser Permanente closed its second quarter of the year with a billion dollars of operating income and a $3.3 billion bottom line—but operating headwinds on the horizon have leadership taking a hard look at the health system’s cost structure and potential efficiencies. The quarter’s performance is a step ahead of last year, when the integrated ...

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New Medicaid Federal Work Requirements Mean Less Leeway For States

When President Donald Trump signed a law adding work requirements for some Medicaid recipients, he may have undercut lawmakers in at least 14 states who were designing their own plans, according to health industry observers. Georgia is the only state with a work requirement in place for Medicaid, but several states have been pursuing such ...

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Drug Price Negotiation Program Sidesteps Latest Legal Obstacle

The drug price negotiation program has withstood another procedural effort in striking down one of the Inflation Reduction Act’s most significant provisions. In the U.S. Court of Appeals for the 6th Circuit, a panel of judges upheld (PDF) a lower court’s decision to dismiss the lawsuit. A judge dismissed the lawsuit last year, saying most of the ...

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A Look At The State Of Prior Authorization In Medicaid

A new analysis from KFF and Health Management Associates takes a dive into prior authorization practices for Medicaid managed care organizations. The study polled state programs on policies in place as of July 2024 and found that more than half of the 36 states that responded required that insurers make “standard” prior auth determinations within seven days ...

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