As you may have read in Paul Roberts’s recent compliance column, A Deep Dive into California “Single Payer,” the most recent effort to pass some sort of single-payer health care legislation in California failed. It marks the sixth time efforts have fallen short in a push to overhaul the state’s health care system.

The Biden administration and states across the country celebrated record-breaking enrollment gains for the Affordable Care Act (ACA) this year. But state-run exchanges are eyeing backup plans for outreach and marketing in case Congress doesn’t extend beyond this year a major driver for those enrollment gains: enhanced income-based subsidies. Some officials have warned that people ...

AHIP, the top lobbying organization for commercial insurers, is warning the feds that provisions in its proposed rule governing the Affordable Care Act’s exchanges for 2023 could “undermine” the growing stability there. For instance, the group says in comments (PDF) submitted late Thursday that potential changes to requirements for essential health benefits would limit the ability for ...

Despite concerns about the bill’s policy and strategy from both sides of the aisle, nearly all House Democrats as well as a dozen Republicans voted for it Thursday.

California is developing a long-sought statewide health information exchange for providers and payers to deliver better care for patients. The health information exchange, or HIE, has received little public attention. But it would cover 40 million people in California’s 58 counties, and would in part quickly inform emergency room doctors and nurses of a patient’s ...

Regional healthcare markets across the country have experienced significant divergence in commercial-to-Medicare price ratios between 2012 and 2019, causing insurers to pay wildly different rates to hospital systems. In areas like Chico, California and Tacoma, Washington, private payers saw hospital price ratios increase by over 100 percentage points. On the other end of the spectrum, ...