For too long, the healthcare system has been reactive, focused on treating illness after it occurs rather than anticipating and preventing it. At the same time, consumers have come to expect personalized, seamless experiences in every part of their lives,…
Author: Jakob Emerson
Nevada Medicaid is seeking proposals from insurers to offer a Coordination Only Dual Eligible Special Needs Plan. Proposals are due Feb. 17, with a contract expected to run from Jan. 1, 2027 through Dec. 31, 2030. The state may award…
A federal judge has ruled that Luigi Mangione will not face the death penalty in the federal case stemming from the killing of UnitedHealthcare CEO Brian Thompson. On Jan. 30, U.S. District Judge Margaret Garnett dismissed two of the four…
CMS has issued a final rule that will end states’ ability to levy provider taxes to generate additional federal Medicaid matching funds, a financing mechanism the agency characterized as a “loophole.” The rule, effective April 3, implements changes included in…
Payers are continuing to trim their workforces amid financial pressures, Medicaid funding cuts and strategic restructuring. Below are workforce reduction efforts or job eliminations that were announced or take effect in 2026. Insurance industry layoffs in 2025 are here. The…
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Enhanced ACA premium tax credits expired Dec. 31, leaving millions of marketplace enrollees facing higher premiums in 2026. A bipartisan group of senators continues negotiating, and Republicans are preparing a “best and final” offer on a two-year extension with income…
Nearly 23 million people have enrolled in ACA marketplace plans for 2026, down from 24.2 million in 2025, according to the latest data from CMS published Jan. 28. For the 30 HealthCare.gov states, the data is through Jan. 15. For…
Over the past week, health insurers have drawn the ire of lawmakers on both sides of the aisle and seen their collective stock prices drop by nearly $100 billion following unfavorable Medicare Advantage news from CMS. All this while millions…
L.A. Care Health Plan has named Rob Geyer as its first chief operating and systems integration officer. Mr. Geyer will be responsible for integrating and aligning the insurer’s information technology, operations, and customer service departments, according to a Jan. 28…
More than 850,000 members of Horizon NJ Health, the managed Medicaid plan operated by Horizon Blue Cross Blue Shield of New Jersey, will lose in-network access to CVS pharmacies after April 30. The insurer is advising affected members to transfer…