Payer Issues Archives - Becker's Payer Issues

A bad week for insurers | CMS snags $600M to support Medicaid work rules | CVS, Horizon BCBS Medicaid to split | ACA enrollment drops to 23M | 5 M&A updates

From disappointing CMS news to massive stock selloffs, insurers are having a tough week January 29, 2026 1. A bad week for health insurers Full story 2. ACA enrollment falls to 23 million for 2026 Full story 3. Health insurance…

UnitedHealthcare projects 2.8M fewer members | Horizon NJ cuts jobs | Elevance posts $5.7B profit in '25 | Providers winning 88% of No Surprises disputes | Providence CEO calls for MA 'reset'

UnitedHealthcare is set to lose millions of members and another Blues plan is cutting jobs January 28, 2026 1. UnitedHealthcare expects to lose up to 2.8 million members in 2026 Full story 2. Horizon BCBS New Jersey lays off 242…

UnitedHealth projects '26 revenue decline | CMS pitches flat MA payments in '27 | Texas governor orders Medicaid fraud probe | CVS accused of impeding pharmacy competition | 8 prior auth updates

UnitedHealth is projecting a revenue decline in 2026 and CMS won’t boost MA rates by much January 27, 2026 1. UnitedHealth's 2025 profit dips to $12.1B Full story 2. CMS proposes nearly flat Medicare Advantage payments for 2027: 6 notes Full story…

Payer CEOs urge 'deescalation of tensions' | ND approves BCBS, Cambia deal | CareFirst sues over MA star ratings | Mangione trial to begin in Sept. | Alignment taps Optum exec for chief digital role

Payer CEOs urge calm after weekend of violence in Minnesota and CareFirst is the latest to sue CMS January 26, 2026 1. Payer CEOs call for 'deescalation of tensions' in Minnesota Full story 2. CareFirst BCBS sues over 2026 Medicare Advantage…

Congress grills payer CEOs | Ind. bill targets Elevance's out-of-network penalty | Payers prep for major winter storm | House passes health spending package | Mo. eyes prior auth reform

Payer CEOs squared off for hours with House lawmakers and Indiana is targeting Elevance’s out-of-net January 23, 2026 1. 'Vertical integration is destroying people's ability to access care': Payer CEOs face bipartisan congressional grilling Full story 2. Hospital, provider groups…

False Claims Act settlements hit record | Trump's health plan: 3 big unanswered questions | 3 drugs to watch: Optum | Improper Medicare payments reach $28B | 5 'most admired' insurers

Big questions loom over Trump’s healthcare plan and False Claims Act settlements hit a record high i January 22, 2026 1. False Claims Act settlements, judgments top $6.8B in 2025: 6 notes Full story 2. 3 big questions about Trump's…

Payer CEOs prep for Congress | Congress' bipartisan health deal: 8 notes | ACA plans unaffordable in most markets: Study | The case for copay-only plans | 5 prior auth updates

Payer CEOs are headed to D.C. this week and Congress has pitched a new healthcare package January 21, 2026 1. Payer CEOs point to hospitals, drug manufacturers for rising costs ahead of congressional hearings Full story 2. Congress pitches bipartisan…

States ranked by ACA enrollment change | Hawaii BCBS, Hawaii Pacific Health proposal under fire | U of Utah Health Plans names part-time CFO | Alignment CEO at JPM | Missouri sues PBMs over insulin

States in order of ACA enrollment change, and affiliation tensions January 20, 2026 1. States ranked by ACA enrollment change since 2025 Full story 2. 'Too good to be true': Providers, insurers weigh in on potential HMSA, Hawaii Pacific Health…

Trump's 'Great Healthcare Plan': 3 notes | ACA open enrollment wraps | Top-rated plans for member experience | Wash. fines Kaiser over mental health parity | Mass. considers prior auth reform

Trump pitches a health policy framework and ACA open enrollment has wrapped January 16, 2026 1. Trump pitches healthcare policy outline aimed at lowering costs: 3 takeaways Full story 2. ACA open enrollment wraps: 6 things to know Full story…

Kaiser to pay $556M to settle MA case | Calif. payer to cut 3% of workforce | 4 Corewell hospitals leave UHC network | NY to reform prior auth | 4 payer M&A deals

Kaiser Permanente’s settlement, and L.A. Care Health Plan to lay off 225 January 15, 2026 1. Kaiser Permanente agrees to pay $556M to resolve Medicare Advantage whistleblower allegations Full story 2. California payer laying off 3% of workforce amid Medicaid…

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