No solution reached for expiring ACA subsidies and BCBS consolidation continues December 12, 2025 1. Competing bills tackling ACA subsidies fail in Senate Full story 2. Highmark, BCBS Kansas City to affiliate Full story 3. What's helping pharmacies meet payer…
Payer Issues
ACA enrollment hasn’t slowed down and insurers are prepping for Medicaid work rules December 11, 2025 1. ACA enrollment tracking ahead of last year: 6 notes Full story 2. Louisiana cuts UnitedHealthcare Medicaid contract, affecting 330,000 enrollees Full story 3.…
Republicans aren’t pitching an ACA subsidy extension and Optum is accused of worsening the opioid cr December 10, 2025 1. GOP prepares vote on competing bill addressing ACA subsidy expiration Full story 2. West Virginia sues Optum over opioid crisis Full story…
CMS weighs in on the MA broker pay issue and a new vertically integrated system could form in Hawaii December 9, 2025 1. Hawaii health system, state's largest payer in merger talks Full story 2. CMS: States cannot regulate Medicare Advantage…
UnitedHealth calls a hospital’s MA lawsuit a publicity stunt and Florida eyes ICHRA innovation December 8, 2025 1. 'This litigation is a PR stunt': UnitedHealth seeks to dismiss Medicare Advantage lawsuit from Ballad Health Full story 2. Florida floats insurance…
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Humana and Mark Cuban hint at partnership and Senate Dems push for ACA subsidies’ last chance December 5, 2025 1. Senate Democrats push 'last chance' 3-year ACA tax credit extension Full story 2. Humana CEO, Mark Cuban hint at pharmacy partnership…
UHC shooting fallout, Aetna revamps auth and Zing challenges CMS December 4, 2025 1. One year after CEO's killing, UnitedHealth navigates a financial reset Full story 2. Aetna merges prescriptions, procedures into single prior authorization Full story 3. 83% faster…
J&J wins an employee benefits lawsuit and hospital-insurer network splits loom in ’26 December 3, 2025 1. CVS settles insulin dispensing case for $38M Full story 2. Judge dismisses lawsuit accusing J&J of mismanaging employee drug benefits Full story 3.…
Mangione returns to court and a contract break in NC leaves thousands without coverage December 2, 2025 1. Luigi Mangione returns to court for pretrial hearings in UnitedHealthcare CEO killing Full story 2. UNC Health goes out of network with…
UnitedHealth is leaving South America and another Blues plan is offering employee buyouts December 1, 2025 1. UnitedHealth to sell last South American business Full story 2. Arkansas BCBS offers employee buyouts Full story 3. EDs overcrowded, telemetry overused. A…