The Department of Labor is proposing a new rule that would let employer group health plans deliver required documents to workers electronically by default, a change the department estimates could save plans $3.9 billion over the next decade. The proposed…
Policy Updates
In June 2025, health insurers pledged to simplify and reduce prior authorization requirements, affecting plans covering 257 million Americans. It’s been over one year since, and, while payers have been vocal about their progress, there are still big steps left…
A newly proposed federal bill would create a government-run public health insurance option sold on the ACA exchanges and permanently extend the enhanced premium subsidies that lapsed at the end of 2025. The Medicare-X Choice Act, introduced July 15 by…
Senate Republicans have blocked an effort to advance a Democratic-led resolution to repeal CMS’ Wasteful and Inappropriate Service Reduction model, an AI-assisted prior authorization pilot within the traditional Medicare program. On July 16, senators voted 46-50 along party lines against…
The Coalition Against Surprise Medical Billing, which includes AHIP and employer groups as members, rolled out a six-figure ad campaign July 13 against the No Surprises Act Enforcement Act. Rep. Gregory Murphy, MD, R-N.C., introduced the bill July 23, 2025,…
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Hawaii Gov. Josh Green signed a bill July 8 that expands colorectal cancer screening coverage and creates state-funded assistance for uninsured residents. The legislation requires state-regulated fully insured plans to pay for colorectal cancer screening using all A and B…
The Alliance of Community Health Plans formed a patient advisory council — including those with diabetes, caregivers and community advocates — to guide research. The council strives to include patient perspectives in chronic disease research and initiatives, a July 9…
Vermont Republican Gov. Phil Scott signed an executive order July 8 to kick off a state initiative focused on healthcare affordability. The order prompts state agencies to act within their existing authority and develop statutory reform recommendations for the 2027…
Sens. Kirsten Gillibrand, D-N.Y., and Eric Schmitt, R-Mo., sent a letter June 26 to Defense Secretary Pete Hegseth urging the Defense Department to act on a report regarding Tricare’s autism program. A September National Academies of Sciences, Engineering, and Medicine…
Prior authorization reform is moving on multiple fronts in 2026 — through Congress, state capitals, federal courtrooms and the exam rooms where physicians spend an average of 13 hours per week on PA paperwork alone. Here are 10 recent updates…