Rising Specialty Drug Costs Drive Use of Controversial Employer Funding Programs
Increasing specialty drug costs lead to greater use of alternative funding programs in employer health plans, raising access and cost concerns amid rising drug prices.
U.S. Sterilization Coverage and Access: Policies, Trends, and Market Implications
Comprehensive overview of sterilization coverage, insurance policies, provider restrictions, and post-Dobbs trends affecting family planning in the U.S.
Republican Megabill Cuts Medicaid and Expands Care Tax Credits with Limited Impact
The 2025 Republican megabill introduces Medicaid cuts and expanded care tax credits, affecting access to child care, paid leave, and long-term care services with mixed outcomes.
Trump Administration Ends ACA Health Coverage Eligibility for DACA Recipients
The Trump administration ends ACA health coverage eligibility for DACA recipients, potentially affecting thousands in the U.S. insurance market and public health.
Congressional Opposition Mounts Against CMS Medicare Prior Authorization Expansion
Congresswoman Maggie Goodlander and colleagues urge CMS to halt the proposed expansion of prior authorization in Traditional Medicare, citing risks to patient care and administrative burdens.
2026 Medicare Part D Updates: Premium Increases, Penalties, and Cost Caps
Explore the 2026 Medicare Part D updates including premium increases, delayed enrollment penalties, and maximum out-of-pocket caps for prescription drugs, with insights into Medicare Advantage plan impacts.
CMS Proposes Voluntary Medicaid and Medicare GLP-1 Coverage Trial
CMS plans a voluntary five-year trial allowing state Medicaid and Medicare Part D plans to cover GLP-1 weight management drugs, including Ozempic and Wegovy, starting in 2026-27 amid pricing and coverage challenges.
Medicaid Coverage for Nursing Home Care: Eligibility, Risks, and Financial Pressures
Explore Medicaid's role in funding nursing home care, eligibility requirements, risks of coverage loss, and financial pressures facing providers and states amid a rising senior population.
Understanding the Medicare Cliff: Transitioning from Medicaid at 65
Explore the Medicare cliff phenomenon where older adults lose Medicaid coverage at 65, leading to increased Medicare costs and coverage changes. Understand eligibility, cost differences, and programs to ease the transition.
Medicare LI NET Program Offers Temporary Drug Coverage for Low Income Beneficiaries
The Medicare LI NET program provides temporary prescription drug coverage without restrictions to low income beneficiaries not yet enrolled in a Part D plan, ensuring seamless access during the transition period.