Congress faces a deadline to extend ACA subsidies that prevent premium hikes for millions, but partisan divisions create uncertainty amid a critical midterm election year.
CMS’s 2026 OPPS final rule updates outpatient payment policies, adjusts 340B drug recoupment, extends site-neutral payment models, expands ASC services, and enhances hospital price transparency requirements effective January 2026.
Bipartisan INVEST Act advances to House, expanding 403(b) access to collective investment trusts and annuity options, enhancing retirement security and reducing costs.
The Medicare Diabetes Prevention Program has enrolled less than 1% of eligible beneficiaries since 2018 due to administrative, referral, and awareness challenges despite proven effectiveness. CMS changes aim to improve access and provider reimbursement.
Medicare's outdated reimbursement system is jeopardizing rural office-based medical practices by underpaying for advanced outpatient procedures, leading to consolidation and increased healthcare costs. Proposed reforms aim to preserve independent care and improve access.
CMS's 2027 Proposed Rule for Medicare Advantage revises Star Ratings by focusing on clinical quality and member experience, delaying equity-focused rewards, and enhancing integrated care for dual-eligible populations.
Florida's 2022-2023 insurance reforms have significantly stabilized its P&C market by reducing litigation abuse and attracting reinsurers, according to Insurance Commissioner Mike Yaworsky. The reforms curb assignment-of-benefit abuses and reduce claims litigation, leading to improved market stability and expanded consumer coverage options.
Starting 2026, Cleveland Clinic expands healthcare access through AmeriHealth Caritas Florida’s network, enhancing provider options for Marketplace and Medicare Advantage members in South Florida.
This analysis reviews the critical role of health insurance coverage under the ACA in improving access to care, health outcomes, and financial protection for millions of Americans amid ongoing policy debates.
CMS introduces the ACCESS Model to enhance chronic care for Medicare beneficiaries using digital health tools and outcome-based payment models starting in 2026.
