Health insurance news covering payers, premiums, Medicare Advantage, ACA markets, and benefit design.
Approximately 94,000 Virginians have dropped their Affordable Care Act insurance since last year, reducing total enrollees from 389,000 to 295,000. The decline is largely attributed to the expiration of federal subsidies that previously expanded marketplace access for lower-income individuals.
GoodRx announced Companion, a new family healthcare subscription offering 250 free generic medications and discounted services for $24.99 monthly. The program addresses affordability gaps caused by rising deductibles and will launch through employer health benefits starting January 1, 2027.
Large and small employers face an average 11 percent increase in healthcare coverage costs next year, marking the largest rise in decades. This projected hike exceeds double the current inflation rate, prompting businesses to raise employee premiums, copays, and deductibles to manage expenses.
Mercer and Aon project US employer health benefit costs will rise by 8.2% to 9.5% in 2027, driven by provider consolidation and AI-enabled billing. Marsh attributes one percentage point of this increase to the growing use of expensive GLP-1 weight loss drugs in employer plans.
A JAMA Health Forum study finds that Medicare Advantage enrollees diagnosed with serious conditions, particularly Alzheimer's disease, are significantly more likely to switch to traditional Medicare. Other health issues prompting these switches include heart attacks, chronic kidney disease, and stroke, highlighting the challenges of maintaining private coverage during severe illness.
Oregon Health & Science University and Regence BlueCross BlueShield of Oregon announced a multi-year agreement to keep OHSU facilities in-network for employer-sponsored health plans. The deal excludes OHSU from Medicare Advantage and individual marketplace networks starting January 1, 2027, affecting over 44,000 enrollees.
The article argues that electing COBRA coverage after divorce does not pause Medicare's eight-month Part B Special Enrollment Period. It warns that delaying enrollment until COBRA expires can result in permanent premium penalties and reduced benefits, as COBRA is not considered current employment-based coverage.
The article argues that high-net-worth individuals can still qualify for Affordable Care Act subsidies because eligibility is based on modified adjusted gross income rather than net worth. It highlights the return of the 400% FPL cliff for 2026 and warns that Roth conversions increase MAGI, potentially disqualifying retirees from these tax credits.
Oregon will launch ExploreHealthOR.gov on November 1, replacing Healthcare.gov for private coverage shoppers. The transition affects nearly 120,000 residents currently using the federal platform. State officials cite improved flexibility for local needs as a key benefit over the federal system.
Derrick Duke, CEO of eHealth, argues that Medicare beneficiaries suffer from a dangerous knowledge gap despite high self-reported confidence. He contends that the complex system leads to costly mistakes, such as late enrollment penalties and skipping Part D coverage, emphasizing the necessity of annual plan reviews.