Healthcare policy news covering health insurance, Medicare, Medicaid, hospital regulations, and healthcare reform legislation.
Japan will increase caps on out-of-pocket medical expenses by 4% to 38% depending on income, starting August 2026, with a second hike in August 2027. For middle-income patients, the monthly cap rises from ¥80,000 to about ¥86,000. These are the first changes for the working generation since 2015.
Medicare's new GLP-1 Bridge trial starts July 2026, offering certain GLP-1 drugs for $50 monthly to eligible beneficiaries with Part D coverage and specific BMI/health criteria. The program runs through 2027, excluding those with sleep apnea, diabetes, or fatty liver disease who may have separate coverage.
California and Nevada lawmakers are advancing laws to publicly identify large companies whose employees rely on Medicaid, ahead of a Trump administration deadline for new work requirements. California's bill targets firms with 100+ workers on Medi-Cal, while Nevada has had a similar law since 2017.
One year after health insurers pledged to reduce barriers to care, some now refuse to implement all promised initiatives. Patients and advocates report little improvement, and Rep. Greg Murphy called the pledge 'no teeth.' Insurers claim a reduction in prior authorizations.
A federal judge appointed former Ohio prisons chief Annette Chambers-Smith as receiver with sweeping powers over Arizona's prison healthcare system, citing constitutional violations. She can override state laws on privatization and pay caps.
CMS proposed an overhaul allowing Medicare ACOs to reduce or eliminate cost-sharing for Part B services starting 2027. The plan also recognizes 'Software as a Medical Service' and explores payment for tech-enabled care, aligning with the administration's health directive.
The author argues that Massachusetts' primary care reform bill, while beneficial, must not undermine safety net hospitals. She contends that increasing primary care spending to 15% of health expenditures by 2030 is prudent, but warns that safety net hospitals, which bear the brunt of policy changes, need protection to ensure the reform's success.
Elizabeth Mitchell of the Purchaser Business Group on Health outlined employer priorities for healthcare reform, including boosting primary care, banning anti-competitive practices, and increasing price transparency. Employers cover over 160 million Americans, with healthcare as their second-largest cost.
New York state now spends more on Medicaid ($39.4 billion) than on K-12 schools ($37 billion) in the 2025-26 fiscal year, per Comptroller Tom DiNapoli. New York pays the highest per-person Medicaid costs in the US, and the federal government is investigating potential waste and fraud in the program.
An NHS scheme to clean up patient lists has wrongly removed homeless and migrant patients, with 400,000 removed between January and June. London accounts for over 40% of removals, costing surgeries £17 million in lost funding.