Healthcare policy news covering health insurance, Medicare, Medicaid, hospital regulations, and healthcare reform legislation.
New Trump administration Medicaid work requirements, issued June 1, 2026, force states to overhaul systems by January 1, 2026, with stricter exemptions that may not cover early-stage cancer or HIV patients. The rules, stemming from the One Big Beautiful Bill Act, could affect 18.5 million adults across 42 states and D.C., raising concerns about coverage losses due to system errors.
The Paragon Health Institute report alleges 6 million people were improperly enrolled in ObamaCare exchanges in 2026, with improper subsidies totaling nearly $25 billion. CMS Administrator Mehmet Oz stated that 35% of enrollees may not be legitimate because they have never filed a claim. The report claims improper enrollments are especially problematic in states that did not expand Medicaid and those using the federal healthcare.gov platform.
Non-ACA-compliant health plans are attracting enrollees after Congress let enhanced marketplace tax credits expire. Critics warn these plans offer inadequate coverage, can deny claims with limited appeal rights, and may impose caps. A retired teacher switched to two alternative plans costing $341/month after her ACA premium nearly tripled to $914.
This commentary argues that Canada's approval of generic semaglutide highlights how US drug patent laws delay access to affordable medications. It contends that while Canada and other countries benefit from lower prices, Americans face high costs due to extended monopolies, suggesting the US system prioritizes pharmaceutical profits over patient access.
This commentary argues that the expiration of pandemic ObamaCare subsidies has not led to the predicted coverage losses, but instead reveals widespread fraudulent enrollment. Citing a Paragon Health Institute study, it contends that millions remain improperly enrolled, costing taxpayers billions in improper subsidy payments.
This commentary analyzes the Trump administration's new Medicaid work requirements, arguing that the narrow definition of 'medically frail' and reliance on self-reporting could make it harder for low-income sick people to maintain coverage. It contends the rules are stricter than anticipated and may lead to coverage losses.
Public advocate Kelly Lamrock's report found that the death of an elderly dementia patient, Alice, resulted from systemic failures in the government welfare system. Despite staff following procedures, the system prioritized compliance over care. Alice wandered 12 times and waited a year for higher-level care before being found unresponsive.
This commentary argues that state-level PBM reforms, such as ownership bans, risk worsening pharmacy access in underserved areas. It contends that while PBM practices like spread pricing need regulation, heavy-handed bans may face legal challenges and harm communities, urging lawmakers to consider market-driven alternatives.
The commentary argues that the US federal crackdown on healthcare fraud, while necessary, has imposed a nationwide moratorium on new home health and hospice providers, harming legitimate providers and patients. It contends that the administration should target enforcement against fraudsters in high-fraud areas rather than applying a broad-stroke approach that denies services to honest patients.
The author argues that the US elder care system is failing, particularly for the 'forgotten middle' who earn too much for Medicaid but too little to afford care. She contends that cultural narratives of rugged individualism and personal responsibility ignore systemic inequalities, such as racial wealth gaps and the financial burden on women caregivers.