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Five midterm winners and losers: MAHA mowed down, Dem docs scrub in, Medicare for All returns
Democratic doctors were among the winners in the midterm elections, while the MAHA movement and President Trump's health agenda were losers.
Medical Advantage plans to leave NH including CVS Health, BMC Health System
There are major upcoming changes to Medicare Advantage plans that will impact thousands of Granite Staters.
Why science is on the ballot in the 2026 midterm elections
From Medicare for All to research grants, science-driven issues are playing a role in the midterm elections
Clover Health boosts outlook amid continued membership growth, financial momentum in Q3
Clover Health is continuing to see strong traction in its Medicare Advantage plan, with membership growing 49% year-over-year in the third quarter to approximately 157,000 members. | The company posted $130 million in profit, up 77% year-over-year, according to Q3 2026 financial results.
E-Z Health helps seniors find relief with dedicated healthcare phone guides
Closing the technology gap, a Medicare-covered program is helping seniors find local resources and save money on essential services. FOX 10's Annalisa Pardo reports.
Local health insurance broker highlights changes coming to Medicare, healthcare policies in 2027
As over a million Coloradans review their healthcare plans for Medicare’s open enrollment period — running from Oct. 15 to Dec. 7 — a local health insurance broker is preparing
Can AI solve our mental health access problem?
Last week I asked you what worries you most about AI in health. It was close, but your top answer was “AI giving bad health advice.” Last week’s poll results: You’re in good company. This concern was top of mind at a conference I joined at Stanford last week, where researchers, clinicians, and people who build AI systems spent a day debating trust and safety in health AI. Stepping back, I’m also hearing your emerging concerns about AI’s impact on our well-being generally. I see this as a matter of public health, and we’ll take it in pieces as we learn together. Today we’ll focus on AI chatbots used for therapy for mental health. Early this month, Governor Newsom vetoed Senate Bill 903, California’s most ambitious attempt to regulate AI use for mental health. It’s at the center of active debate, and raises the questions patients, family members, citizens, and voters will face as AI moves deeper into health care. Let’s work through it. What is “AI-based therapy”? It’s really two things: purpose-built mental health apps designed to deliver structured support, and general chatbots like ChatGPT, Claude, and Gemini that people increasingly use for emotional support—even if they weren’t built for it. Spoiler alert: I don’t know whether the shift toward AI therapy is good or bad. The evidence isn’t there yet. But I do know it’s already happening, and I have some ideas about how we can roll it out with safety in mind. The therapy dilemma, in a nutshell Mental health challenges are common, and strain health and well-being across populations. Therapy (interactive dialogue with a trained, empathetic practitioner) helps many people heal. The demand for licensed therapists far exceeds the supply in California, and AI-based therapy can narrow that gap. AI-based therapy remains novel, unproven, and not well tested. Right off the bat, we can see we’re dealing with trade-offs here. Since the main driver of demand for therapy from a robot is lack of access to therapy from a human, we’ll start there. It’s too hard to find and afford a human therapist California is short roughly 55,000 licensed, non-prescribing therapists and counselors, about 40% of what we need. Psychiatrists, who rely on talk therapy as a complement to prescribed medications, are even more scarce. Eight counties have none, and density ranges from 1.7 per 100,000 residents in San Benito County, to 68.1 in Marin County. My wife is a psychiatrist in Marin, and even here access is tight. If it’s hard in the best-supplied county, imagine rural Sierra County, or the San Joaquin Valley. In 2024, more than half of Californians who tried to make a mental health appointment struggled to find a provider who took their insurance, compared with 14% for physical health care. When Senate staff posed as “secret shopper” patients and called 120 mental health providers in Medicare Advantage networks, they landed an appointment less than once for every five tries. Insurers pay behavioral health clinicians about 22% less than medical and surgical clinicians for comparable office visits. On top of that, billing denials and prior authorizations hit hardest at the solo and small practices common in mental health. Psychiatrists opt out of Medicare at the highest rate of any specialty. In many places, a cash practice for therapy fills quickly with patients paying $250 or more an hour, with no insurance paperwork at all. Families who can pay cash find providers more easily. Those who rely on insurance, including Medi-Cal enrollees, older adults, rural residents, and non-English speakers, compete for what’s left. So we can’t pretend the human system works, and we can’t blame people for turning to AI for support when they’re in distress. AI is filling the gap It’s estimated that roughly a quarter of AI users use it for mental health support. If you have internet, it’s available 24/7, it’s cheap, and it speaks your language. Uninsured adults are about twice as likely as insured adults to do it (30% vs. 14%). It feels anonymous in ways that may enable people to ask things they’re unsure or embarrassed about. The largely hidden, personal use makes it hard to study whether it’s actually helping people with their mental health issues, but researchers are trying. Does AI therapy work? A 2026 analysis of nearly 40 randomized trials found chatbots showed a real but small reduction in depression symptoms. But most of these trials were compared to an alternative of no therapy, not a human therapist. So the benefit of AI therapy is probably real, but modest, and mostly untested against the alternative of human contact. We need more studies. Serious concerns OpenAI’s own estimate is that more than a million ChatGPT users each week show signs of suicidal planning or intent. These are high stakes encounters, and AI doesn’t always get it right. That’s partly because a chatbot can sound like a therapist, but it has no license, no duty of care, and it’s not clear who to hold accountable when it gets things wrong. AI is also designed to help users in whatever task they’re seeking to accomplish. People may feel like they’re getting therapy, but they’re mainly getting a convincing conversation. It’s easy for an AI companion to wander into gray areas, like playing along with “creative writing” that may be about the user’s own suicidal intent. Courts are driving safety conversations A wave of lawsuits have been filed on behalf of families claiming that chatbots pushed people they loved toward self-harm, including teens who died by suicide. The first settlements came this year. OpenAI is headquartered in San Francisco, and dozens of cases alleging that ChatGPT drove users to suicide or self-harm are now before a San Francisco judge. Character.ai has filed for bankruptcy after several states brought lawsuits accusing the chatbot of pushing dangerous content to kids. But the technology seems to be improving. Last month, an independent evaluation found that newer AI models “almost never endorse suicide.” That’s progress, but our societal appetite for even one preventable death is very low. So how do we move forward? Finding a middle ground Earlier this month the governor vetoed Senate Bill 903, a bill designed to place guardrails on the use of AI for therapy. The bill would have prohibited any AI-based platform from being advertised as psychotherapy, and would have required a licensed professional to review and approve each encounter where AI was used to support therapeutic decisions. Newsom called it overly broad, since even routine screening questions would have needed clinician sign-off. Knowing we’re already short on mental health providers, requiring human review of AI encounters may not relieve our access problems. Still, the answer isn’t no oversight. Here’s one feasible short term solution. Rather than reviewing each encounter, a licensed clinician can design the guardrails: what counts as a crisis, what triggers an immediate handoff to a human, and what gets sampled for audit each month. The AI runs inside that structure. Conversations get checked, failures get reported, and a real clinician owns the framework. Medicine already has models to learn from. The FDA process for rolling out newly approved medications is an example. After a product reaches patients, we keep watching for adverse events. Patient-facing AI needs the same “digital pharmacovigilance”: systematic tracking of harms, near misses, and the types of groups that get hurt and why. It’s also critical that users know that they can reach a human if they’re in crisis. Most chatbots now include messages like these: Bottom line The rush to use unproven AI tools for mental health support is mostly a workaround, a sign of a health system people can’t get into. We need better access to proven care from licensed clinicians. That takes reimbursement that makes accepting insurance viable, and a bigger workforce. But, built and tested well, AI could be part of the answer. It could be the 2 a.m. check-in when no one else is awake, or a way for patients to practice skills their therapist taught them. It could be the first step to get someone the right level of care, and take paperwork off clinicians’ plates so they spend more time with patients. None of this is simple. The SB 903 veto doesn’t end the debate, and the legislature will be back. In the meantime, those of us using these tools need to stay informed, ask hard questions, and hold the companies building them accountable. I’ll try to do my part, and we’ll keep learning together. Love,Matt P.S. If you or someone you know is struggling with mental health challenges, emotional distress, substance use problems, or just needs to talk, call or text 988- you’ll reach a real person— or chat at 988lifeline.org 24/7. Dr. Matt Willis is the author of Your Local Epidemiologist in California. A California native, he’s served as a primary care physician, CDC epidemiologist, and public health officer for Marin County, where he guided the pandemic response. He lives in Marin with his family and their dogs, Teddy and Ramona. Thank you Cynthia He, MD, PhD, and Parnika Saxena, MD, for their guidance in preparing this article. Cynthia works in an outpatient mental health clinic, treating patients who have Medi-Cal or, sometimes, no insurance. Parnika works in an inpatient psychiatric unit, treating patients with public or private insurance or self-pay ability. All opinions are their own and do not represent their employers.
Older breast cancer survivors fall through Medicare home health gap
Among the increasing number of women who survive breast cancer, many older, long-term survivors remain frail. A new study out today in the Journal of the National Cancer Institute shows that in a given ...
WKYT Fact✓Check|Booker, Barr claims on health care costs and Medicare for All
Democratic U.S. Senate candidate Charles Booker and Republican U.S. Rep. Andy Barr are clashing over health care affordability as they compete to replace retiring Sen. Mitch McConnell.
CMS Finalizes 2027 Home Health Rule With Sweeping Regulatory Changes
The U.S. Centers for Medicare & Medicaid Services (CMS) has finalized its 2027 home health rule, which contains significant regulatory updates that
Health care on the ballot; Botox billing doctor gets 15 years; Medicare prior auth pilot curbs services
The top news stories in medicine today: At least 125 health professionals are on today's ballots as California votes on a clinic spending rule; a California doctor gets 15 years for $45 million in Medicare Botox billing; Medicare's prior authorization pilot curbs targeted services.
Centene reports early Medicare Advantage rebound
Centene said lower-than-expected medical costs put its Medicare Advantage business on track to break even in 2026, a year earlier than planned.
NH News Recap: Health insurance changes and a new season of Bear Brook
Looming changes to Medicaid and Medicare in New Hampshire are leaving recipients with questions, and the first episodes of the latest season of NHPR podcast "Bear Brook" are now available.
Trump increased investments in drugmakers that benefited from Medicare exemptions, Democrats say
WASHINGTON (AP) — Investments in pharmaceutical companies made on behalf of President Donald Trump increased significantly after he returned to the White House last year, with his portfolio adding mil...
UP Health System to leave Humana’s Medicare Advantage network in 2027
The coverage will end effective Jan. 1, 2027, and may impact some patients’ in-network access to UP Health System offerings.
Medicare for All vs. moderate Democrats
Most Democrats in competitive races are moderates who aren't big fans of a single-payer system.
Jefferson Health-Independence contract dispute worries Jefferson patients with IBX Medicare Advantage plans
IBX Medicare Advantage customers who are Jefferson Health patients have a choice: switch plans or risk losing access to their Jefferson doctors next year.
AI Breach of Australian Healthcare Website Sparks Regulation Debate
Nearly three months after a June attack involving OpenAI on the Australian Medicare website, the Australian government received a five-paragraph email from the company informing officials of the breach. Although the Australian government has promised to take further action, such as establishing task
Opinion
The candidate calls his proposal ‘Medicare for All,’ but it would function differently.
Twenty Hours a Week at an Amazon Warehouse for Health Insurance at 60? Here Is the Math a Retired Paralegal Will Run
A 60-year-old paralegal with $350,000 saved and five years until Medicare faces a decision that could quietly reshape her entire retirement, and the answer turns on a warehouse job that pays less than half what she used to earn.
SMH and United Healthcare at odds on Medicare Advantage pact
About 33,000 UnitedHealthcare Medicare Advantage subscribers who receive healthcare services at both Sarasota Memorial Hospital and First Physicians Group will be out of network starting Jan. 1, 2027, unless the two sides sign a new contract before the end of the year.
Baba nabs $40M series A, backed by FirstMark Capital and CVS Health Ventures, for AI-powered Medicare patient navigation
Applied artificial intelligence company Baba
Navvis Introduces New Solution to Help Health Systems Build the Operating Capabilities Required to Achieve High Performance in CJR-X
ST. LOUIS, October 22, 2026--Navvis, the leading value-based care enablement company, today announced a new CJR-X solution built to help health systems achieve high performance in the Centers for Medicare & Medicaid Services (CMS) mandatory and newly finalized Comprehensive Care for Joint Replacement Expanded (CJR-X) model. Joint replacement is one of the most profitable service lines for health systems across the U.S. today, and CJR-X gives health systems a mandatory new way to protect and grow
Autism care is bigger than ABA. Federal policy should be, too
The Centers for Medicare & Medicaid Services (CMS) took an important step last month when it released a new toolkit for states on applied behavior
What to expect from the 2027 Medicare outpatient pay final rules
Medicare payment rules for outpatient care are due within days.
Many Medicare Patients Could Lose Access to Remote Monitoring Devices
A proposed federal rule could dramatically reduce access to remote patient monitoring programs for people on Medicare. The services aim to keep patients out of the hospital by giving them devices to monitor their health at home, but critics say there isn’t enough oversight.
KFF Analyzes the Role of Health Care in the Midterms
The midterm elections mean changing power dynamics and shifting legislative agendas in Congress, both next year and during the upcoming lame duck session—the period between the November election and the new session beginning in January. As policymakers consider next steps, new KFF polling analysis examines the role health care played in voters’ decisions. Key Takeaways […]
The Midterm Election Was About Health Care
In the face of Trump’s destruction of public health and modern science, voters are putting candidates who support Medicare for All, doctors and nurses into positions of power.
Judge blocks Trump administration's Medicaid work requirement rule forcing proof of medical frailty
Twenty-five states sued the Trump administration in June over the new Centers for Medicare and Medicaid Services guidance tied to the 2025 law known as the "One Big Beautiful Bill."
America's largest health insurance companies cancel nearly 1M Medicare Advantage plans — here's what that means for recipients
In Virginia and beyond, Democratic candidates increasingly embrace Medicare For All
Rep. Don Byer was among 118 co-sponsors of last year’s Medicare For All Act, a measure that didn’t advance after its introduction.
Federal healthcare programs' open enrollment kicks off
For Medicare, there are two big differences coming in 2027
Revenue And Earnings Growth Could Be A Game Changer For agilon health (AGL)
agilon health has reported strong annual revenue and earnings growth from its model of partnering with primary care physicians to deliver value-based care for Medicare patients through long-term, globally capitated contracts. The combination of accelerating financial performance and the scaling of its value-based primary care network indicates that agilon health is gaining share where payers and physicians seek partners willing to take on population-level risk. We will now look at how agilon...
Commentary: Health care should serve people, not the companies that profit from denying or delaying it
Medicare for All will not pass tomorrow. That is no reason to stop working for it, or to turn down reforms that help people in the meantime, writes N.H. union president.
Healthcare dispute strikes fear, confusion among southern Illinois retirees
About 5,000 Illinois retirees face health care disruptions as BJC HealthCare drops Aetna Medicare Advantage plans.
Health Brief: Medicare’s big payment shake-up
Plus: A new “STEM wave” is headed to Congress, with doctors and other medical professionals ready to take on health policy fights.
Year one, $200 million funding of North Dakota’s Rural Health Transformation Program allocated
Year one allocations for North Dakota’s Rural Health Transformation Program (RHTP) have been submitted to the Centers for Medicare & Medicaid Services (CMS), according to Director of Rural Health Transformation Krissie Mayer.
He Kept Driving for Uber and Paying for Health Insurance. Medicare Could Still Add a 10% Late-Enrollment Penalty
Driving for Uber while carrying your own health insurance feels like playing by the rules, but Medicare draws a line most gig workers never see coming, and crossing it quietly locks in a surcharge that compounds every year you stay on the road.
Blessing Health to host free Medicare presentation
Medicare open enrollment is happening now. On Tuesday, Oct. 27 Blessing Health System is hosting a free informational presentation for those who have questions about enrollment.
Missouri sets 2027 health rates as plan networks change
Missouri finalized 2027 health insurance rates as consumers face increases, changing provider networks and key enrollment deadlines.
Trump Says Americans Have ‘Best Health Care Plans in the World’ Amid Concerns Auto Workers Could Lose Coverage Under El-Sayed's ‘Medicare for All’ Plan
President Donald Trump said "we have the best health care plans in the world" during a discussion of Medicare for All. Trump spoke in a phone interview that aired Sunday on Fox News’ "Sunday Morning F...
CMS Finalizes CY 2027 Physician Fee Schedule to Shift from Sick Care to Healthcare and Curb Waste
The Centers for Medicare & Medicaid Services is prioritizing prevention, strengthening primary care, cracking down on duplicate billing
Minnesota seniors navigating ‘incredibly complex’ system for Medicare Advantage
More than 300,000 in Minnesota are being forced to shop as insurers change the lineup of health plan options. Here are some tips.
North Texas voters raise concerns about healthcare, Medicare and insurance costs ahead of midterms
North Texans say rising medical costs, insurance premiums and gaps in care for seniors are among the health care concerns they want elected officials to address ahead of the midterm elections.
Avanlee Care, platform for family caregivers, raises $3.5M, targeting Medicare Advantage plans
Avanlee Care, a platform to engage family caregivers, has clinched $3.5 million in seed funding, Fierce Healthcare has learned. | Avanlee Care helps MA plans and other organizations engage caregivers within their member populations, enabling them to take action and measure what happens as a result.
Medicare paying billions in Utah health care, new study shows
Medicare is spending $6 billion on Utahns yearly as enrollment in the health insurance program inches closer to 500,000. That’s the most any federal health care program is spending on the Bee…
Letters to the Editor: Not all patients have complaints about UCLA Health’s quality of care
'I am a retiree relying on Medicare. I am getting the best medical care of my life through UCLA Health,' writes an L.A. Times reader.
The Midterm Election Was About Health Care
In the face of Trump’s destruction of public health and modern science, voters are putting candidates who support Medicare for All, doctors, and nurses into positions of power.
Rising health costs and coverage changes are big concerns for older adults as Election Day nears
Rising healthcare costs are a major concern for older Americans, and it's affecting their finances and political priorities. Open enrollment for Medicare began in October, with changes in costs and
Michigan regulators approve double-digit health insurance rate hikes
The new health insurance rates take effect in January for those with individual plans or small groups coverage.
Seniors Left Waiting as Treatment Bill Faces Uphill Climb
This is an exclusive BHB+ story. Many adult seniors have been locked out of accessing residential addiction treatment for the sector's entire
USA Health and UnitedHealthcare agree to extend contract negotiations
USA Health says without a new agreement, members of UnitedHealthcare’s commercial and Medicare Advantage plans will be out-of-network at all USA Health hospitals.
Tips for covering Medicare open enrollment
It's that time of year again when traditional Medicare enrollees can change their Part D prescription drug plan, move from a Medicare Advantage plan back to original Medicare, and in a handful of states, switch Medigap plans.
SMH talks with United Healthcare on Medicare Advantage pact stall
Talks could affect 33,000 SMH and First Physicians Group patients in 2027 if a deal is not reached by Dec. 31
Health Plan Unlocks More Than $10M in Savings in Six Months Using Cohere Health's AI-Powered Pre-Payment Review
Cohere Health®, the leading clinical intelligence and operations platform for health plans, today announced that a Medicare Advantage client identified more than $10 million in savings in six months by finding complex clinical and coding errors in high-cost drug and durable medical equipment claims before payment.
CMS COO: Hospice, Home Health Moratoria a Successful Approach
The U.S. Centers for Medicare & Medicaid Services’ (CMS) temporary moratoria on hospice and home health provider enrollment in Medicare has been
2 major health insurance companies cancel Medicare Advantage plans covering 1 million people
The two companies are the largest private health insurance companies for older adults in the U.S.
SMH and United Healthcare at odds on Medicare Advantage pact
Dispute does not affect traditional Medicare coverage or commercial contract negotiations
Health insurance rules are changing. Here’s how to avoid an unanticipated bill.
Older adults not yet eligible for Medicare could be the most affected, particularly if they are self-employed or ineligible for workplace plans. Some in this group could face annual premiums of more than $20,000.
Mind Your Business: #19 Affordable Care Act & Medicare Updates
In this episode of Mind Your Business, host Gabriel Castillo, Executive VP of Corporate Marketing for IBC Bank, talks about the Affordable Care Act and Medicare program updates.
Medicare Advantage's next golden goose: Special Needs Plans
Chronic Condition Special Needs Plans enrollment has more than doubled since 2024.
Winners, losers, and MAHA
Democratic doctors won big, MAHA faces an uncertain future, and what the election could mean for Medicare for All.
Open enrollment season: How Texans can navigate health insurance
From Medicare to Medicaid and Marketplace to employer plans, here's where to start when picking the best health plan for you and your family
Humana, Dartmouth Health look to hash out Medicare Advantage agreement
Humana is offering the only Medicare Advantage plan in Cheshire County, but the plan doesn't include Dartmouth Hitchcock or Cheshire Medical Center in it's coverage.
Democrats could explore 'Medicare for All' and other health cost fixes
Democrats will seek to restore ACA subsidies and reverse nearly $1 trillion in Medicaid cuts. Will "Medicare for All" be next?
38% of Retirees Say Health Care Has Cost More Than They Expected. Here’s What a 65-Year-Old Should Budget Instead
Medicare looks like a safety net until the bills arrive, and most new retirees discover the gaps only after they have already retired. A breakdown of what a 65-year-old actually owes in 2026 reveals a number that surprises even people who thought they had planned ahead.
MetroPlusHealth Earns 4-Star Medicare Rating for Second Consecutive Year
New York, NY – MetroPlusHealth, New York City’s high-quality, affordable health plan, announced today that its Medicare Advantage plans have earned an
Americans are warming to a healthcare idea that once seemed politically impossible
A new national survey reveals an unexpected divide over Medicare for All, but Americans appear to agree on one thing: Healthcare is getting too expensive.
Idaho to receive $185 million in federal funding for rural health care
The Centers for Medicare and Medicaid Services (CMS) has announced an initial $185 million in funding for Idaho through the Rural Health Transformation Program.
Kaiser Permanente Hawaiʻi earns high rating for Medicare health plan
Kaiser Permanente Hawaii tied for the highest rating in the state earning 4.5 out of 5 stars from the Centers for Medicare & Medicaid Services (CMS) in its 2027 star ratings.
Health Brief: Election Watch | Rising health costs become a key issue in governors’ races
Plus: Medicare drug plan costs rising by 50 percent
Rising health costs and coverage changes are big concerns for older adults as Election Day nears
Rising healthcare costs are a major concern for older Americans, and it's affecting their finances and political priorities. Open enrollment for Medicare began in October, with changes in costs and
38% of Retirees Say Health Care Has Cost More Than They Expected. Here's What a 65-Year-Old Should Budget Instead
Medicare looks like a safety net until the bills arrive, and most new retirees discover the gaps only after they have already retired. A breakdown of what a 65-year-old actually owes in 2026 reveals a number that surprises even people who thought they had planned ahead.
CMS freeze on health insurance exchange brokers lifted by court
The Centers for Medicare and Medicaid Services argued that suspending new marketers was necessary to fight fraud.
Abdul El-Sayed is running against money in politics in Michigan
Democratic candidate Abdul El-Sayed is running for the U.S. Senate against Republican Mike Rogers, focusing on his platform of Medicare for All and campaign finance reform.
Medicare enrollment underway, more Health Headlines
Medicare open enrollment started Thursday, Oct. 15, with less than two months to compare and potentially change plans before the Dec. 7 deadline.
Seniors Left Waiting as Treatment Bill Faces Uphill Climb
This is an exclusive BHB+ story. Many adult seniors have been locked out of accessing residential addiction treatment for the sector's entire
Medicare delays controversial RPM rule update
Despite widespread opposition, Medicare will finalize a controversial proposal that will prevent providers, such as hospitals, from using third parties to deliver remote patient monitoring services.
Oregon to increase 2027 payments to care organizations for Health Plan members
Oregon health officials say that they expect the U.S. Centers for Medicare & Medicaid to approve the rise by the end of 2026.
Health Care in the 2026 Midterm Election
This dashboard focuses on KFF’s analysis of the role health care costs and other health policy issues played in voters’ decisions in the 2026 midterm elections, including in key Senate races. It examines the role of rising health costs on voters’ decisions, views on the Trump administration’s health care policies, and opinions on the government’s role in health care amid discussions of Medicare for All.
Illinois health insurance enrollment opens
Get Covered Illinois opens enrollment Nov. 1, with residents able to compare health plans, seek financial help and enroll through Jan. 15, 2027.
Batesville’s White River Health dropping UnitedHealthcare Medicare Advantage
White River Health will end its relationship with UnitedHealthcare Medicare Advantage on Jan. 1, 2027, due to frequent claim denials and administrative hurdles.
Why Minnesota seniors face the nation’s biggest health insurance shake-up
An era of low costs and more generous benefits may be ending for hundreds of thousands enrolled in Medicare Advantage plans in Minnesota.
Democrats say Trump increased investments in drugmakers that were given Medicare exemptions
The report from congressional Democrats found that Trump’s pharmaceutical stock holdings grew from a maximum reported value of $1.7 million in 2024 to as much as $56.2 million at the end of 2025.
What hospice can learn from home health’s fight against fraud
As policymakers intensify efforts to combat fraud, waste and abuse in hospice, there may be an important lesson hiding in Medicare’s history.
Why 2026 Is a Health Care Election
_Ypsilanti, Michigan_THE MIDTERM ELECTION IS ABOUT a lot of things: gas prices and groceries, the spread of corruption, and the future of democracy. And yet, as much as any single issue, it’s about health care. You can tell by listening to all the Democrats talking about high deductibles, drug costs, and insurance companies as they campaign around the country. Or you can tell by reading all the public-opinion surveys in which voters consistently rank health care as one of their top concerns. But if you really want to know why this is a health care election, your best source isn’t the politicians or the pollsters. It’s the people on the front lines. One of them is Raymond Rion, a family medicine physician and executive director of Packard Health, a small network of clinics spanning Ann Arbor and Ypsilanti on the western outskirts of the Detroit metro area. Packard is what’s known as a Federally Qualified Health Center, where anybody can get care regardless of income or insurance status. And like similar safety-net providers all over America, for the past decade it has benefited directly from the Affordable Care Act. “We almost went bankrupt in 2011,” Rion told me in a conversation last week, recalling how in the old days staff at Packard would work the phones furiously to get supplies and find specialists who would take referrals. Now many more patients have either Medicaid or private coverage they’ve purchased through HealthCare.gov, the online marketplace that the law created, so that the proportion of uninsured patients has fallen from around one in three to one in ten. It’s a lot easier to find referrals for these insured patients, though thanks to the infusion of paying customers Packard can do much more on its own. In particular, Rion said, the organization has opened two new branches, started a pharmacy, begun offering prenatal services, and vastly expanded behavioral health care by bringing on a half-dozen new doctors, nurses, and case workers. Now a retrenchment is underway. Coverage options on the HealthCare.gov marketplace got more expensive because Donald Trump and the Republicans refused to renew temporary subsidies that had been reducing the price of insurance. On top of that, the first cuts to Medicaid as part of last year’s “One Big Beautiful Bill” are starting to take effect. Rion told me Packard has already laid off a provider in anticipation of less revenue next year.1 Patient volume is down, he went on to explain, in part because uninsured patients sometimes avoid care altogether out of fear a single visit will lead to more treatments with more bills. And postponing care in that way can have serious medical consequences, as his colleague Ron Romero told me. “So you have somebody with diabetes, their chronic condition isn’t getting cared for,” said Romero, who like Rion is a family physician. “Their sugars rise, and they end up having other medical problems. Their kidneys start to get damaged. They start to have eye damage. They increase risk for heart attacks and strokes. . . . They end up in the emergency room.” And things are likely to get worse. Partly that’s because next year most of the remaining Medicaid cuts will take full effect, throwing more people off coverage. And partly it’s because forces that have nothing to do with Trump or Republican actions are making medical care more expensive for everyone, including those with employer insurance and Medicare. That will lead to still more people delaying or skipping care, ending up in the emergency rooms, and putting yet more cost pressure on providers. Rion wasn’t taking a position on the election or political parties, he made clear. He was just describing the reality he sees around him: “The whole system is being pressured. Nobody is immune to this stuff.” He’s right. And here’s the thing: This has all happened before. We know happens next.
Changes in the health and longevity of the elderly in the US
Spending on public pensions through Social Security and on elderly healthcare through Medicare accounted for over one-third of federal expenditures in the US by 2024. This column explores how improvements in elderly health and life expectancy affected the relative finances of Social Security and Medicare. The elderly are not only living longer but also are in better health, so expected lifetime Medicare spending per elderly individual has grown much slower than expected lifetime Social Security spending. The authors analyse the forces that affect the optimal allocation of a given public budget across these two social insurance programmes.
Ballad Health, UnitedHealthcare reach agreement over Medicare Advantage plans
JOHNSON CITY, Tenn. (WJHL) — Ballad Health announced Thursday that it and UnitedHealthcare had finalized a multi-year agreement for UnitedHealthcare’s Medicare Advantage individual and group …
Why your Medicare drug plan costs will be higher in 2027
The average monthly premium for millions of Americans enrolled in a Medicare stand-alone prescription drug plan will rise 50% in 2027.
She’s Eyeing a $4,500 Mental Health Rage Retreat. Calling It Therapy Doesn’t Make It Medicare-Covered
A $4,500 rage retreat lists licensed therapists on staff and promises room to process grief and anger, but the word "therapy" on a brochure and Medicare coverage are two very different things.
Slimantics: Medicare for All could bridge gap between mental health breakthroughs and accessibility
Tuesday is Election Day across the country, and although it is not always the leading headline in this year’s midterms, health care remains an issue that is fiercely debated on the campaign trail.
2026 Health Care Congressional Voter Guide
At NC Health News, we care about you and your family’s health and we think our elected officials should too. We started in September to reach out to all of North Carolina’s Congressional candidates asking them to answer a series of questions about health care issues that you care about: Social Security, Medicare and Medicaid, […]
Senior Health Insurance Program navigators available to help during Medicare open enrollment
Chrissy Childers is the lead navigator for SHIP at Rural Health, Inc. This year, she said she’s reminding people to check their Part D plan, since many plans have changed.
White River Health leaving UnitedHealthcare Medicare Advantage network in 2027
White River Health announced Wednesday that its hospitals and facility-based services will leave the UnitedHealthcare Medicare Advantage network effective Jan. 1, 2027.
Judi Health launching employer Medicare Part D plan with a focus on transparency
Judi Health is launching a new Part D plan that aims to lean on its tech stack to drive transparency and outcomes. | Judi Health is launching a new Part D plan that aims to lean on its tech stack to drive transparency and outcomes.
Is Costco the next healthcare disrupter?
Its warehouse brand is built on trust, and that trust may be the edge it needs to move into Medicare coverage.
Republicans laud feds for awarding Florida $193.7M for rural healthcare
Florida has been awarded $193.7 million in federal funds to support telemedicine, remote patient monitoring, pharmacy services, diagnostic kiosks, and community paramedicine for rural areas in Florida, the Centers for Medicare and Medicaid Services announced. The grant is $5 million-plus more than the DeSantis administration had previously announced it was requesting. The money is made […]
Medicare for All, Medicaid cuts and rising costs: Where Flanagan and Tafoya stand on health care
The U.S. Senate candidates differ over Medicare for All, Medicaid funding and the federal government’s role in making health care more affordable.
Roman Health Ventures Lobbies For Medicare Telehealth Fix
Roman Health Ventures is lobbying to permanently extend Medicare telehealth flexibilities after the waiver expired Sept. 30, 2025. Read the full update now.