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Rules Governing Human Oversight of AI in Health Care Could Shape Public Trust
New regulations and guidelines for the use of AI in health care have sought to answer questions about human oversight and accountability. Separately, a new HHS initiative aims to expand research into potential vaccine injuries, but some medical organizations have questioned how the efforts may be perceived.
Medicaid recipients face new renewal requirements beginning in 2027
Allegheny County is partnering with health care providers and community organizations to help Medicaid recipients navigate new federal eligibility requirements taking effect Jan. 1, 2027.
Orange County school board to vote on teacher health care contract dispute
The dispute comes down to health care costs. A special magistrate was brought in to find middle ground between the school district and the union, but the two sides could not reach an agreement.
Health Care Roundup: Market Talk
Find insight on Sanofi, Novo and more in the latest Market Talks covering the health care sector.
Bipartisan Bill Aims to Cut VA 'Red Tape' and Speed Up Health Care Innovation
Backers say VA deals with outside innovators can take months or years. Here's what the INNOVATE Act would change and who's backing it.
Incoming statehouse Dems want focus on health care affordability, access, Medicaid
Presumptive NC House Speaker Robert Reives outlines priorities for Medicaid, rural health care and affordability as Democrats prepare to take control.
Opinion: Health care needs payment reform
Faced with mounting administrative burdens, many physicians choose to close or merge their practices with large systems -- at the cost of clinical autonomy.
Royal Health Group Sells Four Upper Cape Nursing Homes
Royal Health Group has sold four Upper Cape nursing homes as part of a broader transfer of its Massachusetts and Rhode Island facilities to a newly formed health care company,
Perceiving greater discrimination in health care, the LGBTQIA+ community delays seeking medical appointments
People in the LGBTQ+ community face extra barriers in their daily lives due to their sexual orientation or gender identity. One of the areas where these individuals sometimes suffer discrimination is ...
Trailhead Foundation pledges $10 million to health care across 5 Ohio counties in 2027
Trailhead Community Health Foundation, born from Summa Health's $485M sale, released its first strategic plan Thursday, pledging $10 million in 2027 grants across five Northeast Ohio counties.
Massachusetts health care violence bill stirs disability concerns
Advocates fear legislation under consideration could criminalize the behavior of people with intellectual and developmental disabilities.
Abdul El-Sayed on Democratic leadership, health care access and inspiring a new generation
The Iowa Clinic retains lung cancer care designation for second year
The Iowa Clinic has been recognized as a Center of Excellence by GO2 for Lung Cancer for the second consecutive year. The designation recognizes health care providers for their commitment to patient-centered, evidence-based lung cancer care, including access to specialized services and coordinated treatment. The recognition comes as Iowa continues to face higher lung cancer…
Diabetes in the Americas: 112 million adults live with the disease as gaps in diagnosis and treatment persist
More than 4 in 10 people living with diabetes worldwide are unaware they have the condition. Ahead of World Diabetes Day, PAHO calls for stronger early detection and primary health care, as well as measures to prevent or delay type 2 diabetes and its complications.
UND Center for Rural Health highlights National Rural Health Day on ‘North Dakota Today’
Director Jacob Warren discusses the importance of rural health care and the Center's work supporting communities across North Dakota
New study reveals gaps in healthcare, access to benefits for veterans
A new report highlights gaps in health care and support for veterans long after active-duty service ends.
Will rural health funding offset Vermont’s Medicaid cuts?
New federal funding aims to bolster rural health care, but questions remain about whether it will offset the impact of Medicaid cuts.
LIVE: Federal officials to announce charges in multimillion-dollar health care fraud scheme in Jacksonville
Federal officials will announce charges Thursday in a multimillion-dollar health care fraud scheme during a news conference.
North Carolina receives $216.8 million in rural health funding
North Carolina has been awarded more than $216.8 million in continued federal funding to improve rural health care, bringing the state’s total under the program to more than $429 million since April 2026.
Democrats Have a Shot at Restoring Health Care
With some maneuvering, the new Congress could strike a deal with Trump to avert Medicaid cuts, the expiration of Affordable Care Act subsidies.
Federal Employees Face Higher Health Premiums as 2027 Open Season Begins
Open season is underway for federal employees– the time of year when employees select their health care plans and benefits for the upcoming year. Open season runs from Monday, November 9, through Monday, December 14. The average enrollee share of premiums will rise by 10.9 percent in 2027, alth
Study explores leveraging dental hygienists to expand access to oral health care
Dental hygienists play a critical role in delivering preventive oral health care, helping patients maintain good oral health and preventing more serious and costly dental problems. Yet in many states, ...
Helping Journalists Track Community Health By the Numbers
NYU's Dr. Marc Gourevitch briefed journalists about the City and Congressional District Health Dashboards, two free data portals that can reveal health care access and policy gaps in communities.
Fighting for rural communities
Rural communities face significant barriers to adequate health care. That’s why USC is bringing major players to the fight for better rural health through innovative programs in medicine, nursing, pharmacy, behavioral health and more. For National Rural Health Month, we’ve gathered a few highlights of the work being done by the USC community.
GW professor, local healthcare leader discuss immigration policies’ impact on health care access
Milken Institute School of Public Health Professor Leighton Ku and local community leader Nancy Ban discussed how federal immigration policies have affected immigrant families’ access to health care and how community organizations are working to connect them with services.
New parents with intellectual disability 9 times more likely to be hospitalized for mental health care
People with intellectual disability are nine times more likely to be hospitalized for mental health reasons during pregnancy and up to one year after giving birth, new Australian research led by UNSW ...
Treating nightmares early may lead more trauma survivors to access mental health care
Nightmares are common in the wake of a traumatic event, and emerging research suggests that offering sleep-focused telehealth therapy early in recovery could help more patients engage in continued mental ...
America’s oldest hospital and the future of brain science
Growing from its origins in progressive mental health care, Pennsylvania Hospital is shaping the future of advanced care for neurological diseases.
State Street Health Care SPDR (XLV) Adds Eli Lilly and Johnson & Johnson on Nov. 10
The fund bought $132.2 million of stock, increasing all 60 of its positions and selling nothing.
Democrats unite against corporate health care
It's the common ground they share, including newly elected Democrats from red states.
Mental health care may not keep pace with needs of women veterans, study finds
Nearly half of the post-9/11 veterans surveyed in a new study showed signs of depression, anxiety or post-traumatic stress disorder. But women veterans, who reported substantially more mental health and substance use problems than men, did not see an increase in mental health appointments, finds a new study from the Brown School at Washington University in St. Louis.
Health insurance premiums increase as Affordable Care Act open enrollment underway in Wisconsin
Estimates from KFF find premiums for Affordable Care Act health plans are expected to jump by 13 percent next year. A health care navigator and the head of a program that helps people find insurance explain what residents should expect.
Walberg Supports Legislation to Modernize Veterans Health Care and Benefits
Today, Congressman Tim Walberg (MI-05) supported H.R. 9237, the Take Care of America’s Veterans Act, as the legislation passed the House.
From Navy nurse to home health pioneer: Eileen Klimkowski's journey of service and innovation
A small-town girl from New Jersey never imagined that a chance decision to join the Navy would lead her to Charlotte, a degree from UNC Charlotte’s School of Nursing, and a pioneering career that would transform home health care across the region. But for Eileen Klimkowski ’79, following opportunity and trusting her instincts became a […]
New Mass. plan helps veterans to transition to civilian health care jobs
The program, known as the Military to Medicine pilot, would help veterans transition into health care careers while also supporting hospitals facing workforce shortages.
Sophia Paffenroth to report in UK for national health journalism fellowship
Sophia Paffenroth, women’s health reporter for Mississippi Today, has been selected for the Association of Health Care Journalists’ International Health Study Fellowship.
How artificial intelligence is changing health care
Artificial intelligence is changing the way doctors diagnose diseases, treat patients and develop new medicines. But how well is it working? Coming up at 9 a.m. on Wednesday, MPR News host Angela Davis talks about the growing role of AI in health care.
Feds award $10B to states, including $188M to SD, in second year of rural health grants
The federal government awarded $10 billion in rural health grants to all 50 states for 2027, funding efforts to improve health care access and services.
Reporting on Health Systems: Meet the 2027 AHCJ Fellows
AHCJ is thrilled to announce our 2027 cohort for two fellowship programs, each designed to empower journalists in advancing the public’s understanding of health care systems both in the U.S. and globally.
Nurse practitioners help address health care shortages, association president says
Valerie Fuller of the American Association of Nurse Practitioners discusses access to care, regulations and training during National Nurse Practitioner Week.
State Street Health Care SPDR (XLV) Sells Eli Lilly and J&J on Nov. 9
The fund sold $320.2 million of stock, cutting all 60 positions and adding nothing on Monday.
Allina board chair: Sutter partnership is a bold strategy to secure Minnesota’s health care future
"In the last five years, Allina Health has experienced almost $1 billion in operating losses, with another loss of more than $150 million projected for 2026," Tim Welsh writes.
Gun violence prevention programs saved Virginia hospitals more than $100 million
By Sandra Jones/WHRO Hospital-based violence intervention programs across Virginia have served nearly 10,000 patients since 2019 and helped avoid an estimated $101.8 million in health care costs, according to the Virginia Hospital & Healthcare Association. Four of those programs in Hampton Roads have served 5,290 patients since March 2020. Fitzroy Smith, hospital violence intervention program […]
‘Endless walk of shame’: A Delaware mother’s cross-country journey for mental health care
A Delaware traveled across the country in search of effective mental healthcare after a traumatizing experience in the First State.
A new tactic in the war over out-of-network bills: Health care providers are suing employers
Providers increasingly are suing employers, claiming they are responsible for out-of-network medical bills that insurers haven’t fully paid or have delayed paying.
New report charts path to better health care and support for North Carolina veterans
The report identifies gaps in care and recommends improved access, coordination and support for military families.
Study reveals gaps in women's heart health care in New Zealand
A review of 25 years of New Zealand research has revealed significant gaps in women's heart health care, highlighting opportunities to improve diagnosis, treatment and outcomes. Published in the New Zealand ...
Minnesota Employers Seek Nearly 21,000 Health Care Workers
(KNSI) - Minnesota employers were looking to fill nearly 21,000 health care jobs last year, even as the overal...
As you age, more screenings and doctor visits help you stay healthy
As people get older, their health care often changes, with more screenings and more doctor visits aimed at helping them stay healthy long-term.
El-Sayed says he would vote for ‘Trumpcare’ for all
Michigan senator-elect Abdul El-Sayed told CNN’s Kaitlan Collins that he supports “cradle-to-grave” health care and “what you call it is a secondary issue.”
Army shaped Dr. Gill's correctional health care career
Whether caring for soldiers in the US Army Reserve or leading medical operations inside a prison, Dr. Ravijot Gill is devoted to service.
Axios Live: Democrats have a "mandate" on health care affordability, Rep. Raul Ruiz says
Lower costs and broader access to medical care are priorities for Democrats after the "blue tsunami" of the midterm elections
First in-home health care training center breaks ground in Albuquerque
ALBUQUERQUE, N.M. (KRQE) — New Mexico’s health care workforce could soon be getting a boost through a new home health care training center that broke ground today. Near 4th Street and Hazeldi…
Billings Clinic–Logan Health Looks to the Sky for a New Name
Billings Clinic–Logan Health, the state’s largest hospital organization, is rebranding under a simpler name: One Sky Health. While the name nods to Montana’s moniker as Big Sky Country, it is designed to represent the unification of the two health care systems and the states they cover. The new name nods to Montana’s nickname, Big Sky […]
How health care and reproductive rights in Texas could change under Democrats
Houston Matters examines how last week’s historic election results in Texas could affect health care and reproductive rights in the state.
Sexual minority health care providers report more depression, psychological distress, and cost-related barriers to care
In this cross-sectional study, health care providers (HCPs) identifying as a sexual minority reported more lifetime depression diagnoses and psychological…
Opinion | A new Congress should mean a new agenda for health care
Lawmakers have an opportunity to lower health care costs, protect coverage, and restore the scientific independence that drives medical progress.
USC Arcadia Hospital nurses and health care workers ratify new contracts with strong measures to improve patient safety and retention
Registered nurses and health care workers at USC Arcadia Hospital in Arcadia, Calif. voted overwhelmingly in favor of ratifying their respective three-year contracts on Nov. 5 and 6, winning protections to improve patient safety and nurse and health care worker retention.
Trump administration disburses $10 billion in rural health care funds
The Trump administration announced Monday that it is going to roll out $10 billion to 50 states in its second installment of the $50 billion rural healthcare fund which was created as part of the a…
South Dakota announces $187.7 million for rural health care program
South Dakota will receive $187.7 million in second-year funding for a program aimed at improving health care access in rural and frontier communities, Gov. Larry Rhoden and the state Department of Health announced.
The Next Behavioral Health Dollar Should Go to High-Acuity Patients
Are we solving the wrong problem in behavioral health care? In a recent Behavioral Health Business piece titled "Beyond the Worried Well," the
The Next Behavioral Health Dollar Should Go to High-Acuity Patients
Are we solving the wrong problem in behavioral health care? In a recent Behavioral Health Business piece titled "Beyond the Worried Well," the
Patient comfort with AI-driven health care hinges on provider oversight
More than half of patients (56%) are comfortable with artificial intelligence (AI) making diagnosis or treatment decisions when their health care provider can change or override them, but that figure ...
Federal Employees Face Higher Health Premiums as 2027 Open Season Begins
Open season is underway for federal employees– the time of year when employees select their health care plans and benefits for the upcoming year. Open season runs from Monday, November 9, through Monday, December 14. The average enrollee share of premiums will rise by 10.9 percent in 2027, alth
Tennessee basketball players propose model employment agreement to university leaders
Tennessee athletes have proposed a model collective bargaining agreement to university leaders that covers compensation, health care and more.
Attacks on Health Care in Sudan, 16-31 October 2026
Situation Report in English on Sudan about Health, Protection and Human Rights and more; published on 9 Nov 2026 by Insecurity Insight
Can $13.5 Million Change Health Care In Rural New Mexico?
ALBUQUERQUE, N.M. (KRQE) – Can a $13.5 million investment help close New Mexico’s rural health care gap? UNM has secured a major National Institutes of Health award aimed at bringing medical …
11/10/2026: Supervisory Status and Health Care Rule Quirks
Union Electric Company D/B/a Ameren Missouri, 14-RM-394835 (Regional Election Decision) A Regional Director dismissed the Employer's petition after finding that Distribution System Operating Supervisors (DSOS) II are statutory supervisors under Section 2(11) of the NLRA, but not managerial employees. The Employer, an electric and gas utility, filed the petition after the Union demanded recognition for DSOS I and II positions. Because the DSOS II are supervisors excluded from the NLRA's protection, no election was ordered. The DSOS I position was not decided, since no one currently holds it, and ordering an election for a unit with zero employees would be contrary to Board policy. As a preliminary matter, the Union was precluded from litigating supervisory or managerial status because it filed its Statement of Position with the Region but did not serve it on the Employer by the deadline. The Regional Director still took evidence sufficient to decide unit appropriateness, as the Board's rules require. Supervisory status rested on the authority to assign. The DSOS prioritize work tickets, choose which Line Troubleman or Traveling Operator to send, pull employees off lower-priority jobs, hold employees past shift end, decide whether to call in crews and how large they should be, and handle sick call-outs, all without consulting anyone. Relying on Oakwood Healthcare and Entergy Mississippi, the Regional Director found this resembled utility dispatchers who used independent judgment in assigning employees to places. It did not matter that the record did not show who selects the specific employees who respond to a call-out. The Employer failed to prove responsible direction because nothing showed DSOS face adverse consequences for field employees' performance. The one Performance Improvement Plan involved a DSOS's own errors. The Employer also failed to prove discipline authority, since switching error forms merely report incidents and upper management decides whether discipline follows. The managerial claim failed because there was no evidence the DSOS formulate high-level employer policy. They exercise technical discretion, sit below Superintendents and a Manager, and are first-level supervisors. Significant Cases Cited Oakwood Healthcare, Inc., 348 NLRB 686 (2006): Defined "assign" and "responsibly direct" under Section 2(11) and placed the burden of proving supervisory status on the party asserting it. Entergy Mississippi, Inc., 367 NLRB No. 109 (2019): Held utility dispatchers were supervisors because they used independent judgment in prioritizing outages and assigning field employees. NLRB v. Kentucky River Community Care, Inc., 532 U.S. 706 (2001): Established the three-part test for supervisory status under Section 2(11). NLRB v. Yeshiva University, 444 U.S. 672 (1980): Described managerial employees as those who formulate and effectuate management policies and are aligned with management. Ikea Distribution Services, Inc., 370 NLRB No. 109 (2021): Affirmed preclusion of issues for a late-served Statement of Position while confirming the Regional Director must still determine unit appropriateness. NLRB Edge is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe Prime Healthcare Services – St. Michael’s, LLC D/B/a Saint Michael’s Medical Center, 22-RC-392696 (Regional Election Decision) The Regional Director dismissed a petition seeking an Armour-Globe self-determination election for two full-time radiation therapists at a Newark hospital. The union wanted the therapists to vote on joining its existing nonconforming unit of registered nurses, nurse anesthetists, and technical employees. The Regional Director found the union had not shown the therapists could appropriately be added to that unit under the Board's Health Care Rule and the community-of-interest factors. The Regional Director first explained that the Health Care Rule does not categorically bar an Armour-Globe election in a partially organized hospital with existing nonconforming units. Under St. Vincent Charity Medical Center, such an election does not create a new unit and so does not offend the Rule's concern with unit proliferation. The petitioner still bears the burden of showing the group is identifiable and distinct and shares a community of interest with the existing unit. The therapists were an identifiable, distinct group because they do identical work in the same department under the same managers. On community of interest, the evidence was mostly unfavorable to the union. The therapists work in the Cancer Center alongside unit nurses but have separate supervision (apart from occasional coverage), separate break areas, and distinct equipment and functions. Their contact with nurses is limited to routine patient handoffs, and they do not interact with or fill in for technical employees such as radiology technicians. The Regional Director found some overlap in certifications and training, which might tip the scale on those factors, but the union did not establish common terms and conditions. The Regional Director added that shared benefits or work rules would not suffice given separate supervision, no interchange, and physical separation. The decisive problem was the Health Care Rule's classifications. The therapists are professionals who fall within the Rule's "all other professionals" category. The parties' contract expressly excludes "all other professionals," and the union's attempt at hearing to classify some respiratory therapists as professionals contradicted that contract. Adding the therapists would create yet another nonconforming grouping and leave other unrepresented professionals in that category. A separate therapist-only unit would also be inappropriate because the record shows other unrepresented professional employees. A unit of all unrepresented employees in that category may be appropriate. Significant Cases Cited St. Vincent Charity Medical Center, 357 NLRB 854 (2011): An Armour-Globe election in an acute care hospital does not violate the Health Care Rule because it adds employees to an existing unit rather than creating a new one. Rush University Medical Center v. NLRB, 833 F.3d 202 (D.C. Cir. 2016): Section 103.30(c) of the Health Care Rule applies only to petitions for additional units, not to Armour-Globe elections adding employees to an existing unit. Warner-Lambert Co., 298 NLRB 993 (1990): A self-determination election requires that the employees share a community of interest with the existing unit and form an identifiable, distinct segment constituting an appropriate voting group. United Operations, Inc., 338 NLRB 123 (2002): Sets out the community-of-interest factors, and common supervision alone does not require inclusion in one unit absent interchange, contact, or functional integration. Wheatland Electric Cooperative, Inc., 375 NLRB No. 16 (2026): Functional integration requires that positions depend on one another to accomplish their tasks, and minor differences between groups should not be given too much weight.
Open enrollment brings robocalls, scams targeting health care plan seekers
Open enrollment is underway, and the period for choosing health care plans for the year ahead is also a popular time for scammers and robocalls.
Election’s effect on health care (Nov. 10, 2026)
On Tuesday's show: We consider how last week's election results could affect health care and reproductive rights in Texas. And we discuss racial representation on the stage and screen.
Lexington VA Health Care System to host Veterans Resource Fair
Veterans and their families can connect with local VA resources at the fair and learn about VA healthcare eligibility.
Attacks on Health Care Bi-Monthly News Brief, 16 - 31 October 2026
Situation Report in English on World and 9 other countries about Health, Protection and Human Rights and more; published on 10 Nov 2026 by Insecurity Insight
Iowa receives $216 million to boost rural health care
Iowa has been awarded over $216 million in federal funding to enhance rural health care services, including cancer treatment and prevention.
In northern Ethiopia, conflict pushes a strained healthcare system to the brink
Ethiopia's health care system was once considered a model in the region. But in the northern Tigray region, ongoing conflict has left health facilities and medical workers vulnerable to attacks.
Specialty medical care expansion continues in Northwest Arkansas
A shortage of specialty healthcare in Northwest Arkansas costs the region around $629 million annually in lost revenue from patient migration, according to the 2024 Northwest Arkansas Council Health Care...
Healthy curiosity
Dornubari Godpower ('29 integrated health sciences) is finding inspiration and support for her health career ambitions at Iowa State.
Governor Gianforte, DPHHS Announce $239.7 Million Second-Year Award to Strengthen Rural Health Care
HELENA, Mont. — Governor Greg Gianforte and Department of Public Health and Human Services (DPHHS) Director Douglas Harrington, MD, today announced Montana has received $239.7 million from the Trump Administration for the second year of the Rural Health Transformation Program (RHTP).
Oregon receives $197M to improve rural health care
Oregon has receieved another $197.3 million from the Trump administration to continue improving rural healthcare, the U.S. Centers for Medicare & Medicaid Services announced Monday. The new award comes after […]
As Congress’ Lame Duck Session Starts, More than 100 Groups Urge Congress to Pass Health Care Price Transparency Before Year's End
Passing These Pending, Vetted, Bipartisan Bills Would Be a Foundational First Step to Address Voter Demand for Action on Health Care Affordability Washington, D.C. – As Congress returns to Capitol Hill today, less than a week after a historic midterm election, more than 100 organizations are calling on Congress to act on bipartisan measures to […]
Strengthening payer-provider partnerships across health care
The health care industry is investing heavily in AI, prior authorization, interoperability and overall operational excellence. However, the system remains too complex, fragmented and difficult to navigate.
UConn’s Professor Sir Cato T. Laurencin Receives Leadership and Advocacy Award from InterCommunity Health Care
Laurencin was honored for his commitment to bettering public health through his medical advancements, advocacy, and mentorship.
Texans wait months for psychiatric hospital beds as new state report reveals mental health care backlogs
A new report from Texas Health and Human Services shows hundreds of people waiting for psychiatric treatment, with some facilities reporting average waits stretching beyond eight months.
University of Iowa Health Care drops plans to build a new cancer center
Instead, the University is asking for Regents’ permission to expand cancer-focused research space in the College of Pharmacy.
Community Health Fair scheduled for Nov. 12 at Fessenden Center in Buxton
The Fessenden Center in Buxton will host a Community Health Fair on Thursday, Nov. 12, from 11 a.m. to 1:30 p.m., bringing together local health care providers, nonprofit organizations and […]
To become better health care providers, students commit their hearts to community work
A partnership between health professions students and community groups has helped build trust and understanding with patients.
Inside the C-suite: Health system leaders on AI, access and a tough 2027
Chief Healthcare Executive interviewed leaders from Providence, Northwell, Intermountain Health, Kaiser Permanente, Mayo Clinic and more, on the pressing issues facing their systems and health care as a whole.
Protecting health care during the Bundibugyo virus disease response in the eastern Democratic Republic of the Congo: operational guidance - Democratic Republic of the Congo
Manual and Guideline in English on Democratic Republic of the Congo about Health and Epidemic; published on 9 Nov 2026 by WHO
What State Street Health Care SPDR (XLV) Sold: Eli Lilly Leads on Nov. 5
The fund sold $212.6 million of stock, cutting all 60 of its positions and buying nothing.
Community-Based Mental Health Care Offers Promising Alternative to Psychiatric Hospitalization for Adolescents
Intensive community care services (ICCS) provide home and community care for people suffering from psychological distress. These services offer an A new meta-analysis finds that intensive community care can reduce hospital admission days and improve psychosocial functioning and behavioral outcomes in adolescents with severe mental health difficulties.
The 5 medications most likely to cause bone thinning
If you take any of these medications, it’s important to chat with your health care provider about what you can do to stay on top of your bone health.
After midterms, health care costs to be top priority for Democrats
While there will be urgency to pass bills, President Trump quickly reminded Democrats eager to reform the health system that he wields the veto.
Potential impacts Democratic health care proposals on employer-sponsored health care
Summary: Democratic state and federal wins in the midterm elections could lead to Medicaid expansion in some states, and focuses attention on the House Democrats’ memo on health care priorities in the new Congress. Few of these proposals are likely to become law before 2029, but they could form the foundation for Democratic health care reform efforts after the 2028 Presidential election. Portion of total newly eligible for Medicaid if non-expansion states expanded Source: Cervantes, S et al How Many Uninsured Are in the Coverage Gap and How Many Could be Eligible if All States Adopted the Medicaid Expansion? KFF, July 27, 2026 It’s been almost a week since the midterm elections, and the Democrats will have large majorities in both the House of Representatives and the Senate, although not large enough to overcome Senate filibusters or Presidential vetoes. I reviewed some of what I thought these midterm results could mean in a post last week. In retrospect, I might have understated the elections’ impact on health care due to changes in governorship and majorities in many state legislatures. A Democratic trifecta (governorship and both houses) could mean expansion of Medicaid in Wisconsin, and a Democratic governor and House in Texas and Georgia could increase pressure in both states to expand Medicaid. That’s especially important, because Texas currently represents almost half of those who would be newly eligible for insurance from Medicaid expansions. Medicaid expansions matter to employers because they have been shown to decrease the risk of closure of rural hospitals and support workers’ ability to stay employed and productive. The House Democrats’ Cost of Living Healthcare Working Group published an 84-page memo in September with recommendations for the first hundred hours, the first hundred days, and the first year. The midterm results make this document more important. Here’s a review of what some of these recommendations could mean for employer-sponsored health insurance. Elements that could lower employer health care spending Restore the expanded advance premium tax credit for ACA plans. This could bring healthier enrollees back to the marketplace plans, which would improve the risk status of these plans and decrease the rate of uninsurance. Fewer people with insurance puts higher pressures on provider rates of employer plans. More stable ACA plans could encourage employers to consider transitioning from employer-sponsored plans to ICHRA/Choice, providing a fund for employers to purchase their own insurance on an exchange. Repeal Medicaid work requirements and other administrative rules of the One Big Beautiful Bill Act which as written will lead to a large increase in the uninsured rate. Fewer people with insurance leads to more pressures from hospitals for commercial rate increases. Extend Inflation Reduction Act negotiated drug prices to commercial health plans. These are now only applicable to Medicare Parts D (outpatient drugs) and B (drugs administered by providers. The Medicare negotiated prices are lower than net prices negotiated by PBMs. Hospital price limits. Some of the Democratic House proposals would institute site neutral payment and limit outlier hospital prices to 200% of Medicare. The average commercial health plan pays about 247% Medicare rates for inpatient hospital care, and many commercial health plans currently pay over 300% of Medicare for hospital services. PBM regulations. The proposals would mandate more transparency and prevent PBMs from paying subsidiaries more than market rates. Antitrust enforcement. The plan would break up vertically integrated health care monopolies which could lower prices through competition. Ban on non-compete contractual clauses could increase competition by increasing flexibility and supply of clinicians, although it could also increase physician leverage and lead to higher wages which could raise prices. Lower the Medicare eligibility age, which could take older, more expensive, workers off employer sponsored plans. Create a Medi-Kids plan to insure all children and potentially young adults up to age 26. These plan members have low non-preventive utilization and cost less per person than older plan members, but removing children from employer plans would decrease volatility because a few children have very high medical costs. Elements that could increase employer spending (in many instances for high value services) Mandate three primary care and three mental health visits without cost sharing Eliminate cost sharing for mental health care and substance use care during pregnancy and in the year after delivery Require coverage of infertility services Cap cost sharing for insulin, epipen and respiratory inhalers Count copay coupons and assistance toward member deductibles and cost sharing Cap total health care costs (premium and out-of-pocket costs) at 8% of household income Leave a comment Elements that could improve the market Increased price transparency Tightening enforcement of short-term plans, fixed indemnity plans, and cost-sharing ministries. These skimpy health plans skim off healthier people, leaving sicker people on marketplace exchanges and employer-sponsored health plans. Here’s a past post on the perils of cheap insurance. Most of these proposals are likely not to become law in the next two years, but could form the foundation of a Democratic proposal for health care reform in 2029 and beyond. The document does not provide cost estimates for these proposals. Share Thanks for reading! If you found this useful, please share, subscribe, like, and restack. You can find previous posts at this link. Views expressed in Employer Coverage are purely my own. Thanks for reading Employer Coverage ! Subscribe for free to receive new posts and support my work. Subscribe
How Lindsay Clancy case could reshape postpartum mental health care
Experts point to better screening, provider training and care coordination as Massachusetts expands postpartum mental health support.
Democrats begin asking: How far can we go on health care?
Many in the party are pushing for Democratic lawmakers to go big on health care, but their dreams may crash into reality.
Learn & Earn: The Health Care Connection: Radio Builds Familiarity, Trust.
Choosing a health care provider is a deeply personal decision, with trust, affordability and accessibility all playing important roles. As consumers embrace digital tools while continuing to value professional expertise
Carteret Health Care mobile health bus to hold free screenings
Carteret Health Care’s mobile health bus is offering free community health screenings at two Carteret County locations Monday, November 9. No appointment is nee
Newsmakers: Dartmouth Health doctor appointed president of A...
This week’s Newsmakers highlights leadership appointments, professional certifications and expanded health care and education services across New Hampshire and ...
Colorado Mountain College Breckenridge to screen documentary about behavioral health careers
On Thursday, Nov. 12, Colorado Mountain College Breckenridge will be hosting a free showing of “Homegrown Healing Opportunity Now,” a new documentary exploring career opportunities in Colorado’s behavioral health field. The event will run from...
Karla Hult talks jump into politics
Former KARE 11 journalist Karla Hult is preparing for a new role at the Minnesota Capitol after being elected to represent Senate District 50, covering parts of Bloomington and Edina. In an interview with FOX 9, the senator-elect discusses her transition from journalism to public service and outlines legislative priorities, including affordability, housing costs, child care, health care and gun safety.