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Amy Robbins’ reaction as Clancy Juror talks about Massachusetts’ postpartum mental health plan
Employee health plans to remain unchanged for 2027, contributions to increase
When Penn State’s 2027 benefits open enrollment period begins on Nov. 2, benefits-eligible faculty and staff will continue to have access to the same high-quality health care coverage and programs. Beginning Jan. 1, 2027, employees will see an increase in their payroll contributions to keep pace with rising health care costs.
Inland Empire Health Plan receives 4-star NCQA Medicaid plan rating
/PRNewswire/ -- The National Committee for Quality Assurance (NCQA) awarded Inland Empire Health Plan (IEHP) an overall rating of 4 out of 5 for Medicaid...
NYC Health + Hospitals and Maimonides Health Transaction Moves Forward After New York State Health Planning Council Vote
New York, NY – In a unanimous vote, the full New York State Public Health and Health Planning Council (PHHPC) today approved the proposal for Maimonides
Outcome of suit against Department of Labor could boost skimpy employer health plans
A long-running lawsuit challenging what it means to be an employee and therefore have access to work-based health plans is being closely watched by health policy analysts.
Zocdoc for chatbots and what's new with Medicare's ACCESS
In this edition of STAT Health Tech: Zocdoc enables appointment scheduling from chatbots and health plan websites, and more.
Comstock Schools: Teachers could get raise by dropping MESSA for cheaper health plan
Michigan schools grapple with rising insurance costs
Vitality and Google Expand Technology Partnership to Bring AI-Driven Health Platform to the United States to Incentivize Healthier Behaviors
Vitality AI, built on Google Cloud and using Gemini Enterprise, expands into the U.S. market — bringing proven personalized health recommendations, coaching, and incentives to health plans and...
Dario Wins Contract with One of New Jersey's Largest Health Plans Representing 1.5 Million Covered Lives
/PRNewswire/ -- DarioHealth Corp. (NASDAQ: DRIO) (the "Company", "DarioHealth" or "Dario"), a leading AI-powered healthcare technology company transforming the...
CT adds guardrails on AI use in some health plans. It could expand to all
In January, Comptroller Sean Scanlon will recommend lawmakers require all state-regulated plans to adhere to the same policies.
CT announces AI regulations for state employee health plans
The new rules apply to enrollees in state employee health plans and the CT Partnership Plan for municipal and other public-sector employees.
SCAN Health Plan, Walmart partner on Medicare Advantage plans
SCAN Health Plan is partnering with retail giant Walmart to launch a co-branded Medicare Advantage plan in two states, the companies
In new State Health Plan program, a cluster of rural NC hospitals could cost patients more
State employees will likely pay more for healthcare if they use hospital systems in four rural counties north of the Triangle.
Kaiser Permanente leads the nation in top-rated health plans
/PRNewswire/ -- Kaiser Permanente continues to provide some of the highest-rated health care in the nation. In the 2026 National Committee for Quality...
Outcome of suit against Department of Labor could boost skimpy employer health plans
The Trump administration has been sharply focused on expanding access to alternative coverage.
NCQA Unveils 2026 Health Plan Ratings
18 health plans earn top 5-star rating. / ACCESS Newswire / September 16, 2026 / The National Committee for Quality Assurance () announced its 2026 Health Plan Ratings \- an annual report that helps healthcare consumers and regulators assess the quality and effectiveness of health plans.
Survey: 54% of Small- to Mid-Sized Businesses Report Double-Digit Health Plan Premium Increases for 2027
/PRNewswire/ -- eHealth (Nasdaq: EHTH), a leading private online health insurance marketplace, today published new original research showing that over half of...
Ayble Health banks $16M series A to expand AI-driven precision digestive, autoimmune healthcare
Ayble Health secured a $16 million oversubscribed series A funding round to accelerate its expansion into artificial intelligence-driven precision digestive and autoimmune healthcare. | Ayble Health says it is currently in-network with most commercial health plans, covering more than 80 million patients through its various partnerships.
CaroMont Health plans new hospital near Lake Wylie as York County grows
CaroMont Health plans to build a neighborhood hospital in Clover, South Carolina by 2031 to serve the Lake Wylie and York County region.
CaroMont Health plans new hospital near Lake Wylie as York County grows
CaroMont Health plans to build a neighborhood hospital in Clover, South Carolina by 2031 to serve the Lake Wylie and York County region.
SAN FRANCISCO HEALTH PLAN EARNS HISTORIC 4.5-STAR RATING IN 2026 NCQA HEALTH PLAN RATINGS
For the first time in its history, San Francisco Health Plan (SFHP) has earned a 4.5-star rating in the 2026 NCQA Health Plan Ratings. NCQA considers health plans earning 4.5 or 5 Stars to be among the highest-rated health plans in the nation. This achievement comes as SFHP prepares to celebrate 30 years of serving San Francisco's most vulnerable communities.
Wausau city employees face 76% deductible hike under 2027 health plan
Wausau city employees' health insurance deductibles would jump 76% in 2027 under a plan committees approved to hold the premium increase to 9.6%.
Only 46% of Gen Z, Millennial health plan members trust payers: Accenture survey
Member trust in insurers is on the decline among Gen Z and Millennials, down 10.5% between 2023 and 2026, new research from Accenture found. | This trust gap, according to analysts, could cost $3 billion in future member lifetime value for the largest commercial payers over the next decade.
Medallion Acquires Andros to Expand AI-Native Credentialing Across Health Plans and Provider Organizations
/PRNewswire/ -- Medallion, the only AI-assisted credentialing and enrollment platform with expert oversight, today announced it has acquired Andros, an...
NC State Health Plan, Atrium Health partner to expand options for 750,000 members
RALEIGH, N.C. — The North Carolina State Health Plan and Atrium Health have announced a new partnership that will expand coverage options for plan members begin
Outcome of employment lawsuit could promote use of skimpy health plans
A long-running lawsuit challenging what it means to be an employee and therefore have access to work-based health plans is being closely watched by health policy analysts.
As Federal Law Kicks In, Oregon Health Plan Will Soon Be Harder for Thousands to Get
In the coming weeks, more than 600,000 Oregonians on the Oregon Health Plan are set to get letters notifying them that they may soon be subject to new work or activity rules if they want to keep the health coverage.
In a reversal, NC Health Plan moves some Atrium hospitals to mid-tier for 2027
A dozen Atrium hospitals will no longer be designated as “non-preferred” under the plan’s new tiered network, taking effect Jan. 1, 2027.
New NC State Health Plan agreement will avoid big cost hikes for using some Atrium hospitals
NC State Health Plan reaches an agreement with Atrium Health to move some of its hospitals and clinics to a lower expense tier.
CT insurance department approves rate hikes for 2027 health plans
CT elected officials criticized the approved average rate hike of 11.3% for 2027 state-regulated, individual health plans.
Rising health care costs prompt changes for Washoe County, school district employees
Washoe County and school district boards approved health plan changes for 2027 due to rising costs, impacting thousands of employees.
United Way launches health plan for Indiana nonprofits
By Eniola Longe | Inside INdiana Business
Your Employer's Health Plan Is the Single Largest Tax Break in America, and It Never Shows Up on Your Return
The biggest tax break most American workers receive never appears on their return, never gets debated at filing time, and quietly delivers a bigger federal subsidy to higher earners than anything they could ever itemize.
Arkansas Department of Health plans to cut 38 jobs, eliminate additional 33 empty positions
The Arkansas Department of Health plans to eliminate 71 positions, including 38 that are currently filled, effective Nov. 1, a department spokesperson said Friday.
Arkansas Department of Health plans to cut 38 jobs, eliminate additional 33 empty positions
The Arkansas Department of Health plans to eliminate 71 positions, including 38 that are currently filled, effective Nov. 1, a department spokesperson said Friday.
Arkansas Department of Health plans dozens of layoffs in November
The Arkansas Department of Health will eliminate 71 positions on Nov. 1 to better align its resources with the agency’s budget priorities and long-term goals.
His Retiree Health Plan Kept Paying After 65. It Paid Only What Medicare Would Have Left Over, and He Had Never Enrolled
His former employer's retiree plan kept paying claims for three years, and every explanation of benefits looked fine until a hospital stay produced a bill worth thousands of dollars that no one had warned him was coming.
Provider data errors are putting health plan AI investments at risk
Only 12% of health systems and health plans rate their provider data quality as excellent, new research finds
Sticker shock as health insurance premiums increase ahead of new coverage cliff
Washington’s insurance commissioner has approved an average 22.2% increase in premiums for health plans sold through the state’s insurance exchange next year.
WA officials rush to help thousands keep health plans as Medicaid cuts loom
Washington state leaders are trying to help about 200,000 people retain their health insurance as federal changes to Medicaid are rolled out in the coming months.
Nearly All Health Systems and Health Plans Need Better Provider Data. Few Have It, and AI Investment Is at Risk.
/PRNewswire/ -- Health systems and health plans rank network and market expansion as the strategic priority that would benefit most from better provider data....
WA approves double-digit rate hike for individual health insurance plans
The state insurance commissioner on Wednesday approved a 22.2% average rate increase for individual health plans in 2027 — an announcement that set off alarm bells from consumer advocates and policymakers over the ballooning cost of coverage. Washingtonians who buy...
St. John's parent company sues Medi-Cal plan for over $30M left unpaid
Gold Coast Health Plan is being sued by a hospital system that alleges it is owed more than $30 million in unpaid claims.
Ohio-based Clarence Health brings personalized health support to everyday life
Managing your health doesn’t stop when you leave the doctor’s office. Clarence Health helps people stay organized, prepare for medical visits and create personalized health plans, all in one place.
600,000 Oregonians may be impacted by Medicaid work requirement changes
More than half a million Oregonians who are currently enrolled in the Oregon Health Plan could be impacted by new work requirements.
Health Plans Have the SDoH Data. New Research Shows only 7% are Highly Effective at Using It.
Health plans are collecting significant amounts of social drivers of health (SDoH) data, but only few believe they are highly effective at turning that information into action, according to new research from national health care consultancy Sage Growth Partners. Sage's survey of 50 health plan leaders found that 60% collect SDoH screening data, yet just 7% describe their organizations as "very effective" at acting on that information.
NASCO and Doxim Partner to Modernize Health Plan Administration and Improve Communications
/PRNewswire/ -- NASCO, a leading provider of healthcare technology solutions, today announced a strategic partnership with Doxim®, a leader in customer...
NASCO and Doxim Partner to Modernize Health Plan Administration and Improve Communications
NASCO, a leading provider of healthcare technology solutions, today announced a strategic partnership with Doxim®, a leader in customer communications management (CCM) and engagement technology for highly regulated markets. The collaboration brings together NASCO's deep health plan administration expertise with Doxim's omnichannel communications capabilities to help health plans modernize operations and deliver more seamless, personalized experiences for all healthcare stakeholders.
H1 acquires Defacto Health to expand provider network intelligence
H1 has acquired Defacto Health, a healthcare data company focused on provider network intelligence, in a move to expand its offerings for health plans and strengthen its healthcare data assets. | H1 has acquired Defacto Health, a healthcare data company focused on provider network intelligence, in a move to expand its offerings for health plans and strengthen its healthcare data assets.
Trinity Health plans to lay off 500 information technology-related roles
Association Health Plans Could Give Small Businesses A Break On Health Costs
Small businesses have struggled with the rising cost of health insurance for years. The Trump administration may soon give them a meaningful way to fight back.
Association Health Plans Could Give Small Businesses A Break On Health Costs
Small businesses have struggled with the rising cost of health insurance for years. The Trump administration may soon give them a meaningful way to fight back.
NC Medicaid, State Health Plan strategies diverge on GLP-1 coverage
More than 34,500 Medicaid beneficiaries had $47.9 million in weight-loss GLP-1 claims in June, while State Health Plan coverage remains limited.
Pa. Health insurers propose 2027 rate hikes as Pennsylvanians grapple with rising costs
Thousands of Pennsylvanians dropped their health plans purchased on the state’s Affordable Care Act marketplace, Pennie, after the expiration of federal subsidies more than doubled monthly costs. Now, many health insurers that offer plans through Pennie are proposing rate increases for 2027.
Public health planner answers questions on homelessness strategic plan
City staff has planned focus groups, stakeholder input meetings and one-on-one interviews to develop a strategic plan.
3 Stocks Tied To Rising HSA Use Including CVS Health Stock
Health Savings Accounts are quietly becoming a core part of how Americans pay for care, with more employers auto enrolling workers and pairing HSAs with high deductible health plans. That shift channels more money through platforms that handle contributions, custody, and investments. For investors, the question is which stocks may benefit most from this structural change. This article walks through three HSA exposed stocks from our screener and what the news could mean for each. The three...
Cancer patient feels "like collateral damage" after MGB Health Plan removes Dana-Farber from Medicare Advantage network
Vitality Acquires Icario, Creating Health Engagement Platform Serving 19 Million Members
Vitality has acquired Icario, creating a combined health engagement platform that will serve approximately 19 million members and 30% of U.S. health plans, including eight of the country's 10 largest plans.
MGB Health Plan removes Dana-Farber Cancer Institute from Medicare Advantage network
NJ panels OK rate hike for public worker health plans, deadlock on increase for teachers
Double-digit hikes approved for state and local government worker plans, but a separate panel deadlocked on increases for school workers' plan
Blue Ridge Health plans new medical facility in Hendersonville
WLOS News 13 provides local news, weather forecasts, traffic updates, notices of events and items of interest in the community, sports and entertainment programming for Asheville, NC and nearby towns and communities in Western North Carolina and the Upstate of South Carolina, including the counties of Buncombe, Henderson, Rutherford, Haywood, Polk, Transylvania, McDowell, Mitchell, Madison, Yancey, Jackson, Swain, Macon, Graham, Spartanburg, Greenville, Anderson, Union, Pickens, Oconee, Laurens, Greenwood, Abbeville and also Biltmore Forest, Woodfin, Leicester, Black Mountain, Montreat, Arden, Weaverville, Hendersonville, Etowah, Flat Rock, Mills River, Waynesville, Maggie Valley, Canton, Clyde, Franklin, Cullowhee, Sylva, Cherokee, Marion, Old Fort, Forest City, Lake Lure, Bat Cave, Spindale, Spruce Pine, Bakersville, Burnsville, Tryon, Columbus, Marshall, Mars Hill, Brevard, Bryson City, Cashiers, Greer, Landrum, Clemson, Gaffney, and Easley.
Johns Hopkins Health Plans taps interim CEO as it searches for successor
Daniel Chojnowski, JHHP’s current CFO, will provide stability so that the Baltimore-area insurer can recruit full-time for its next chief executive, the company said.
New research: For lower costs without worse outcomes, vertically integrate healthy health systems with certain health plans
Hospital-operated Medicare Advantage plans can help streamline post-hospitalization care of discharged inpatients while cutting episode-of-care costs and maintaining good patient outcomes.
Stanford Health Care, John Muir Health to cut 173 Bay Area jobs
Stanford Health Care is eliminating 95 technology and administrative jobs in Palo Alto, while John Muir Health plans to cut 78 positions across several East Bay locations.
CHI St. Vincent & CommonSpirit Health opt out of AR Blue Cross Blue Shield networks
CHI St. Vincent has opted out of the healthcare provider networks of Arkansas Blue Cross and Blue Shield and its associated health plans (Arkansas Blue Medicare
Novant is making it easier for health plan members to get ready for 2027 benefits
Novant and UNC Health will become preferred providers starting Jan. 1.
NYC Health + Hospitals and Maimonides Health Transaction Moves Forward to Next Step After Unanimous New York State Advisory Board Vote
In a unanimous vote on Thursday, August 27, the Establishment and Project Review Committee of the New York State Public Health and Health Planning Council
Health plan in NY deny your claim? Research says keep appealing
For home health care, 78.4% of claims denials taken to the second level of appeals were overturned during tthe study period, researchers found.
Healthcare Costs Are Squeezing Montana’s State Workforce
Some employees will see their insurance contributions double and individual deductibles triple as the state confronts dwindling reserves in its employee health plan.
Neronha urges R.I. regulators to reject proposed health insurance premium hikes
Neronha’s office has formally submitted a brief objecting to Neighborhood Health Plan of Rhode Island’s request for a rate increase of 22.4 percent.
Labor Department to propose expansion of association health plans, which could lower insurance costs for some workers
The agency has submitted a rule proposal to the White House that could allow more workers to get health insurance through association health plans.
Neronha urges state regulators to reject proposed health insurance premium hikes
Rhode Island Attorney General Peter Neronha is urging state regulators to deny proposed 2027 health insurance premium increases from Neighborhood Health Plan and Blue Cross Blue Shield, arguing the hikes are untenable for Rhode Islanders.
Corewell Health plans hospital facility updates in Troy, Grand Rapids
“High-Deductible Health Plans Are Not the Answer”
In a new study, LDI Fellows found that high-deductible plans reduce health care spending at first, but may not slow spending growth over time.
Morehouse School of Medicine, Atrium Health plan new teaching hospital in southwest Atlanta
Highmark Health Plans appoints new president
Highmark Health Plans — the Pittsburgh based nonprofit that insures nearly 8 million people — has a new president. Gustavo “Gus” Giraldo will begin effective immediately, parent company Highmark Health announced Monday. Giraldo comes most recently from CVS Health-owned Aetna, where he served as senior vice president of individual and
Highmark Health boosts Q2 operating income
Led by gains in its health plans and hospital subsidiaries, Highmark Health on Monday reported more than a six-fold increase in operating income for the...
Highmark Health Plans names new president
Gustavo (Gus) Giraldo has been named president of Highmark Health Plans, replacing Tom Doran, who is leaving the organization to pursue other opportunities,...
Health plans will cost more in 2027, for employers and workers
Insurance broker Aon says employer-sponsored plans are poised to increase 9.5% next year, to average more than $19,000 per worker.
Cityblock to Acquire Homeward Health, Secures $116M Series E
Cityblock Health plans to acquire rural healthcare provider Homeward Health and has raised $116 million to expand its value-based care model to rural and Medicare Advantage populations.
How a physician with a 1 a.m. bedtime optimizes his health: I try to 'tick all the longevity boxes that I can'
Dr. Ronald Primas, a longevity physician, offers concierge services like developing personalized health plans for clients. Here are his own wellness practices.
Aon: U.S. Employer Health Care Costs Continue Multi-Year Climb, Projected to Rise 9.5% in 2027
Fourth straight year of near double-digit increases for U.S. employers Employers now absorb more than 80% of health plan costs as rising expenses increasingly impact workforce and business...
NJ panel deadlocks on vote to raise health premiums for teachers
The NJ-run health plan for teachers may see a 34% premium hike next year. The panel tasked with approving rates punted on a vote Wednesday.
Providence Health Plan to close completely after Medicare Advantage deal falls through
The regional health plan was in talks with an unnamed national insurer to keep its MA plans afloat. But the agreement sputtered “despite significant effort on all sides,” a Providence spokesperson said.
NJ towns, school districts in debt to 'death spiral' health plans
As rates about to rise, about 50 local entities owe millions of dollars, led by Paterson, Newark and a Hudson County school district
Costco plots major expansion into senior healthcare with Medicare partnership
In a first-of-its-kind venture, Costco is partnering with SCAN Health Plan on senior-focused insurance products that could include pharmacy, vision and hearing benefits.
Costco strikes first comprehensive Medicare plan partnership with SCAN Health Plan
Costco announced a partnership withSCAN Health Plan to provide medical care to Costco members.SCAN Health Plan and Costco Wholesale Corporation announced an en
Dartmouth Health says it needs to close telehealth services for emergency and intensive care
Dartmouth Health plans to end its Tele-ICU and Tele-ED services, affecting five Vermont hospitals and more in the region
Mississippi weighs three-year short-term health plan as coverage drops
One-year short-term plans are already available. The state is working on a three-year option through an online portal where people could compare doctors, drugs and provider networks.
Blue Shield of California Renews NCQA Health Plan Accreditation, Advancing Commitment to Quality
"NCQA accreditation is a widely recognized benchmark of healthcare quality,"
New Mexico behavioral health committee approves $40M in funding for rural behavioral health plans
The New Mexico committee tasked with rebuilding the state's behavioral health infrastructure approved $40 million in funding requests Friday.
As It Walks Toward Its Doom, Providence Health Plan Gets More Bad News
In change of plans, the Portland-based health insurance company say it would be closing down its Medicare Advantage line too after negotiations with a national big insurance company failed.
N.J. towns, school districts owe millions to public worker health plans
Some districts that disenrolled years ago haven’t settled debts.
Sunflower Health Plan Maintains Strong Member Satisfaction Ratings in Annual LTSS Survey
Independent survey finds nearly 98% of respondents are satisfied with the care they receive from Sunflower and 99% report feeling safe with those who support them. LENEXA, Kan., Aug. 13, 2026...
NJ towns, school districts owe millions to public worker health plans
As state-run health benefits plans rise in cost, some towns and school districts owe the plans tens of millions of dollars.
US Employers Abandon Group Health Insurance as Price Hikes Bite
As US employers brace for the largest price hikes on employee health plans in 15 years, a growing number are opting out of group insurance altogether.
State Meditates Another Huge Pay Bump for Oregon Health Plan Operators
The proposal, which is preliminary, comes as alarm bells clang over runaway medical inflation.
The U.S. Healthcare System is Already Mostly Socialized
Now that Abdul El-Sayed is the Democratic nominee for Michigan’s open Senate seat, the outcome of this crucial race will depend mainly on two things: Whether Republicans succeed in demonizing El-Sayed because he’s brown and a Muslim, and whether they succeed in demonizing him as a left-wing radical. I will defer for the now the question of whether bigotry will be effective this year, although I will address it another day. What I want to address instead is El-Sayed’s signature issue — healthcare. Yes, El-Sayed advocates Medicare for All, a position the usual suspects denounce as “socialism.” I will get to the politics of his stance soon. Today, however, I want to talk about the substance. We should be clear that El-Sayed doesn’t even call himself a socialist. On the contrary, he explicitly disavows the label, saying “I’m a capitalist who just knows about capitalism”. In fact, as I explained in a previous post, the policies that El-Sayed advocates qualify him as a social democrat, not a socialist. Still, El-Sayed advocates a system under which the government would pay almost all medical expenses. Isn’t that socialism? Well, if that is the criterion then much of U.S. healthcare is already socialist. In fact, the government’s role is so large that U.S. healthcare is better described as partially privatized socialism than as anything resembling a free market. Let’s start with the raw numbers on health insurance, which pays the bulk of Americans’ medical expenses. Americans receive health insurance either from private companies or from public programs, overwhelmingly Medicare and Medicaid. Here’s what the breakdown of coverage and spending between private and public looked like in 2024: While a majority of Americans with health insurance get it from private companies, well over 100 million of us are covered by government programs instead. And these government programs pay more total dollars for medical bills than the private insurers do. Why do government programs that cover a minority of the population account for a majority of health insurers’ outlays? Mainly because Medicare covers seniors, and we’re expensive. Also, while Medicaid covers many younger Americans, disabled and elderly beneficiaries account for most of its spending. Even by the raw numbers, then, U.S. health insurance looks as much public as private. But that understates the government’s role: Private health insurance in the U.S. is both highly regulated and heavily subsidized. This is obviously true for the insurance coverage purchased by tens of millions of Americans through the exchanges established by the Affordable Care Act. But employment-based health insurance, which covers 161 million Americans, is far more of a government creation than most people realize. For employment-based insurance exists largely because of huge implicit government subsidies that come with major strings attached. Here’s how that works. If your employer pays you $10,000, that’s taxable income. But if your employer pays $10,000 toward a company health insurance plan that meets certain criteria, it isn’t taxable. That’s a huge effective subsidy, running at more than $300 billion a year. Take that subsidy into account, along with the more than $100 billion per year spent subsidizing policies purchased under the ACA, as well as the outlays on Medicare and Medicaid, and net effect is that the government pays for more than two-thirds of Americans’ health insurance. Granted, there are strings attached. Roughly speaking, employment-based health plans can’t discriminate based on medical history — that is, they can’t deny coverage to employees with pre-existing conditions — and they also can’t offer the plans only to highly compensated employees — a health plan that is only for the C-suite is considered taxable income. So given the restrictions of the federal tax code, employer-based health insurance is a lot like Obamacare, which also prohibits discrimination based on medical history and provides subsidies to make insurance affordable to lower-paid workers. The fact is that virtually all of private healthcare insurance is already well under some form of government control through regulation and tax subsidies. How should we think about this system? First of all, is Medicare socialist? Don’t tell anyone, but the way Medicare operates — it covers every senior’s medical expenses, whatever they turn out to be, while being funded by taxes that depend on one’s income — could be summarized by the old Marxist slogan “From each according to his ability, to each according to his need.” And back in 1961, when Ronald Reagan was the face of a last-ditch effort by the American Medical Association to block the creation of Medicare, he denounced Medicare as “socialized medicine” and warned that it would destroy our freedom. In reality, American freedom survived until Jan. 20, 2025, while Medicare is immensely popular, with an 82 percent favorable rating in the most recent KFF survey. Medicaid, government health insurance for lower-income Americans, comes in at 73 percent. This is in sharp contrast to public views about private insurers, who are widely disliked if not hated and accused of denying essential care. Furthermore, if Medicare is socialism, then the whole U.S. health insurance system, with the government paying most of the bills and placing conditions on private insurers, is almost equally socialist. If you insist on calling any program the government pays for and regulates socialist, then U.S. healthcare would best be described as a partially privatized form of socialism. And one must ask, what is the point of the part that is privatized? Do private insurers add anything positive? Or are they simply parasites, skimming off money that could have been paying for care? The case for viewing insurers as parasites is strong. Many Medicare benefits are now delivered via Medicare Advantage, that is, plans paid for by the government but run through insurance companies. MedPAC, an independent advisory commission, estimates that last year Medicare Advantage plans were overpaid by $84 billion, thanks to practices such as “upcoding,” in which patients’ health problems are overstated to get larger sums from Medicare. Assessing the waste from employer-based insurance is harder, but most evidence suggests that private insurers have substantially higher administrative costs than Medicare does. Furthermore, the complexity of private insurance, with multiple payers all trying to deny care when they can, is a huge burden both on providers — doctors, nurses, and hospitals — and on patients. What do private insurers offer to compensate for these costs? One must go through intellectual contortions to avoid the conclusion that they are, in fact, parasites. Which brings me back to El-Sayed. In supporting Medicare for All, he’s basically calling for an end to the partial, parasitic privatization of a healthcare system that is already hugely dependent on public funding. When one looks at it that way, it’s not at all a radical proposal. Admittedly, the political lift requires overcoming the opposition to higher taxes to pay for Medicare for All. Political realism rather than economics was the reason I and many other progressives supported Obamacare, with all its complexities, rather than demanding an immediate move to Medicare for All. But the political calculus may very well have shifted since the 2000s, as Americans are fed up with a system of unaffordable premiums, rampant claim denials, and byzantine claim administration. Moreover, funding healthcare insurance through taxation would allow for a much more progressive distribution of the cost. That is, compared to the present system, middle-income households would pay less as high-income households would pay more. And the U.S. would stop wasting large sums on pointless administrative costs. So let’s be clear: El-Sayed’s healthcare platform is perfectly reasonable on the merits of cost, fairness and health efficacy. And with private insurers never more hated, while millions of Americans are losing their health insurance, 2026 may be its time. MUSICAL CODA
Here’s how a summertime health plan review can pay off during fall open enrollment
Learn key timelines, evaluation tips, and important documents to prepare for health insurance enrollment to avoid coverage gaps in 2027.