Live Insurance News

Obesity Crisis Meets Policy Standstill as Trump Halts Medicare Expansion

April 7, 2025April 6, 2025 Ester Adams

Medicare’s role in weight-loss drug coverage

Trump Administration Reverses Plans to Expand Medicare Coverage for Obesity Drugs The Trump administration has officially halted a Biden-era initiative that aimed to extend Medicare and Medicaid coverage to include obesity drugs, a move set to impact millions of Americans coping with obesity, disproportionately affecting seniors and lower-income groups. While supporters saw the proposed expansion as a progressive step towards tackling one of the nation’s most pressing health challenges, critics have raised concerns over the potential cost burden. Below, we untangle the implications of this decision, exploring its economic, medical,…

Tragedy, Reform, and the State of Health Care – A Look at UnitedHealth Group

January 23, 2025January 22, 2025 Marc

A Shocking Loss That Shook a Nation The murder of Brian Thompson, the CEO of UnitedHealth Group’s UnitedHealthcare division, stunned the country in December 2024. Thompson, a 50-year-old husband and father of two, was fatally shot while walking to a company meeting in New York City. It was a crime that not only horrified his colleagues and family but also put a harsh spotlight on the broader frustrations with the U.S. health care industry. The accused, Luigi Mangione, reportedly had grievances about systemic issues in the health care system. He…

Massive $21 Billion Medicare Boost Set to Transform Senior Healthcare in 2026

January 14, 2025January 13, 2025 Logan B.

Proposed 2026 Medicare Advantage Reimbursement Rates See Positive Growth The Centers for Medicare & Medicaid Services (CMS) has proposed a 2.2% increase in reimbursement rates for Medicare Advantage (MA) plans in 2026, marking a sharp improvement from the 0.2% decline seen the previous year. When factoring in the 2.1% “risk score” adjustment to account for higher payments for individuals with severe health conditions, the total estimated increase in payments rises to 4.3%—equivalent to more than $21 billion. This proposal is poised to have a significant impact on insurers, healthcare beneficiaries,…

California Health Insurance Law SB 1120 Takes a Stand Against AI-Driven Health Insurance Denials

January 11, 2025January 10, 2025 Angela Linders

California Enacts SB 1120 to Rein in AI-Powered Health Insurance Decisions California has taken a groundbreaking step in regulating the role of artificial intelligence (AI) in health insurance decision-making. Senate Bill 1120 (SB 1120), also known as the “Physicians Make Decisions Act,” prohibits health insurers from denying, delaying, or altering claims solely based on AI algorithms. Signed into law by Governor Gavin Newsom, this legislation ensures human oversight in healthcare coverage decisions, addressing mounting public concerns about fairness and accuracy in the use of AI technologies. Effective as of January…

Work-Related Stress Compensation Reform in New York – Understanding S.B. 755

January 10, 2025January 10, 2025 Logan B.

The Stress Debate and Who Really Deserves Compensation? The New York State Senate is set to deliberate on S.B. 755, a bill proposing significant amendments to the workers’ compensation law passed in December 2024. This 2024 statute opened a pathway for employees experiencing “extraordinary work-related stress” to file compensation claims, broadening access to mental health support in the workplace. However, S.B. 755 seeks to narrow this scope, limiting eligibility for such claims to first responders only. If adopted, the bill would focus on professions such as police officers, firefighters, paramedics,…

Affordable Care Act Enrollment Breaks Records But Faces an Uncertain Political Future

January 10, 2025January 10, 2025 Live Insurance News

Record ACA Enrollment Under Biden Administration The Biden administration has announced a groundbreaking achievement in health care access, with nearly 24 million Americans enrolling in Affordable Care Act (ACA) Marketplace plans for 2025. This record-breaking figure nearly doubles the enrollment totals from four years ago, solidifying the ACA as a critical pillar of American health care. The success is attributed to expanded federal subsidies, streamlined enrollment processes, and heightened outreach efforts under President Joe Biden’s leadership. The Role of Enhanced Federal ACA Subsidies A significant driver behind the surge in…

How Aetna is Challenging Big Pharma in a Price-Fixing Battle

January 7, 2025January 7, 2025 Tate Ellison

Aetna Files Lawsuit Against Major Drugmakers Alleging Price-Fixing Conspiracy Aetna, a leading health insurer, has initiated a lawsuit against major pharmaceutical companies including Pfizer, Novartis, and Teva Pharmaceuticals, accusing them of conspiring to manipulate the market for generic drugs. The lawsuit alleges that the drugmakers colluded to artificially inflate prices, disadvantaging insurers, federal programs, and consumers. This legal action highlights growing concerns over anticompetitive practices in the pharmaceutical industry, with potential implications for healthcare costs nationwide. Details of the Lawsuit According to Aetna’s complaint, filed in Connecticut on December 31,…