KFF: Insurer Participation in ACA Marketplaces Is Down
KFF’s analysis found that the average number of issuers offering plans on the Marketplaces declined to 9 issuers per state in 2026, compared to 9.6 issuers per state in 2025.
It Took Years for Congress to Enact PBM Transparency, Delinking. What About Vertical Integration?
Experts say the bipartisan Break Up Big Medicine Act — aimed at breaking up vertically integrated healthcare companies — faces slim chances of passing despite recent PBM reforms.
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New Webinar: The Payer AI Readiness Gap: Why Better Data Will Define the Next Era of Health Plan Performance
We'll explore why the next era of payer performance will depend on building a trusted data foundation that connects people, providers, and relationships across the enterprise.
Why a US Judge Paused Several Provisions of the Marketplace Rule
A judge temporarily blocked key parts of a Trump rule that would have restricted access to Marketplace coverage, marking a legal victory for Democrats and healthcare advocates who argued the rule would cause widespread coverage losses and violated federal law.
ACA Marketplace Insurers Proposing 15% Median Premium Increase in 2026
Most ACA Marketplace insurers are requesting premium increases between 10% and 20% for 2026, according to a new analysis. More than a quarter (27%) are requesting increases of 20% or more.
Report: Majority of Medicare Advantage Markets Lack Competition
A recent KFF report showed that in 2024, 79% of counties in the U.S. were highly concentrated for Medicare Advantage, and 18% were very highly concentrated.
Could the Trump Administration Change the Medicare Drug Price Negotiation Program?
CMS recently issued a statement saying that it's continuing the Medicare Drug Price Negotiation Program but is leaving the door open for potential changes. Experts weighed in on what changes could be made and what changes they would like to see.
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Inside an Automated Healthcare Practice: Redesigning Care Around People, Not Paperwork
By reducing administrative burden and redesigning workflows around human needs, it creates space for what matters most: connection between clinicians and patients.
Report: HealthCare.gov Insurers Denied 19% of In-Network Claims in 2023
About one in five in-network claims were denied by insurers of qualified health plans on HealthCare.gov in 2023, according to KFF. There is also wide variation by insurer and state.
7 States Passed Abortion Rights Ballot Measures. But Changes Won’t be Like a “Light Switch,” Experts Say
In the 2024 election, seven out of 10 states passed ballot measures protecting abortion rights. But the effects won't be seen immediately, experts say.
Report: MA Insurers Denied 3.4M Prior Authorization Requests in 2022
About 7.4% of prior authorization requests submitted to MA insurers were denied in 2022, according to a recent KFF report. Of these denials, only 9.9% were appealed.
Report: MA Beneficiaries Represent Growing Share of Inpatient Hospital Days
A new KFF report detailed the growth in Medicare Advantage's share of total inpatient hospital days.
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The Power of Real World Data to Study Women’s Health at Scale
Veradigm examines key clinical trends, comorbidity profiles, and treatment trends across adolescence, reproductive years, and peri-/post-menopause. Download it today!
The FTC Released a Scathing Interim Report on PBMs. What’s Next?
The Federal Trade Commission recently released an interim report that details how the practices of pharmacy benefit managers negatively impact patients and pharmacies. Some experts hope for legislative action based on the report.
1 Year Later: How Has the Unwinding of Medicaid Continuous Enrollment Gone?
One year after the Medicaid continuous enrollment provision ended, 19.2 million people have been disenrolled from Medicaid, according to KFF. This is higher than many expected, and experts have mixed reviews on how they think this process has gone.
Report: Few Large Employers Have Changed Abortion Coverage Following Dobbs v. Jackson
Only 8% of large employers have reduced or expanded their coverage for abortion after the Dobbs v. Jackson decision, a new report from KFF found.
Is AI in Prior Authorization Promising or Dangerous?
AI can improve the prior authorization process, but there needs to be more transparency, experts said during a recent panel held by KFF.
Medicaid Spending on Prescriptions Has Risen Despite Lower Utilization
A new KFF report analyzed recent trends in Medicaid outpatient prescription drug utilization and spending. It discovered that although there's been lower utilization of prescription drugs in recent years, Medicaid spending on prescription drugs has increased.