Morning Briefing
Summaries of health policy coverage from major news organizations
ACA Coverage Losses Might Be More Severe Than We Think, Analysis Indicates
Newly released state enrollment data show ObamaCare coverage losses could be even more severe than initially anticipated, due to Congress’s unwillingness to renew enhanced subsidies. Monthly enrollment data through April from Arkansas, Colorado, Maryland, Massachusetts, New Mexico and New York showed a significant number of people canceled their coverage or did not pay their premium bills after signing up for coverage in 2026, according to an analysis from Georgetown University. (Weixel, 6/10)
Medicare and Medicaid developments —
Patients enrolled in some of the nation’s largest Medicare Advantage plans were denied requests for rehabilitation and other critical services at unusually high rates, according to a report released Thursday by the Department of Health and Human Services’ inspector general. It comes amid increased scrutiny of how insurers use prior authorization, a cost-cutting tool that experts say often leads to the delay or denial of necessary care. (Lovelace Jr., 6/11)
Legislation aimed at reducing delays when Medicare Advantage plans require preapproval for care could hit the House floor under fast-track rules for bills that have broad support. The bill, sponsored by Rep. Mike Kelly, R-Pa., targets use of prior authorization in Medicare Advantage — in which insurers approve or deny services before they can be delivered. (Hellmann, 6/10)
The Centers for Medicare and Medicaid Services has granted Clover Health higher Medicare Advantage quality scores after the insurer won a lawsuit last month, the company announced Wednesday. Clover Health’s largest Medicare Advantage contract — which comprises multiple plans — earned a boost to its 2026 star rating. The company successfully challenged the legality of some of the measures CMS uses to evaluate Medicare Advantage plans. (Tepper, 6/10)
North Carolina’s Department of Health and Human Services waited nearly a year for federal guidance on implementing the Medicaid work requirement approved by congressional Republicans last summer. The mandate, passed in the summer of 2025 as part of the One Big Beautiful Bill Act, takes effect on Jan. 1. (Baxley, 6/11)
Following widespread outcry from providers and state lawmakers, the Minnesota Department of Human Services said it will lift payment suspensions for providers who filed an appeal, according to a memo sent to providers and obtained by MPR News on Wednesday. (Roth, 6/10)
More about healthcare costs and coverage —
Providers and payers want regulators to enforce a convoluted out-of-network arbitration process they say remains unchecked despite recent efforts to streamline it. A weedy new Independent Dispute Resolution rule resolves myriad communication and transparency concerns that have long ensnarled the arbitration process. But the technical rule issued in May wasn’t designed to address larger enforcement and policy questions, and that’s chafing the industry. (Early, 6/10)
Despite steady demand for obesity medications, 49% of payers who do not currently cover GLP-1s for obesity would not do so at any price, a new report from Pharmaceutical Strategies Group (PSG) found. (Gleeson, 6/10)