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In addition to the decrease in premiums since costs spiked in 2018, more insurance carriers are now participating in the marketplaces, according to a report published by the Urban Institute, a left-leaning think tank based in Washington, D.C. The authors examined policies offering similar benefits in the 15 states that run their own marketplaces and the 36 states that rely at least in part on the federal marketplace. Premiums fell by an average of 1.2% from 2018 to 2019, 3.2% from 2019 to 2018 and 1.7% from 2020 to 2021, they found. That contrasts with a huge increase from 2017 to 2018 of nearly 32%, which the authors attributed largely to policies of the Trump administration intended to undercut the Affordable Care Act. (Ollove, 6/1)

Betsy Hargreaves wanted to save a few bucks on health insurance a couple of years ago so she switched to a religious-based plan. For a while it worked, cutting her monthly premium by hundreds of dollars. Then, in March, she had double hip-replacement surgery to relieve acute pain, followed by a four-day stay in the hospital and extensive physical therapy. The surgery was successful, but Hargreaves’s “insurer” refused to cover any of the costs, saying her surgery was the result of a preexisting condition. She was saddled with nearly $75,000 in medical bills. They told her the day before the surgery that it would not be covered, she said. (Murphy, 6/1)

Privately insured individuals are more likely to report worse access to care, higher medical costs and lower satisfaction than those on public insurance programs like Medicare, suggesting public options may provide more cost-effective care than private ones, according to a new study published in JAMA on Tuesday. (Pifer, 6/1)

The state Board of Finance on Tuesday recommended a 5% increase next year in health insurance premiums for both current and retired employees in the state's health insurance plan for state employees. The board also recommended changes in how wellness credits are handled. The plan covers more than 58,000 people. In a 6-3 vote, the Board of Finance approved a motion by board member Eric Munson for the changes, which mostly followed the recommendations made by the State and Public School Life and Health Insurance Board on April 20. (Wickline, 6/2)

Nevada looks set to become the second state in the nation to enact a “public option” health insurance plan after Gov. Steve Sisolak said he intends to put his signature to state Democrats’ signature health care legislation. “I’m going to sign the public option (bill),” Sisolak said in a wide-ranging, post-Legislature interview Tuesday with reporters. The first-term Democrat also explained his reasoning for not supporting the failed death penalty ban, where his signature “innovation zones” concept goes from here and more. While billed as a “public option” by supporters, Nevadans who purchase plans via the system created by Senate Bill 420 won’t be buying their insurance directly from the state. (Lochhead, 6/1)

The U.S. Supreme Court heads into the last month of its current term with several major cases yet to be decided including a Republican bid to invalidate the Obamacare healthcare law, a dispute involving LGBT and religious rights and another focused on voting restrictions. The court, which has a 6-3 conservative majority, now has 24 cases in total left to decide after issuing two rulings on Tuesday. There also is speculation about the potential retirement of its oldest justice, Stephen Breyer. Some liberal activists have urged Breyer, who is 82 and has served on the court since 1994, to step down so President Joe Biden can appoint a younger liberal jurist to a lifetime post on the court. (Hurley, 6/1)

The Supreme Court is staring at its self-imposed end of June deadline, but the justices have not yet released some of the most significant opinions of the term, including a challenge to the Affordable Care Act, the Voting Rights Act and a case on religious liberty involving a Philadelphia foster agency. Recent weeks have seen justices clear their desks of those opinions that produce fewer divisions, as the tension grows for the big-ticket cases. (de Vogue, 6/1)

It has been a tumultuous year for the court. Just before the justices began hearing cases last fall, Justice Ruth Bader Ginsburg, long the most prominent liberal on the bench, died after a long battle with cancer. And when former President Donald Trump tapped Justice Amy Coney Barrett to fill her vacant seat, Democrats reacted with dismay and called for court expansion. Once President Joe Biden won the 2020 election, Justice Stephen Breyer faced increased pressure from many liberals to retire and make way for a younger judge. (Rowan, 5/31)