Insurers grapple with expanding overage for weight loss medications; a new analysis reveals a potential correlation between COVID-19 vaccinations and various adverse effects (AEs); reshaping Medicaid programs remains an ongoing debate about ensuring health care access.
Weight Loss Drugs Reaching Coverage Milestones Under the ACA
As the obesity crisis continues, semaglutide (Wegovy) has gained attention for its effectiveness in weight loss, according to Stat. However, its high cost—more than $16,000 annually—poses challenges for insurers under the Affordable Care Act, (ACA), raising questions about accessibility and affordability for patients seeking the treatment. Despite hurdles, efforts are underway to expand coverage under the act, potentially reshaping the landscape of weight loss interventions.
Multicountry COVID Study Links Vaccines, Potential Adverse Effects
The most extensive study conducted across several countries has identified a correlation between COVID-19 vaccines and potential adverse effects, including myocarditis and Guillain-Barré syndrome, according to The Hill. The findings highlight the importance of ongoing monitoring and research to ensure the safety and efficacy of worldwide vaccination campaigns, underscoring the need for transparent communication and vigilant surveillance in the ongoing global effort to combat the pandemic.
Trump Pushes States to Overhaul Medicaid Amid Political Tensions
Former President Donald Trump's renewed advocacy for Medicaid overhaul has placed pressure on states to navigate complex health care decisions, including potential changes to eligibility criteria and finding of health safety-net programs, according to Politico. Amid concerns over access and the federal-state partnership, this development amplifies the ongoing debate over Medicaid's role in ensuring health care access for vulnerable populations and highlights the overall complexities of state-level health care policymaking.
The Legal Architecture of Psychedelic Therapy: Risks, Responsibilities, and Reimbursement Realities
July 30th 2025Key legal, ethical, and compliance considerations for managed care professionals navigating the evolving landscape of psychedelic-assisted therapy include regulatory risks, data privacy challenges, reimbursement limitations, and the need for culturally informed care models.
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Managed Care Reflections: A Q&A With Charles N. (Chip) Kahn III, MPH
July 30th 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The August issue features a conversation with Charles N. (Chip) Kahn III, MPH, the president and CEO of the Federation of American Hospitals and a longtime member of the AJMC editorial board.
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