Enrollment for ACA Coverage Declined for the First Time
Amid Republican talk to repeal and replace the Affordable Care Act, and a temporary halt on ads calling people to sign up, enrollment through HealthCare.gov dipped. According to POLITICO, 9.2 million people signed up for coverage through HealthCare.gov, a decline over the previous open enrollment season. The deadline to sign up had been January 31, and just days before the Trump administration decided to nix the remainder of the ad campaign calling people to sign up. Enrollment numbers for the 11 states and the District of Columbia that use their own exchanges have yet to be counted.
Block Grant Idea Faces Increased Opposition
Meanwhile, President Donald Trump and Republicans in Congress are facing increased opposition to an idea of using block grants to fund Medicaid. Block grants would provide a fixed amount of money to each state, and opponents say it would reduce benefits, according to Forbes. AARP has come out against the proposed strategy, claiming that it would end guaranteed access to care. With opposition mounting, some think Republicans will back off of block grants—which the party has been interested in for 20 years—and instead turn to per capita caps.
California Bill Bans Drug Coupons
A new bill in California would ban coupons from drug makers to help lower the cost of copayments for some drugs. California Healthline reported that the bill would prohibit coupons for drugs that have cheaper, FDA-approved equivalents. According to assembly member Jim Wood, who introduced the bill, drug coupons are driving patients to use higher-priced drugs, which in turn drive up premiums.
New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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Integrated CKD Care Model Cuts ED Visits by 30%, Boosts Specialized Treatment
April 21st 2025An analysis of an interdisciplinary care model for managing chronic kidney disease (CKD) shows hospital admissions dropped by 26% and emergency department (ED) visits decreased by 30% after clinic initiation.
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