Policy Updates

Feds Taking Another Shot at 340B Changes

Only a week after a federal court rejected for a second time its attempt to introduce a new approach to administering the 340B Drug Pricing Program, the Health Resources and Services Administration is going back to the drawing board and trying again to launch the model. In its first step, HRSA has issued a Request for Information (RFI) to gather input from interested parties on whether the agency should implement a rebate model under the 340B program and how best to implement such a model. The RFI notes that in 2024, HRSA began receiving inquiries from drug companies seeking to [...]

joe2026-02-18T10:37:51-05:00February 18, 2026|340b|

ACA Premium Subsidy Talks Over?

Negotiations seeking to strike a compromise in the elimination of enhanced subsidies for lower-income purchasers of health plans sold on Affordable Care Act insurance exchanges appear to have died a quiet death. Talks between Democratic and Republican negotiators focused on a one- or two-year extension of those subsidies, but once the subsidies ended at the close of 2025 and then Congress enacted an FY 2026 funding bill for the Department of Health and Human Services, those talks appeared to collapse. Learn more about the issues that negotiators stumbled over and how those talks faltered and ultimately failed from the Wall [...]

joe2026-02-12T14:39:00-05:00February 13, 2026|Affordable Care Act|

Federal Health Policy Update for February 12

The following is the latest health policy news from the federal government for February 6-12. Some of the language used below is taken directly from government documents. The White House The White House announced the launch of TrumpRx, a service that will enable consumers to purchase a limited number of discounted prescription drugs directly from the manufacturers of those drugs and in some cases from pharmacies without the benefit of health or prescription drug insurance. Learn more about TrumpRx and its launch from this White House announcement, an accompanying fact sheet, and the TrumpRx web site. Congress Following passage of [...]

joe2026-02-12T16:12:39-05:00February 12, 2026|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicare, Medicare reimbursement policy|

CMS Proposes Major Changes in Exchange Plans

The Centers for Medicare & Medicaid Services has proposed sweeping changes in the health plans offered by Affordable Care Act marketplace exchanges. The changes, revealed in CMS’s proposed Notice of Benefit and Payment Parameters for 2027, affect both the regulations governing the types of health plans that can be offered on exchanges and how potential buyers of those plans are deemed eligible for those plans. The major changes include: Permitting insurers to offer catastrophic plans with terms of either one year or multiple consecutive years, up to ten years. Repealing standardized plan options and related limit requirements. Permitting low-deductible plans [...]

joe2026-02-11T12:46:23-05:00February 12, 2026|Affordable Care Act, Centers for Medicare & Medicaid Services|

CMS Axes 340B Model

Following two defeats in federal court, the Centers for Medicare & Medicaid Services has ended its 2025 attempt to launch its 340B Rebate Model Pilot Program. The program, which would have introduced a new approach to the 340B prescription drug discount program under which a limited number of pharmaceutical companies would pay rebates to 340B-eligible entities after they purchase drugs instead of offering discounts for the purchase of those same drugs, as has been the practice since the 340B program’s launch in 1992. Late last year a federal court ruled against the imminent introduction of the model, doing so largely [...]

joe2026-02-11T08:22:39-05:00February 11, 2026|340b|

Docs Not Always Caring for Medicaid Patients

More than a quarter of all doctors enrolled to serve Medicaid patients in 2021 did not serve any Medicaid patients at all while another ten percent treated fewer than 10 Medicaid patients, according to a new Health Affairs study. Among different types of doctors, primary care physicians and cardiologists were most likely to care for higher numbers of Medicaid patients while Medicaid patients seeking the services of psychiatrists were mostly out of luck. Many of the doctors who care for Medicaid patients, and especially those who do not, cite reimbursement that is lower than – and often much lower than [...]

joe2026-02-05T16:51:38-05:00February 10, 2026|Medicaid|

Non-Profit Hospitals Face Near-Term Challenges

The end of Affordable Care Act enhanced health insurance premiums will pose a financial challenge for many of the nation’s non-profit hospitals. The challenge to hospitals will be greatest in states that did not take advantage of Affordable Care Act Medicaid expansion and those with especially large concentrations of rural hospitals that also lack a robust health care safety net. On safer ground will be hospitals in states that do have strong health care safety nets or that have taken recent steps to attempt to fill the void left by the expired insurance premium subsidies. Learn more about the challenges [...]

joe2026-02-05T15:07:41-05:00February 9, 2026|Affordable Care Act, hospitals, Medicaid|

Federal Health Policy Update for February 5

The following is the latest health policy news from the federal government for January 30 through February 5. Some of the language used below is taken directly from government documents. Congress On Tuesday Congress passed, and the president immediately signed, a package of appropriations bills that, among other government operations, funded the Department of Health and Human Services for the rest of federal FY 2026. Major provisions include: The extension of telehealth flexibilities through the end of 2027. The elimination of $8 billion cuts in Medicaid disproportionate share (Medicaid DSH) allotments to the states for both FY 2026 and FY [...]

Demise of Enhanced Tax Credits Drives Lower ACA Plan Enrollment

The end of enhanced tax credits for Affordable Care Act health plans has led to a five percent decrease in the number of people who enrolled in ACA plans during the open enrollment period that ended on January 15. According to federal data, about 23 million Americans signed up for such plans this year, down 1.1 million from last year – a significant decline, although not as great as predictions that enrollment could fall as much as 30 percent. Because of the loss of the enhanced premiums tax credits, insurance premiums doubled for some applicants, putting them out of the [...]

joe2026-01-29T15:49:01-05:00February 2, 2026|Affordable Care Act, Congress|

Federal Health Policy Update for January 29

The following is the latest health policy news from the federal government for January 23-29. Some of the language used below is taken directly from government documents. Congress The Senate today failed to advance a package of the remaining six FY 2026 appropriations bills, including funding for the Department of Health and Human Services. Democratic senators continue negotiating with the White House on how to proceed with Department of Homeland Security (DHS) funding, including the possibility of separating the DHS bill from the broader appropriations package and making targeted amendments to that measure. The Labor, HHS, Education, and Related Agencies bill, [...]

joe2026-02-02T08:58:43-05:00January 29, 2026|Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, MACPAC, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|