September 3, 2026

Hospitals Say Revenue Losses Will Mount With More Changes

Hospital lobbies are turning up the heat on lawmakers given multiple funding reductions that threaten hospital finances. Impacts of the One Big Beautiful Bill Act will be $340 billion through 2034. But new rules proposed by the Trump administration would reform site neutral payments for imaging and enact reductions to drug reimbursement in Medicare for those with 340B status. That would mean another $681 billion loss over ten years.

While I favor site neutral payments and some 340B reforms, it seems clear that all the reductions threaten to undermine providers.

#hospitals #obbba #340b #siteneutral #medicaid #exchanges

https://www.politico.com/news/2026/09/02/hospitals-say-coming-regulations-worse-than-medicaid-cuts-01060086

Centene To Exit Some Commercial Markets

Centene subsidiary Health Net is pulling out of the commercial employer group market in California and Oregon.

Additional article: https://www.modernhealthcare.com/insurance/mh-centene-california-oregon-commercial-group-plans/

#centene #employercoverage

https://www.beckerspayer.com/payer/centenes-health-net-to-exit-commercial-group-market-in-california-oregon/

ICHRAs Now CHOICE

The Centers for Medicare and Medicaid Services (CMS) has announced the rebranding of individual coverage health reimbursement arrangements (ICHRAs) to CHOICE Arrangements, or Custom Health Option and Individual Care Expense.

#ichras #choice #exchanges #employercoverage

https://www.beckerspayer.com/payer/ichra/cms-rebrands-ichra/

Wakely White Paper on 1115 Medicaid Changes

Wakely Consulting has published a great white paper for state Medicaid agencies on a new rule that proposes to rein in Section 1115 Medicaid waivers.

#medicaid #1115waivers

https://www.wakely.com/blog/cms-section-1115-budget-neutrality-review-what-states-need-to-prepare-now/

Epic Research On Rise In Self Pay

Epic Research has analyzed the rise in self-pay in the last four years. Self pay rose in all four care settings studied between early 2022 and early 2026.

  • Emergency department self pay rose from 5.5% to 7.6%.
  • Inpatient admission self pay rose from 1.9% to 2.6%.
  • Birth self pay rose from 0.8% to 1.3%.
  • Primary care from 1.8% to 1.9%.

Medicaid declined in all four settings.

#medicaid #uninsured #coverage

https://media.epic.com/epicresearch/wordpressmedia/pdfs/self-pay-encounters-rose-and-medicaid-fell-across-all-care-settings-from-2022-to-2026.pdf

State Exchanges Report Major Enrollment Losses

The State Based Marketplace Network reports major enrollment drops in the state Exchanges. While they reported a minimal 1.4% drop in enrollment at the start of this year, enrollment has now dropped 8.5% from 2025.

#uninsured coverage #exchanges

https://statemarketplacenetwork.org/state-marketplace-network-summer-2026-enrollment-update/

Insulin Copay Cap Proposed

A bipartisan group of House lawmakers have introduced legislation to ensure people with private health insurance don’t pay more than $35 a month for insulin. 

#insulin #drugpricing #branddrugmakers

https://thehill.com/policy/healthcare/6069932-bipartisan-house-introduces-insulin-cap-legislation/

Government Will Stay Open

President Trump signed a stopgap government funding bill into law, keeping government open until after the midterms and through Dec. 11.

#governmentshutdown #trump #congress

https://thehill.com/homenews/administration/6067996-trump-stopgap-funding-law-government-shutdown/

— Marc S. Ryan

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