Medicaid GLP-1 Program Getting Little Traction
President Donald Trump’s deal offering states discounted pricing on GLP-1 drugs for Medicaid patients is getting little traction. Only Indiana has publicly signed on, while 29 state Medicaid programs have said they will not participate and 14 more did not respond. States are citing budget costs if they joined.
#glp1s #weightlossdrugs
https://www.beckerspayer.com/payer/medicaid/states-reject-trumps-discounted-medicaid-glp-1-deal
2025 Health Plan Losses
An analysis by Mark Farrah Associates says health insurers collectively lost $10.4 billion on underwriting in 2025 in the individual, employer-group, Medicare Advantage (MA) and managed Medicaid segments, a dramatic deterioration from $1.7 billion the year before. The individual and MA segments accounted for the bulk of the underwriting losses. The analysis represented about 80% of the industry.
#healthplans #margins
https://www.beckerspayer.com/financial/health-plan-underwriting-losses-balloon-to-10-4b-report
Coming Medicaid Woes
Despite some financial stability in 2026 at Medicaid health plans, the story could soon change as Medicaid work requirements and coming limits on state match sources put pressure on states and drop enrollments. States have raised Medicaid managed care payment rates, but that could come to a close as these One Big Beautiful Bill Act (OBBBA) changes go into effect.
#medicaid #obbba #workrequirements
https://www.modernhealthcare.com/politics-regulation/mh-medicaid-managed-care-insurers-rates-states
Health Affairs Publishes Biased Blog On MA
Health Affairs Forefront is continuing its pattern of publishing misleading analyses from Medicare Advantage (MA). In the latest case, Brown University researchers cover the proposed Saving Medicare Enrollees from Deceptive Insurers and Creating Ample Resources for Everyone (Save MEDICARE) Act. It purports to reform Medicare Advantage. While some proposals in the act, such as risk adjustment reforms, are reasonable, many more would cripple the program and hurt seniors. These include a favorable selection adjustment. The article repeats bogus figures on the size of overpayments and endorses the dubious favorable selection argument.
#medicareadvantage #riskadjustment
— Marc S. Ryan
