Gearing Up For 2026 Election and Medicaid
Interesting The Hill article on Medicaid being a huge election 2026 issue. Democrats will try to argue that the $1 trillion in cuts in the budget reconciliation bill will devastate coverage and providers, especially rural ones. Republicans will argue they are attacking fraud, waste, abuse, and improper enrollment. As the article notes, while many policy changes will not be in effect yet, in prior midyear cycles issues still resonated.
See my recap of what is in the budget reconciliation bill: https://www.healthcarelabyrinth.com/saga-over-big-beautiful-bill-has-passed-for-good-or-bad/
In other news, another study details impacts of healthcare cuts on providers throughout the nation.
As well, Molina Healthcare released preliminary results from its second-quarter financials and is bracing for elevated medical costs. Centene pulled its earnings forecast earlier.
Molina sees ongoing financial troubles in its Affordable Care Act (ACA) Exchange, Medicaid, and Medicare Advantage lines of business. The budget reconciliation bill and expiration of enhanced premiums subsidies at the end of 2025 hurt further.
Additional articles: https://www.modernhealthcare.com/medicaid/mh-medicaid-cuts-tax-bill-states-hospitals/ and https://www.fiercehealthcare.com/payers/molina-healthcare-lowers-2025-guidance-warns-elevated-medical-costs and https://www.healthcaredive.com/news/molina-cuts-earnings-guidance-costs-rise-aca-medicaid-medicare/752297/
(Some articles may require a subscription.)
#election2026 #budgetreconciliation #mediaid #coverage #molinahealthcare
https://thehill.com/homenews/campaign/5384501-trump-democrats-medicaid-cuts-2026-midterms
Troubled Humana Continues with Provider Focus
Financially troubled Medicare Advantage plan Humana continues to go all in on provider acquisition. Its CenterWell primary care business announced the acquisition of The Villages (Fla.) Health. CenterWell will acquire eight primary care and two specialty clinics. The provider serves 55,000 patients in The Villages area. CenterWell has about 350 clinics.
#humana #medicareadvantage #primarycare
https://www.beckerspayer.com/m-and-a/humana-to-acquire-10-florida-clinics
ACA Risk Adjustment Payments Paid Out For 2024
Total risk adjustment payments in individual and small group insurance plans increased modestly in 2024. The Centers for Medicare and Medicaid Services (CMS) found that:
- A total of 592 plans participated in the risk adjustment program in 2024, a decrease from 605 in 2023.
- Risk adjustment transfers as a share of premiums declined compared in 2024 to 8.9% from 10.3% to 2023.
- Enrollees with at least one hierarchical condition category (HCC) rose from 21.8% in 2023 to 22% in 2024.
#aca #obamacare #exchanges #riskadjustment
— Marc S. Ryan
