House Dems Run Spending Cut Ads In Swing Districts
A House Democratic campaign organization officially kicked off the 2026 elections by running a television advertising blitz hitting House Republicans over the prospect of Medicaid cuts in budget reconciliation. The ads are running in 23 swing districts in 13 states.
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#medicaid #election2026 #budgetreconciliation
https://www.modernhealthcare.com/politics-policy/medicaid-cuts-tv-ads-gop
BCBSMI Had Major 2024 Loss
Blue Cross Blue Shield Michigan (BCBSMI), a top insurer in the nation, reported a $1.03 billion loss in 2024 due to rising costs and what it called “unsustainable” market conditions. It had revenue of $40.6 billion. It said the costs were driven by rising utilization of expensive medical services and costs for prescription and specialty drugs.
Additional article: https://www.modernhealthcare.com/insurance/blue-cross-michigan-2024-healthcare-costs
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#healthplans #margins #bcbsmi
https://www.beckerspayer.com/payer/bcbs-michigan-posts-1b-loss-in-2024.html
SNP Plans Grow In Enrollment Season
While enrollment growth in Medicare Advantage (MA) was lower than previous years, the industry is celebrating the growth of Special Needs Plans (SNPs). Data say SNPs grew 10.1%, which was greater than expected. More than 7.3 million people were enrolled in SNPs as of Feb. 1. But not all plans had SNP growth. UnitedHealthcare had huge growth, while Humana, Aetna, and Centene shed lives due to fiscal problems.
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#medicareadvantage #snps
https://www.modernhealthcare.com/insurance/special-needs-plans-2025-winners-and-losers
UnitedHealthcare To Cut Prior Authorizations
UnitedHealthcare says it plans to cut nearly 10% of prior authorizations this year in its Medicare Advantage (MA) products. Removal of PAs is a growing trend in the industry in all lines of business. Plans are faced with increased requirements at the state and local level and finding some PAs cost more to conduct than they save now. United says part of the reduction will include removing PAs on home health services managed by its home and community division.
Additional article: https://www.beckerspayer.com/policy-updates/unitedhealth-to-cut-prior-authorization-by-10.html
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#priorauthorizations #unitedhealthcare #medicareadvantage
https://www.modernhealthcare.com/insurance/unitedhealth-prior-authorization-home-health
Two Brand Drug Makers Have Not Said If They Are In Second Round Of Drug Price Negotiations
Novo Nordisk and Boehringer Ingelheim would not say whether they have agreed to participate in the second round of Medicare Part D drug price negotiations under the Inflation Reduction Act (IRA). At the same time, drug companies have complained that the Centers for Medicare and Medicaid Services (CMS) published 18 drugs in round two and not the 15 allowed.
Pfizer, Astellas, GlaxoSmithKline, Bristol Myers Squibb, AstraZeneca, and Amgen confirmed they agreed to participate despite their opposition to the program.
Novo Nordisk issued a statement saying: “Novo Nordisk remains opposed to government price setting through the Inflation Reduction Act and has significant concerns about the law and with how CMS implemented the statute.” What it did not say, though, is that it participates in drug price programs in all other developed world countries.
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#ira #drugpricing #branddrugmakers
GOP Doctors Caucus Wants Medicare Physician Fix
GOP Doctors Caucus co-chair Rep. Greg Murphy, R-NC, is pushing for a full Medicare physician payment fix to be included in the upcoming continuing resolution (CR). Provider groups are pushing this as well. House Speaker Mike Johnson, R-LA, says he wants a clean CR extension through FFY 2025’s end in September. But without a doc fix, he could be short of votes. As of January 1, Medicare physician rates dropped.
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#providers #physicians #medicare #rates
— Marc S. Ryan
