CDC Data: Uninsured Rate In US Steadies At 7.6%

Modern Healthcare: US Uninsured Rate Hits 7.6%, CDC Report Shows
The share of Americans lacking health insurance has remained largely steady in recent years, but questions remain about the future. A Centers for Disease Control and Prevention report released Friday shows 7.6% of Americans, or 25.3 million people, lacked health insurance during the time of data collection from April to June. Although the rate represents a 0.4 percentage point increase from the year-ago period, it is consistent with 2023's full-year uninsured rate — a historic annual low. (Berryman, 11/11)

Cigna and Humana won't pursue merger —

Bloomberg: Cigna Says It Won’t Pursue Combination With Rival Humana
Cigna Group said it won’t pursue a combination with rival insurer Humana Inc. The two health insurance giants held talks about a deal last year, but Cigna walked away after the two companies failed to agree on a price, Bloomberg News reported in December. The discussions were revived as the US government intensified its effort to control Medicare costs that have eaten away at Humana’s finances and market value, Bloomberg News reported last month. (Tozzi, 11/11)

Forbes: Why Cigna Deal With Humana Made Little Sense To Begin With
Despite speculation in certain media outlets, including the Wall Street Journal, such a deal really made little sense to begin with, especially given Cigna’s move to get out of the Medicare business. Cigna is nearing the completion of the sale of its Medicare business to Health Care Service Corp. by early 2025. Humana operates one of the nation’s largest Medicare operations, selling an array of products for seniors including Part D drug plans and Medicare Advantage plans that contract with the federal government to provide coverage available in traditional Medicare plus extra benefits and services to seniors, such as disease management and nurse help hotlines with some also offering vision, dental care and wellness programs. (Japsen, 11/11)

In other health insurance news —

The Wall Street Journal: The Sickest Patients Are Fleeing Private Medicare Plans—Costing Taxpayers Billions
A Wall Street Journal analysis of Medicare data found a pattern of Medicare Advantage’s sickest patients dropping their privately run coverage just as their health needs soared. Plans run by the private insurers in the Medicare Advantage system are supposed to offer old and disabled people the same benefits they would get from traditional Medicare. The plans can be a bargain for people because they limit out-of-pocket expenses and often offer extra benefits such as dental care. As recipients get sicker, though, they may have more difficulty accessing services than people with traditional Medicare. (Mathews, Weaver and McGinty, 11/11)

Fortune Well: Shopping For A 2025 Medigap Policy? There May Be Some Good News For You
In all but four states—Connecticut, Maine, Massachusetts and New York—if apply for a Medigap policy after the first six months of Medicare eligibility, the insurer can reject you due to a pre-existing condition or charge you more because of it. (A pre-existing condition could be anything from high blood pressure to diabetes to Alzheimer’s, according to a recent KFF health research group report.) “A Medigap insurer can generally turn you down for whatever reason they see fit,” says Ryan Ramsey, associate director of health coverage and benefits at the National Council on Aging. (Eisenberg, 11/11)

WSBTV-2 Atlanta: Multimillion-Dollar Scheme Leaves GA Families With ACA Coverage With Changed Or No Insurance
Tiesha Foreman says every trip to the doctor has become difficult because she never knows if her health insurance will be there when she goes to settle up. “It’s stressful and scary and it’s embarrassing because you have them looking back at you like, why? Why are you giving us this card saying that you’re covered and you’re not again?” Foreman told Channel 2 consumer investigator Justin Gray. The Douglas County mother said for months now, when she goes to pay her health insurance premium, it gets returned. The family had to pay for an MRI out of pocket and even thought an emergency surgery might not be covered. (Gray, 11/11)

The Texas Tribune: Texas DACA Recipients Qualify For Affordable Care Act Insurance
When Victoria Elizondo first went to see a doctor about her symptoms at Legacy Community Clinic, a low-cost clinic in Houston, she didn’t know what was wrong with her but she knew something wasn’t right. Her hands would shake uncontrollably, her heart would beat fast even while resting and she suffered from insomnia. (Moore, 11/12)

On hospital costs and transparency —

Modern Healthcare: OIG Report Finds Holes In Hospital Price Transparency Compliance
Many hospitals are not publishing their prices in accordance with the price transparency law, a federal watchdog's new report found. More than a third of the 100 hospitals reviewed by the Health and Human Services Department’s Office of Inspector General did not post machine-readable pricing data files correctly, or at all, as required by the 2021 federal law, according to the report released Friday. Most of the violations were related to disclosing the rates hospitals negotiated with insurers, metadata errors and outdated information. Five hospitals did not post any machine-readable files. (Kacik, 11/8)

Crain's New York Business: Optum’s $168M Health Cost Database For NY Facing Major Delays 
Nearly a decade ago New York signed a lucrative contract with a health services firm to build a database to boost transparency on the pricing of medical procedures across health systems. It’s still not ready. The database was intended to pull together medical claims from Medicare and Medicaid, private insurers and hospitals to display the true cost of health services in New York. The database would help patients financially plan for upcoming procedures and aid policymakers in understanding and addressing the drivers of rising health costs.  (D'Ambrosio, 11/11)