Morning Briefing
Summaries of health policy coverage from major news organizations
1 In 5 Privately Insured Americans Have Encountered Coverage Denial In The Past Year, Survey Shows
Fierce Healthcare: 21% Of Adults Experienced A Coverage Denial In The Past Year
One in five adults with private insurance coverage said that they or a family member had a medical service denied in the past year, even though it was recommended by their physician. The Commonwealth Fund released its 2025 Affordability Survey and the results of focus groups on the subject, which found that 8% of coverage denials were due to denied claims, while 13% were due to prior authorization denials. One percent of the denied services fell into both categories, per the report. (Minemyer, 6/4)
Presbyterian Healthcare Services will cut most of its MA plans next year —
Modern Healthcare: Presbyterian Healthcare Services Drops Medicare Advantage Plans
Presbyterian Healthcare Services will discontinue most Medicare Advantage plans next year, the health system said Wednesday. Presbyterian Health Plan, the Albuquerque, New Mexico-based nonprofit provider’s insurance arm, will retain only its Dual Eligible Special Needs Plans, or D-SNPs. The company will lay off about 150 workers. The insurer had about 54,000 Medicare Advantage members through May, nearly 14,000 of whom were enrolled in D-SNPs, according to Modern Healthcare Data & Insights. Presbyterian Health Plan also offers Medicaid, employer and individual plans in New Mexico. (Tong, 6/3)
Also —
NPR: Strict Medicaid Work Rules Could Harm People With Serious Illnesses, Advocates Say
Advocates for people with serious illnesses, like cancer and HIV, say the strict Medicaid work rules that the Trump administration released this week are likely to put ongoing treatments in jeopardy. States must put the work requirements into effect by January 1. That was already a tight timeline, says Adrianna McIntyre, assistant professor of health policy at the Harvard T.H. Chan School of Public Health. (Simmons-Duffin, 6/3)
The Hill: Conservative Think Tank Alleges Widespread ObamaCare Enrollment Fraud
An influential conservative think tank contends that a quarter of all ObamaCare exchange enrollments were improper, adding more fuel to claims from the Trump administration and GOP lawmakers that the exchanges are rife with fraud. The Paragon Health Institute’s report found more than 6 million people were improperly enrolled in the health law’s exchanges in 2026. The report also argued taxpayers will improperly subsidize the Affordable Care Act program by nearly $25 billion. (Weixel, 6/3)
KFF Health News: Louisiana’s Reporting Law Chills Immigrant Medicaid Applications
Yolibeth’s 4-year-old daughter scrambled headfirst onto a cushy leather love seat at their home near New Orleans and pushed a hairbrush into the hands of Miriam Romero, a health coordinator who works with the family. Romero placed the girl in her lap and started brushing her dark hair. Yolibeth, a 38-year-old single mother who moved to South Louisiana from Honduras 15 years ago, watched them, smiling. The daughter is the youngest of five children living in this mixed-status household. Yolibeth and her two oldest kids don’t have legal immigration status, but the other three — ages 4, 9, and 13 — were born in the U.S. and are citizens. (Parker, 6/4)
KFF Health News: Listen To The Latest ‘KFF Health News Minute’
Arielle Zionts reads the week’s news: For some older adults, the risks of certain preventive screenings might outweigh the rewards. Plus, cost spikes for Obamacare plans have consumers seeking cheaper health coverage, which is often less comprehensive. (6/4)
