Morning Briefing
Summaries of health policy coverage from major news organizations
Obamacare Enrollment Has Plummeted In All But One State, Data Show
AP: New 50-State Data Shows Steep Drops In Affordable Care Act Enrollment
States across the country saw steep drops in the number of people covered by the Affordable Care Act over the past year, with Ohio and Oklahoma each losing nearly one-third of enrollees, according to new federal data that provides the first complete 50-state breakdown of sharp enrollment declines following the January expiration of enhanced subsidies. The data, posted in late June by the Trump administration and first reported on by The Associated Press, reveals how changes in each state’s insured population led to around 2.6 million fewer Americans having Obamacare plans in February compared with the same time last year. (Swenson, 7/6)
Modern Healthcare: ACA Exchange Insurers Owe $11.2B In Risk-Adjustment Payments
Health insurers will swap $11.17 billion in exchange risk-adjustment payments this year, the Centers for Medicare and Medicaid Services disclosed. Centene, Elevance Health, CVS Health subsidiary Aetna and Oscar Health will receive the largest transfers based on their 2025 performance while Molina Healthcare and UnitedHealth Group subsidiary UnitedHealthcare will make the highest payments, according to an analysis from the investment bank Barclays. (Tong and Broderick, 7/6)
"Out of Pocket, Out of Reach" from Stat —
Stat: Part 1: America’s Small Businesses Are Giving Up On Health Insurance
It has never been more difficult for employers to offer health insurance for their workers. That’s especially true for America’s small businesses, the backbones of entire communities. More and more, they’re giving up entirely. (Herman, 7/7)
Stat: Part 2: For A Georgia Entrepreneur, Health Coverage Has Never Been Affordable
Amy Bielawski has gone most of her life without health insurance. For 32 years, the 61-year-old has run her own entertainment company in Tucker, Ga. — setting up bounce houses, petting zoos, stilt walkers, and other attractions for family and corporate events. For several years, she did two of her specialties, face painting and balloon sculpting, for kids before Atlanta Hawks home games. (Herman, 7/7)
Stat: Part 3: Insurance Whistleblower Says Employers Are Not Helpless Bystanders
It should have been a triumphant moment for Chris Deacon. Last November, Horizon Blue Cross Blue Shield, the insurance giant that manages health benefits for 750,000 New Jersey state workers, family members, and retirees, paid $100 million to wipe away allegations that it knowingly overpaid hospitals and doctors and fraudulently won its state contract. (Herman, 7/7)
More about healthcare costs and coverage —
The Texas Tribune: Healthcare Costs Push Texas Businesses To Breaking Point
The expenses to operate three restaurants in Waco are rising across the board, but there’s one growing cost in particular that feels nearly impossible to manage — providing employee health insurance, co-owner Kyle Citrano said. (Cobler, 7/6)
The Colorado Sun: This Rural Colorado Hospital Is Using AI To Go After Health Insurers That Ghosted Payments. Here's How.
At Spanish Peaks Regional Health Center in rural Huerfano County, medical claims submitted by the nonprofit health facility are denied daily by insurance companies. (Chuang, 7/6)
Modern Healthcare: The Strategies Hospitals Are Using Now To Prepare For A Tough 2027
It’s the calm before the storm for hospitals and health systems. As the industry moves into the second half of 2026, many health systems are keeping balance sheets stable with strong patient volumes and revenue diversification, while cutting administrative expenses and rethinking service lines. (Hudson, 7/6)
KFF Health News: Thousands Of Medicare Beneficiaries Thought Their Drug Plan Was Free. Then They Lost It
Jude Pare and his partner, Diane Tix, live in rural Minnesota until temperatures dip below freezing, when they take refuge in Arizona for the winter. While away, their mail is forwarded. But Pare, 77, said he didn’t receive any warning from his Medicare prescription drug plan that his $0 monthly premium was about to increase. So he didn’t know he had a bill to pay. (Jaffe, 7/7)
KFF Health News: Copay Assistance Is Meant To Defray Patient Drug Costs. Some Insurers Keep It Instead
For 16 years, Larry Gruber, a fitness coach from Wilton Manors, Florida, received a coupon card to help him pay for a psoriatic arthritis medication he needs that costs more than $7,700 a month. Each year, Amgen, which makes the drug, called Enbrel, sent the coupon card worth thousands of dollars, and that counted toward Gruber’s health insurance deductible and out-of-pocket maximum. (Chang, 7/7)
