KFF Health News

Affordable Care Act insurers are proposing a median 14% premium increase for 2027 due to rising medical costs and policy changes, with enrollment declining by 3 million since February 2023. The expiration of enhanced subsidies under former President Trump and increased demand for costly treatments like GLP-1 weight loss drugs are cited as key factors.

Derion Blackman died from heart failure after his new health insurance plan, CHAMPVA, delayed approval of his post-transplant medications. The transition from his previous Federal Employees Health Benefits plan to CHAMPVA created bureaucratic hurdles that left him without critical drugs. The article highlights systemic issues in the U.S. healthcare system, including rising costs and fragmented coverage.

Larry Gruber, a psoriatic arthritis patient, found his insurer Oscar HMO of Florida withheld a drug coupon meant to reduce his out-of-pocket costs, forcing him to pay $10,600 to meet his deductible. Insurers like Oscar Health use copay accumulator programs to retain pharmaceutical company discounts, which critics argue harms patients by making medications unaffordable and allows insurers to 'double-dip' on costs.

Thousands of Medicare beneficiaries enrolled in zero-premium drug plans from Wellcare and other insurers lost coverage after their premiums increased and they failed to pay, leading to termination. Jude Pare, a beneficiary, faced coverage cancellation and potential life-threatening risks due to lost access to critical medication.

California voters face a choice between Democrat Xavier Becerra and Republican Steve Hilton on whether to continue state-funded healthcare for low-income immigrants without legal status. Medi-Cal, which expanded to cover such immigrants, now costs $10 billion annually, leading to budget rollbacks and public opposition amid rising economic concerns.

The Trump administration's new Medicaid work rule requires recipients to document exemptions, such as a doctor's note, to avoid losing coverage starting next year. Consumer advocates warn the policy may disproportionately affect individuals unable to meet work requirements.

Journalists from KFF Health News discussed healthcare costs and political fallout on a radio show, and public health concerns related to an immigration detention center in Georgia. The article highlights two reports on healthcare affordability and ICE detention site risks.

A mother accused Mead Johnson's infant formula of causing her son's death from necrotizing enterocolitis (NEC), but the company concluded in an internal memo that the formula was not likely responsible. Mead Johnson closed the case without further investigation, and the FDA found no record of manufacturers reporting infant deaths linked to formula under regulatory requirements.

The article discusses the challenges of the 'sandwich generation'—adults caring for both children and aging parents. It cites Pew Research data showing nearly a quarter of U.S. adults and half of those in their 40s are in this situation. Topics explored include FMLA leave, mental health for children, and early-onset cancer.

Rising cases of Vibrio vulnificus infections in coastal waters and increased health risks are linked to Trump administration cuts in health programs and ocean monitoring. The administration reduced investments in agencies tracking pathogens, leading to challenges in addressing emerging threats like flesh-eating bacteria, screwworm reemergence, and malaria vulnerabilities.

Pfizer and Valneva plan to seek approval for a new Lyme disease vaccine, following the failure of a 1990s vaccine due to lawsuits and public fear. A survey of hunters, a high-risk group for tick exposure, found mixed reactions, with some expressing interest and others seeking more information about safety and effectiveness.

Trinity Moravian Church in Winston-Salem, N.C., unites politically diverse members to eliminate medical debt for local residents through its Debt Jubilee Project, raising over $17,000 in its eighth campaign to retire more than $2.2 million in debt. Despite political divisions on issues like healthcare, the congregation collaborates to address widespread medical debt, inspiring state officials and highlighting common ground on patient financial struggles.

Benjamin Pinckney, 46, dreamed of becoming a physician assistant after a hospital visit during his recovery from gunshot wounds. He recently graduated with a Bachelor of Science degree but faces financial barriers due to new federal student loan limits capping graduate borrowing at $20,500 annually.

A study by The Trace and KFF Health News reveals that uninsured gunshot wound victims in Florida hospitals are discharged significantly faster than insured patients, with some staying half as long. The analysis of hospital data from 2018 to 2024 shows uninsured patients, like Alea Bates who was shot seven times, often receive less comprehensive care and face barriers to rehabilitation due to financial constraints.

Margaret Hvatum, a 70-year-old with primary immunodeficiency, faced insurance denials for her lifesaving drug Hizentra after switching Medicare Advantage plans, leading to health complications and denied hospital charges. The denial stemmed from prior authorization issues, a process that contributed to her hospitalization and financial burden.

The FDA approved a sunscreen chemical, offering a chance to restore faith in sunscreen, and rural dialysis clinics in Nebraska closed despite significant state rural health funding. Two KFF Health News contributors discussed these issues on radio programs.

Insurance coverage for GLP-1 weight loss drugs like Zepbound and Wegovy is being dropped by many plans due to high costs, leaving patients to seek alternatives. Patients may retain coverage if the drugs are prescribed for related conditions like sleep apnea or diabetes through prior authorization.

Florida's attempt to eliminate school vaccine mandates has stalled after the Republican speaker of the Florida House refused to bring the issue to the floor. Governor Ron DeSantis and Surgeon General Joseph Ladapo previously advocated for ending mandates, framing it as a 'medical freedom' issue. Despite introducing anti-vaccine bills in multiple states, similar efforts face challenges due to public health concerns and political calculations.

Elevance Health, a Medicare Advantage company, paid $342 million to the U.S. government to settle allegations of overcharging Medicare for years. The payment followed a CMS enforcement action demanding corrections to billing practices, marking the first time CMS secured such a large repayment from a Medicare Advantage plan.

Opioid settlement funds are being used to expand addiction services in rural Kentucky through The Hub, a harm reduction program offering recovery support and resources. Grants totaling over $800,000 have enabled The Hub to expand from two to five counties, while the Trump administration has cut federal funding for similar initiatives.