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HHS appeals invalidation of 2025 ACA rule
The Trump administration is fighting to restore controversial provisions that a judge threw out last month, including shorter sign-up windows and heightened eligibility verification.
By Rebecca Pifer Parduhn • July 24, 2026 -
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Molina plans additional ACA cuts in 2027
Molina’s second quarter was complicated, with stability in Medicaid and outperformance in Medicare Advantage overshadowed by problems in the ACA exchanges. The trend was “unfortunate,” according to the insurer’s CEO.
By Rebecca Pifer Parduhn • July 23, 2026 -
Explore the Trendline➔
Yujin Kim/Healthcare Dive
TrendlinePayer/provider relationships
As M&A intensifies and companies embrace more holistic and value-based care models, partnerships have become more closely intertwined.
By Healthcare Dive staff -
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No Surprises disputes continue to swell, CMS finds
Providers and payers initiated 16% more disputes in the second half of 2025 compared with the first half, according to new federal data. But arbiters are closing challenges more quickly and tackling a backlog of disputes.
By Emily Olsen • July 23, 2026 -
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CMS appeals Clover MA stars lawsuit
Last week’s appeal is the latest development in Clover’s legal saga to get the CMS to recalculate its Medicare Advantage star ratings.
By Sydney Halleman • Updated July 24, 2026 -
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Labor Department proposes rule expanding disclosure e-delivery for employer plans
The rule pitched Wednesday would make it easier for group health plans regulated by ERISA to share mandatory notices with their members. A DOL official called the proposal a “big step forward.”
By Rebecca Pifer Parduhn • July 22, 2026 -
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1 in 4 workers stay in unwanted jobs for health coverage, survey finds
More Americans are keeping jobs they would otherwise leave for fear of losing their insurance, as healthcare costs rise and non-employer coverage seems less affordable, according to a new poll.
By Emily Olsen • July 22, 2026 -
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CMS moves to codify limits on Medicaid provider taxes
The new proposed rule is meant to prevent states from guaranteeing providers will be refunded for their taxes, and should save Washington $246 billion over the next decade, regulators said.
By Rebecca Pifer Parduhn • July 22, 2026 -
Rebecca Pifer Parduhn/Healthcare Dive
Trump administration pauses $1B in Medicaid payments to California, Minnesota
The HHS halted more Medicaid funding to the states on Tuesday, citing concerns about fraud. Critics have slammed the “attack first, ask questions later” strategy of the deferrals, which have only impacted blue states to date.
By Rebecca Pifer Parduhn • July 21, 2026 -
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Clover Health hit with data breach
The insurer, which disclosed the breach in a securities filing late last week, doesn’t yet know what type of data was exposed or how many people may have been impacted.
By Rebecca Pifer Parduhn • July 20, 2026 -
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Sponsored by Cedar Gate Technologies, an IQVIA business3 essential capabilities to scale impact and collaboration in VBC
Discover the critical tools you need to succeed in a collaborative, tech-enabled VBC future.
July 20, 2026 -
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Doc pay, price transparency on Congress’ healthcare agenda
Lawmakers introduced or advanced a raft of health legislation last week in advance of the midterm elections.
By Emily Olsen • July 17, 2026 -
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Senate Republicans kill bid to end Medicare prior authorization pilot
The Senate voted along party lines to defeat Democrats’ attempt to end WISeR, which some lawmakers argue is delaying care for seniors.
By Emily Olsen • July 17, 2026 -
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Judge stays Trump administration policies set to shrink ACA marketplaces
On Thursday, a federal judge pressed pause on the CMS’ expansion of bare-bones catastrophic plans and other changes finalized in a rule this spring, saying they were likely to raise costs and hurt access.
By Rebecca Pifer Parduhn • July 17, 2026 -
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Employers push health savings plans, nutritional counseling to avoid GLP-1 coverage for weight loss
Cost remains a major factor for employers as the popular drugs represented 11.4% of corporations’ annual claims in 2025.
By Ginger Christ • July 16, 2026 -
Courtesy of UnitedHealth Group
UnitedHealth raises 2026 guidance again as cost controls pay off in Q2
UnitedHealth’s profit spiked to $5.5 billion in the second quarter thanks to notable earnings recovery in its insurance and value-based care delivery businesses. The healthcare juggernaut delivered for investors, analysts said.
By Rebecca Pifer Parduhn • July 16, 2026 -
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Judge tosses another No Surprises lawsuit against HaloMD
It's the third recent legal victory in No Surprises lawsuits for billings intermediary HaloMD, which has also had suits dismissed in California and Texas.
By Emily Olsen • July 15, 2026 -
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Doctor pay to drop in 2027 under proposed Medicare pay rule
Physician groups said the sweeping rule is a double-edged sword, given it includes an unwelcome fee cut but positive changes to Medicare’s value-based and quality payment programs.
By Emily Olsen • July 15, 2026 -
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Elevance shuts down D.C. Medicaid business, eyes additional exits after passable Q2
Elevance will leave D.C. this summer and is considering other markets to depart, executives said. The company outperformed Wall Street expectations in the second quarter — but not by much, and its stock fell accordingly.
By Rebecca Pifer Parduhn • Updated July 17, 2026 -
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CVS Caremark reaches settlement with FTC over insulin suit
Terms of the deal announced Tuesday are very similar to those the FTC reached with Express Scripts earlier this year, including requiring the PBM to stop preferring higher cost versions of drugs on standard formularies.
By Rebecca Pifer Parduhn • July 14, 2026 -
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HHS watchdog says it’s targeting Medicaid, Medicare Advantage fraud
The HHS Office of Inspector General removed over 1,200 people and entities from federal programs between October and March as the Trump administration ratchets up oversight into healthcare fraud.
By Sydney Halleman • July 13, 2026 -
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‘The system is undeniably broken’: More insurers sue CMS over Medicare Advantage stars
SCAN Health Plan and Alignment Healthcare both filed lawsuits against the CMS last week after regulators refused to recalculate industry-wide MA scores using the same methodology as for Clover Health.
By Rebecca Pifer Parduhn • July 13, 2026 -
Kayla Bartkowski via Getty Images
Soon-to-expire ACO REACH generates more savings for Medicare
The model, which is set to sunset at the end of this year, generated $988 million in savings for Medicare in 2024, according to new CMS data. That’s up from almost $695 million in savings from the year prior.
By Rebecca Pifer Parduhn • July 13, 2026 -
Retrieved from Memorial Hermann on July 10, 2026
Memorial Hermann exits commercial insurance business
The Houston-based nonprofit is the latest integrated system to throw in the towel on some of its insurance plans amid a tough cost and policy environment.
By Rebecca Pifer Parduhn • July 10, 2026 -
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Bankrupt Omnicare reaches $440M deal with DOJ in fraud case
The settlement could be the end of a long legal saga for Omnicare, which filed for bankruptcy last year after a judge ordered the company to pay nearly $950 million for fraudulently billing government health programs.
By Emily Olsen • July 10, 2026 -
Permission granted by The Economic Club of Washington, DC/Gary Cameron
CVS CEO says Aetna has a handle on medical costs in advance of Q2 earnings
David Joyner’s assurances, which come about a month before CVS is scheduled to report its second quarter results, will likely be welcomed by investors wary after a difficult few years for insurers.
By Rebecca Pifer Parduhn • July 9, 2026
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