CMS began enforcing updated 2026 hospital price-transparency rules on April 1, 2026, requiring more standardized, machine-readable pricing data (including allowed-amount statistics). Here’s what that posted information can help you estimate—and what it still can’t replace, like plan-specific out-of-pocket costs and network details.
Not everyone on Medicaid will face the new 80-hour rule in 2027. Here is who may have to meet it, who may be exempt, and why paperwork could matter as much as work.
CMS says some adults on Medicaid may need to show 80 hours a month of work, school, service, or another qualifying activity starting in 2027. Here is who may be affected, what can count, which exemptions may apply, and why paperwork could get stricter in 2028.
Federal agencies finalized changes on May 28, 2026 to the out-of-network dispute process under the No Surprises Act. The core protections for patients stay in place, but the new rule is designed to make billing disputes faster, clearer, and less costly to run.
Marketplace coverage remains widely used, but many 2026 shoppers are seeing a less generous mix of plans and higher out-of-pocket costs than they did when enhanced premium tax credits were in place. CMS says 23.1 million people selected or were re-enrolled in Marketplace coverage for 2026, even as bronze plan selections rose and silver selections fell.
2026 ACA Marketplace premiums are still affecting monthly budgets for people who renew coverage, switch plans, or enroll after a life change. The amount many families pay can differ a lot from the insurer’s posted premium, especially when premium tax credits are involved.
A new April 2026 CMS proposal could eventually speed some prescription prior authorization decisions for Medicare Advantage, Medicaid, CHIP, and certain HealthCare.gov plans, but the rule is not final and most coverage will not change right away.
A CMS proposal could eventually speed some drug prior authorization decisions, but it is not final. A new JAMA study shows why even short delays matter.
ACA Marketplace coverage in 2026 may require more paperwork, closer plan shopping, and higher premiums for some after extra tax-credit savings ended on Dec. 31, 2025.
New federal ACA Marketplace rules for 2026 tighten some enrollment steps, though some provisions are on hold. Here’s what shoppers should do now.
The FDA has approved the first generic of Flovent HFA, but this is not a simple fix for every family affected by the brand-name inhaler’s discontinuation. Here’s what changed, who it may help, and why coverage and pharmacy access may still be uneven.
ACA Marketplace sign-ups for 2026 came in below last year, and many households are paying more after tax credits. Here is what changed, who may still qualify to enroll, and what to do if your plan or subsidy looks wrong.
If you get Marketplace premium help in 2026, the financial stakes are higher than they were before. Extra pandemic-era subsidy boosts have ended, and for tax years after 2025 there is no repayment cap if you get too much advance premium tax credit. Here’s what that means, who should act now, and where to get help.
Many ACA Marketplace enrollees are paying more in 2026 after enhanced subsidies ended. If you already signed up, now is the time to verify premium payments, update your income information, and understand the risk of retroactive coverage loss or a tax-time payback.
New federal rules are rolling out in 2026–2027 to shorten prior authorization timelines, require clearer denial explanations, and move more requests online for certain Medicare Advantage, Medicaid, CHIP, and Marketplace plans. Here’s what’s changing — and what it means for patients.
New CMS rules are changing how prior authorization works for many Medicare Advantage, Medicaid managed care, CHIP, and ACA Marketplace plans. Here’s what’s different in 2026, what hasn’t changed, and what to do if your care is delayed or denied.
In 2026, the first negotiated drug prices under Medicare’s new program take effect. Here’s what that means for seniors, how the Maximum Fair Price works, and how the $2,000 Part D cap fits in.
Federal price transparency rules require hospitals and insurers to post negotiated rates and consumer tools—but the data can be hard to use. Here’s what patients should know in 2026.
Medicare Advantage plans and other insurers increasingly use algorithms to review prior authorization and claims. Federal watchdog findings and new CMS rules clarify what’s allowed, what isn’t, and what rights patients have when care is denied.
A surge of FDA-approved biosimilars for adalimumab and a redesigned Medicare Part D benefit with a $2,000 annual out-of-pocket cap are reshaping how Americans with arthritis pay for biologic drugs in 2026. Here’s what that means for your costs, coverage, and care decisions.
Enhanced Affordable Care Act premium tax credits ended December 31, 2025. Here’s how 2026 Marketplace coverage works under the standard subsidy formula, who is most affected, what protections remain, and what families can do now.
The finalized 2026 ACA Marketplace rules shape how premium tax credits are calculated, who qualifies for financial help, and what households should review before enrolling. Here’s what to check now to avoid surprise costs and coverage gaps.
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