Federal and state healthcare policy changes affecting access, benefits, eligibility, and care delivery.
CMS has proposed new electronic prior-authorization rules for some drug coverage in Medicare Advantage, Medicaid, CHIP, and certain ACA marketplace plans, but nothing changes yet because the rule is still only a proposal.
More than 23 million people selected or were automatically re-enrolled in ACA Marketplace coverage for 2026, according to CMS. But for many households, the end of enhanced pandemic-era savings on December 31, 2025, may mean higher monthly premiums even while enrollment remains strong.
CMS has proposed a rule to move more drug prior authorization into electronic workflows and standardize how plans handle requests. If finalized, the change could make some pharmacy delays shorter and denials easier to track, but the rule is still only proposed.
CMS has proposed new rules to speed up prior authorization for prescription drugs and make denials more transparent. The changes are not final yet, so patients should not expect immediate nationwide changes.
CMS has proposed new rules that would extend prior-authorization interoperability requirements to prescription drugs. The plan would not end prior authorization, but it could make requests more electronic, more standardized, and faster to answer for some health plans.
Federal vaccine recommendation wording can shape no-cost coverage. Here’s how private plans, Medicaid, Medicare, and VFC may differ in 2026.
A bigger physician pipeline is good news, but U.S. patients may still face waits and access problems as primary care, nursing, and public health shortages persist.
Medicaid work requirements are edging closer, and the biggest risk may be paperwork. Here is what enrollees should do now to protect coverage before 2027.
FDA approved the first generic Flovent HFA, but access may still depend on strength, pharmacy supply, insurance coverage, and safe switching.
Federal telehealth prescribing flexibility for ADHD stimulants continues through December 31, 2026. Here’s what changed, what did not, and where barriers remain.
SAMHSA’s 2026 988 funding may show up first as faster answers, more local routing, and stronger follow-up, not instant growth in in-person crisis care.
Medicare’s 2026 physician payment rule may improve care coordination, telehealth, and home visits, but local staffing and practice finances still matter.
Some plans now have to post 2025 prior-authorization data. Here is what patients and clinicians can learn from the new CMS reports, and what they cannot.
Minnesota’s Medicaid funding deferral does not automatically end coverage. The closer short-term risk is provider payment strain, tighter oversight, and access friction.
FDA’s 2026 crackdown on mass-marketed compounded GLP-1s could tighten safety oversight but also shrink cheaper options for people struggling to afford approved drugs.
With semaglutide and tirzepatide shortages resolved, the FDA is tightening scrutiny of mass-marketed compounded GLP-1s. Here is what changed and what patients should ask now.
CMS has started a limited Original Medicare pilot in six states that uses technology vendors and clinician review for a narrow set of services. Here’s what WISeR does, what has not changed, how reviews and appeals work, and why some experts worry about delays.
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.
Certain Medicare Advantage, Medicaid, CHIP, and HealthCare.gov marketplace plans now have to post prior authorization data from 2025. Here’s what patients can check, what the numbers mean, and what the reports still leave out.
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.
Medicare has extended many telehealth flexibilities through 2026. Here’s what that means for receiving care at home, what’s covered, what you pay, and what could change next.
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