#health-insurance-policy

#health-insurance-policy

I was devastated. I had been able to get Zepbound for a $30 monthly copay and had lost 50 pounds in a year. The drug helped me focus on being a new mom and gaining strength at the gym, not just counting calories burned.

Many of the medicines on TrumpRx include brand-name drugs that patients can find cheaper elsewhere as generics. For instance, Protonix for heartburn is available for $200 on TrumpRx, but the generic version, pantoprazole, costs less than $30 with a GoodRx coupon.

If you run a business, there's a familiar email you probably opened this fall: the one from your benefits broker with your 2026 health insurance renewal. You scroll. You see a double-digit increase, and your stomach drops. You want to do right by your team. You also have a P&L to protect. And the three standard options you're handed - pay the increase, raise deductibles or push more cost onto employees - all feel bad in different ways.

Health insurance plays a vital role in safeguarding Indians from mounting healthcare costs. With medical inflation rising and hospital bills becoming unaffordable, having robust individual health insurance is no longer an option but a necessity. Recognising this, the Indian insurance regulator made a crucial change in April 2024. Now, health insurance and individual health insurance plans must cover hospitalisation cases where the patient is admitted for as little as two hours.

The issue is particularly critical right now for people who have insurance plans through the Affordable Care Act marketplace. Prices for those plans have skyrocketed this year after Congress failed to extend critical tax credits. Without those credits, monthly premiums for ACA plans have, on average, more than doubled. Early data on ACA enrollments for 2026 not only suggests that fewer people are signing up for the plans, but also that those who are enrolling are often choosing bronze plans, which are high-deductible plans.

The 340B program allows hospitals to buy outpatient drugs at steep discounts, with the purported purpose of helping them fund care for low-income and uninsured patients. The now-axed rebate model would have invited drugmakers to participate voluntarily in a rebate-based discount system. Basically, instead of the provider receiving a discount upfront at purchase, the 340B discount would be applied after purchase via rebate - and subject to tedious data submission requirements.

For years, Congress has signaled that it wants to crack down on Pharmacy Benefit Managers, the middle men that have come under fire for their vertical integration with insurers and their role in spiking drug costs. This week, it finally happened via the Consolidated Appropriations Act of 2026, promptingemployer groups including the Purchaser Business Group on Health (PBGH) and the ERISA Industry Committee to cheer its passage.