1. Medicaid and ACA Changes Under the βOne Big Beautiful Bill Actβ
Signed into law on July 4, 2025, this sweeping legislation introduces:Grantmakers In Health+3The Guardian+3JH Bloomberg School of Public Health+3
Medicaid Work Requirements: New eligibility criteria and work requirements for Medicaid recipients.JAMA Network+2The Guardian+2
Affordable Care Act (ACA) Premium Subsidy Reductions: Declines in ACA premium subsidies, potentially increasing out-of-pocket costs for many.The Guardian
Projected Coverage Losses: An estimated 11.8 million people could lose health insurance by 2034 due to these changes. Grantmakers In Health
Democrats have introduced the Protecting Healthcare and Lowering Costs Act, aiming to reverse these cuts and extend ACA premium tax credits. Senate Finance Committee
2. Medicare Payment Increases
The Centers for Medicare & Medicaid Services (CMS) announced:
2.6% Increase: A net increase in Medicare inpatient payments, translating to approximately 1.9% after adjustments.DeBrunner & Associates
$2 Billion Boost: Additional funding for Medicare Disproportionate Share Hospital (DSH) uncompensated care payments. DeBrunner & Associates
3. Medicaid Managed Care Rate Guide
CMS released the β2025β2026 Medicaid Managed Care Rate Development Guide,β providing states with updated standards for setting capitation rates in managed care programs. Alliance of Safety-Net Hospitals+1
4. Medicare Telehealth Services Extended
Medicare beneficiaries can continue accessing:
Non-Behavioral/Mental Telehealth: Services in the home through September 30, 2025, including audio-only options.telehealth.hhs.gov
Behavioral/Mental Health Telehealth: Permanent access to services in the home, with no geographic restrictions. telehealth.hhs.gov
5. Direct-to-Consumer Drug Sales
Pharmaceutical companies like Eli Lilly and Novo Nordisk are exploring direct-to-consumer sales for medications such as Zepbound and Wegovy. This approach aims to reduce costs and bypass intermediaries, though it may primarily benefit wealthier patients. Barron’s
6. New Drug Approvals
Lung Cancer Treatment: The FDA approved a new antibody-drug conjugate (ADC) for treating lung cancer. Medscape+1
Chronic Lung Disease: Insmed’s drug became the first approved treatment for a specific chronic lung disease. Reuters+1
These updates reflect significant changes in healthcare policy and access. If you need assistance understanding how these developments affect you or your family, feel free to ask.
Barron’s
The Guardian
Reuters