worlds Insurance blog

Marketplace enrollees between the ages of 50 and 64 are disproportionately affected by the expiration of the enhanced premium tax credits, not just because they make up a large number of Marketplace enrollees, but also because the cost of Marketplace premiums tend to rise with age. Older ACA enrollees with annual incomes just above 400% of the federal poverty line (FPL) are expected to see the largest increases in premium payments. from KFF https://ift.tt/tjyfZgH

A new study finds that nearly 10% of cancer research papers showed signs of being fabricated by “paper mills”. The problem may intensify as generative AI becomes more sophisticated, prompting lawmakers to demand information about safeguards in place. And, claims that physicians are financially incentivized to promote vaccines persist, despite lack of evidence. from KFF https://ift.tt/KN69uBl

This tracker examines Executive Actions taken by the Trump administration that have the potential to impact LGBTQ+ people’s health. It lists the action taken by date, provisions relevant to LGBTQ+ health, and describes potential impact, including litigation challenging these actions. from KFF https://ift.tt/aZRzk62

This brief examines efforts in 11 states to fill in funding gaps created by the 2025 federal budget reconciliation law, which prohibits federal Medicaid funding for reproductive-health care services provided by Planned Parenthood and other organizations that also provide abortion care. from KFF https://ift.tt/d5oHGma

Alcohol deaths increased gradually before the pandemic, jumped in 2020 and 2021, and have fallen somewhat since then. Even after these declines, deaths remained above 2019, the year before the pandemic. from KFF https://ift.tt/J2e864Z

In February, the Trump administration launched TrumpRx, a government website that provides prescription drug discounts to consumers. This brief examines issues that may impact consumers, especially those with private insurance, who access drug discounts through TrumpRx. from KFF https://ift.tt/WryRSVO

Just over 35 million people are enrolled in Medicare Advantage in February 2026, an increase of 1.1 million since a year ago. The increase was largely driven by increased enrollment in special needs plans. from KFF https://ift.tt/w9u7bxM

This analysis of trends in health insurers’ financial data shows that insurers’ gross margins per enrollee dipped slightly in 2024 across four markets, remaining highest in the Medicare Advantage market, followed by the individual (non-group) market, the fully insured group (employer) market, and Medicaid managed care. The analysis also examines insurers’ medical-loss ratios across the four markets. from KFF https://ift.tt/KF7rqDV

On February 14, 2026, CMS released a dataset with provider-level spending data that the agency suggests could be used to identify unusual billing patterns for specific services, states, or providers. This policy watch describes what the data include, what they exclude, and how they could potentially lead to mistaken conclusions given the limitations of the data. from KFF https://ift.tt/vOFE0UN

Intrauterine devices (IUDs), along with implants, are known as long-acting reversible contraception (LARCs) because they can be used to prevent pregnancy for several years. This fact sheet reviews FDA-approved IUDs, as well as use, availability, and key issues in insurance coverage and financing of IUDs in the U.S. from KFF https://ift.tt/xrTjMHn

This brief describes the Managed Care Program Annual Report (MCPAR), a relatively new, comprehensive report on state Medicaid managed care programs that includes plan-level data. It is used with other managed care reports to improve state and federal managed care program monitoring, oversight, and transparency. from KFF https://ift.tt/s2brdtm

Explore an overview of the Mexico City Policy, which, when in effect, requires foreign NGOs to certify that they will not “perform or actively promote abortion as a method of family planning” using funds from any source (including non-U.S. funds) as a condition for receiving U.S. government global health assistance. from KFF https://ift.tt/nrqwvNo

The PERM program measures improper payments in Medicaid through cyclical audits of state Medicaid programs. This brief explains the PERM program and its three component error rates as well as upcoming changes to PERM and possible state impacts. from KFF https://ift.tt/NbhvRDl

KFF’s latest Health Information and Trust Tracking Poll shows trust in the CDC for vaccine information is at its lowest point since the pandemic began. Findings are available on KFF’s new polling dashboard. New evidence also finds no link between prenatal acetaminophen use and autism, though confusion may persist as officials question the drug’s safety. from KFF https://ift.tt/NEl0DdI

This data note analyzes the extent to which hospital spending has contributed to the growth in national health expenditures in recent years and over the long term using data from the Centers for Medicare & Medicaid Services (CMS) National Health Expenditures Accounts (NHEA). from KFF https://ift.tt/R80H51w

The Medicare drug price negotiation program could improve coverage of drugs selected for negotiation for Medicare beneficiaries because the law requires all Medicare Part D plans to cover each of the selected drugs, including all dosages and forms, when negotiated prices take effect. This analysis examines 2026 Medicare Part D formulary coverage of drugs selected for negotiation to measure the effect of the IRA's coverage requirement. from KFF https://ift.tt/ZDjecmn

On January 1, 2026, the Center for Medicare & Medicaid Innovation (CMMI) launched the Wasteful and Inappropriate Service Reduction (WISeR) Model that establishes new prior authorization requirements in traditional Medicare. This analysis explores the potential impact of the WISeR model by examining recent spending and utilization trends in traditional Medicare for services selected for prior authorization requirements in the six model states (Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington). from KFF https://ift.tt/8IeC0LN

This brief provides an overview of the role of PBMs in managing pharmacy benefits, discusses federal efforts to reform certain PBM business practices, and explains the estimated federal budgetary impact of the recently enacted legislation, which would be a reduction in the federal deficit of $2.1 billion over 10 years, according to CBO. from KFF https://ift.tt/6tTKg8Z

This interactive tool tracks public opinion on the Affordable Care Act, from the inception of the law to the present. It highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity. from KFF https://ift.tt/dl9Zr1y

This issue brief explains why it can be misleading to compare the first year of Rural Health Transformation Program allocations with estimated Medicaid cuts, which will be implemented on a gradual basis and not fully take effect until 2027, after the rural health fund is exhausted. from KFF https://ift.tt/aD90W5j

Weeks after the Trump administration reduced the number of childhood vaccine recommended for routine use, public trust in the CDC is at its lowest since the COVID-19 pandemic, and less than half are confident in federal agencies' ability to make such recommendations. Among those who have heard about the revised recommendations, more say they expect the changes to have a negative impact than a positive one on children’s health. from KFF https://ift.tt/DMrb5vN

This issue brief provides an overview of the H-1B visa program, analyzes trends in H-1B visa approvals for the health care and social assistance industries using data from the U.S. Citizenship and Immigration Services, and discusses potential implications of recent policies impacting the H-1B program on the U.S. health care workforce. from KFF https://ift.tt/RJBiVk0

This brief explains the limitations of early data in understanding the impact of the expiration of enhanced premiums tax credit on ACA enrollment. It also provides a timeline of when more complete data will become available. from KFF https://ift.tt/Bkuyjr8

Community health centers served more than 32 million patients in medically underserved urban and rural areas in 2024. This brief reports on health center patients, services, and financing in 2024, using national data from the Uniform Data System (UDS). from KFF https://ift.tt/NDlWyk5

KFF's health tracking poll finds that beyond costs, insured adults say prior authorization is their biggest challenges when accessing care. About seven in ten (69%) insured adults say prior authorizations are burdensome, and a third (34%) choose prior authorizations as their single biggest health care burden. from KFF https://ift.tt/rpTVDBE