Blog

January 2026 delivered historic PBM reform, a record Medicare Advantage fraud settlement, flat MA rate proposals, HSA-eligible Bronze plans, Medicare drug price negotiations taking effect, and sweeping state mandates. Here is everything that happened and why it matters.

December 2025 delivered landmark bipartisan PBM reform bills, a major Blue Cross Blue Shield affiliation, California's subsidy lifeline, AI-native insurtech funding, and sweeping employer plan design changes heading into 2026.

November 2025 brought a negative outlook confirmation from AM Best, Aetna's full ACA marketplace exit, record employer premiums in the KFF survey, a historic dependent care FSA increase, state PBM reform momentum, a federal mental health parity pause offset by California's advance, Kaiser Permanente's Nevada entry, and an ICHRA adoption surge reshaping the individual market.

From Google Cloud’s new data on AI agent budgets to SIAA’s distribution OS and fresh funding for pharmacy, telehealth, and cybersecurity platforms, here’s how the mid-October 2025 news cycle resets the roadmap for payers, brokers, and employers.

From CMS rulemaking and Marketplace changes to Medicaid payment oversight and Medicare Advantage stability, September delivered real policy signals that matter for brokers, employers, and carriers building modern, digital benefit experiences. Here’s what changed and how to act.

Critical Medicare telehealth flexibilities expire in just 25 days, potentially eliminating virtual care access for millions of Americans and reversing five years of digital health progress unless Congress acts immediately.

As enhanced tax credits near expiration, ACA marketplace premiums are set to increase by up to 75%, potentially leaving 4.2 million Americans uninsured while employers face their steepest healthcare cost increases in a decade

Health insurers announce the largest premium increases in nearly a decade as enhanced federal subsidies expire, creating a perfect storm for millions of Americans seeking affordable coverage.

The Business Group on Health's latest survey reveals healthcare costs are rising at nearly 8% for 2025, the steepest increase in over a decade, forcing employers to make difficult decisions about coverage, cost-sharing, and benefit design as pharmacy costs and chronic conditions drive unprecedented spending.