Supreme Court to hear challenge to ACA rule requiring free preventive care, cancer screenings

By Angus Chen - For a decade and a half, Americans have been guaranteed that no matter their health insurer, certain preventive care like cancer screenings are free of charge. That’s because an Affordable Care Act provision has required insurers to fully cover services given an A or B recommendation by an expert task force. Read Full Article…

HVBA Article Summary

1. Potential rollback of no-cost preventive care: The Supreme Court's decision in Kennedy v. Braidwood Managementcould invalidate the ACA’s requirement for insurers to fully cover services recommended by the U.S. Preventive Services Task Force—putting no-cost access to cancer screenings, PrEP, and other preventive measures at risk and potentially leading to worse public health outcomes.

2. Significant legal and political implications: The case challenges whether a volunteer expert panel can dictate insurer coverage mandates without presidential or congressional approval. A ruling against the ACA provision could shift power to the HHS secretary, enabling future administrations to approve or veto preventive care coverage, depending on political priorities.

3. Public health and economic concerns: Experts warn that removing cost-sharing protections could reduce access to effective, life-saving services—especially among vulnerable populations—and ultimately increase long-term healthcare costs by allowing preventable diseases to go undetected and untreated until later, more expensive stages.

Hospitals say they could be hurt by Trump’s order on drug prices

By Ron Southwick - President Trump says he’s aiming to cut prescription drug prices for Americans, but hospitals say they could be hurt by Trump’s new executive order. In the executive order issued Tuesday, the president says he plans to improve the Medicare Drug Price Negotiation Program launched by President Biden. He also aims to boost transparency in pharmacy benefit manager fees. Read Full Article…

HVBA Article Summary

1. Hospitals fear a return to 340B payment cuts: The executive order’s directive for a drug pricing survey could pave the way for the Trump administration to reinstate Medicare payment cuts to 340B hospitals, similar to reductions implemented during his first term. These cuts previously cost hospitals around $2 billion annually and were reversed by the Supreme Court only on procedural grounds—not on the legality of the cuts themselves.

2. Essential hospitals face disproportionate impact: Safety net hospitals, already operating on slim or negative margins, warn that renewed payment reductions would devastate their ability to serve low-income and underserved communities. Leaders argue the 340B program is critical for maintaining access to affordable medications and vital services.

3. Ongoing battle between hospitals and pharma: The 340B program remains controversial, with hospitals defending it as a lifeline for vulnerable populations, while pharmaceutical companies and critics argue it has expanded beyond its intent and is being exploited for profit. The executive order has reignited these tensions, with stakeholders anticipating significant changes depending on the survey’s outcome.

UnitedHealth CEO objects to critics' 'obsession' with PBMs' role in drug supply chain

By Allison Bell - The Trump administration seems to want to take a hard look at all players in the U.S. prescription drug supply chain, not just pharmacy benefit managers. Andrew Witty, the chief executive officer of UnitedHealth Group, gave that assessment Thursday during a conference call the company held with securities analysts. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Executive order targets entire pharma supply chain, not just PBMs: A new Trump administration executive order calls for strategies to improve competition, efficiency, and transparency in the pharmaceutical value chain—broadening scrutiny beyond PBMs to include drug manufacturers and other industry players. UnitedHealth CEO Andrew Witty welcomed the move, noting that PBMs like Optum Rx operate on narrow margins and take on significant risk to lower costs for clients.

2. Optum Rx shows growth amid scrutiny: Despite industry focus on PBMs, Optum Rx reported strong performance in Q1 2025, managing 408 million prescriptions (up 3.3%) and increasing revenue by 14% to $35 billion. CEO Witty emphasized that customer loyalty and new wins reflect confidence in Optum Rx’s efforts to push back against high drug prices set by manufacturers.

3. UnitedHealth posts strong financials and enrollment gains: UnitedHealth reported $6.5 billion in Q1 net income on $110 billion in revenue, reversing a loss from the previous year. The company now serves 50 million people across its health plans, with notable gains in commercial enrollment—particularly in self-insured employer and union health plans, which rose to 21.6 million.

Your Employees Need More Than Paychecks and Perks — Here's What They Really Want

By Howard Enders - I've had countless conversations with colleagues, friends and fellow leaders about the main driver of their employees' satisfaction. Over and over, they essentially talk about "the paycheck." No doubt, everyone would agree that solid compensation is non-negotiable. Still, for me, employees these days are increasingly seeking personalized, holistic benefits packages that address their deeper needs — especially when it comes to financial and family security. Read Full Article…

HVBA Article Summary

1. Employees expect meaningful, future-focused benefits: Traditional perks like gym access or basic insurance no longer meet employee expectations. Workers now prioritize support for major life transitions—such as family growth, elder care, and retirement planning—and seek benefits that safeguard their financial future, including estate planning tools, financial coaching, and personalized advisement.

2. Tailored financial support boosts employee loyalty: Offering access to certified financial planners, tax specialists, and estate planning services demonstrates a commitment to employee well-being. Integrated solutions that align with generational preferences and address complex financial needs help employees feel valued and secure—enhancing retention, engagement, and workplace satisfaction.

3. Digital estate planning is becoming a critical benefit: As technology reshapes the benefits landscape, employees increasingly expect secure, on-demand tools for managing wills, assets, and personal data. Providing discounted or covered access to digital estate planning platforms positions employers as forward-thinking partners in their employees’ financial security—supporting both present stability and long-term peace of mind.

'At the mercy of insurance companies': Supreme Court braces for ACA preventive coverage suit oral arguments

By Noah Tong - The Supreme Court will hear oral arguments in a lawsuit consequential for the fate of preventive services April 21. If the Supreme Court rules in favor of the plaintiff, Texas-based employer Braidwood Management, private insurers will no longer be required to cover certain cost-free preventive services through the Affordable Care Act (ACA) marketplace plans or in employer-based coverage. Read Full Article…

HVBA Article Summary

1. Potential rollback of no-cost preventive care: The Supreme Court’s ruling in Kennedy v. Braidwood Managementcould dismantle the ACA mandate requiring insurers to fully cover preventive services recommended by the U.S. Preventive Services Task Force. This would jeopardize access to critical interventions like cancer screenings and PrEP, with public health leaders warning of increased mortality and higher downstream healthcare costs.

2. Legal challenge to USPSTF authority: Plaintiffs argue that the USPSTF’s members are unconstitutionally appointed, claiming the panel wields too much power without proper oversight. While the Court may opt to limit rather than eliminate the task force’s role, a ruling against it could transfer authority to the HHS secretary—raising concerns about political interference in science-based coverage decisions.

3. Broader threat to preventive care infrastructure: Even a government win wouldn’t settle the issue, as courts are still weighing the constitutionality of other expert panels tied to ACA coverage, such as those recommending vaccines and women’s health services. Advocates caution that weakening these protections could embolden insurers to offer fewer services while charging the same premiums, undermining consumer protections and equitable access to care.

UnitedHealth’s stock is plunging on higher medical costs. That may mean trouble for more insurers

By Annika Kim Constantino - UnitedHealth Group’s stock sank 20% on Thursday after the company slashed its annual profit forecast, citing higher-than-expected medical costs in its privately run Medicare plans. Those bleak results from a health-care giant seen as the insurance industry’s bellwether could be a warning sign for other companies with so-called Medicare Advantage plans, according to some Wall Street analysts. Read Full Article…

HVBA Article Summary

1. Rising medical costs strain Medicare Advantage insurers: UnitedHealth’s Q1 results highlighted a sharp and unexpected increase in care utilization—particularly in outpatient services—driven by seniors resuming postponed procedures. This trend, seen across the industry, is raising concerns about 2025 financial outlooks and pressuring insurers that retained or expanded Medicare Advantage market share.

2. Market turbulence and policy headwinds compound pressure: Insurers like Humana, CVS, and Elevance Health are navigating fallout from high costs, low reimbursements, DOJ scrutiny, and public blowback following the murder of UnitedHealth’s CEO. Analysts suggest UnitedHealth may be easing utilization controls due to political and reputational challenges, further straining margins.

3. Regulatory and strategic shifts ahead: UnitedHealth is addressing performance issues within its Optum unit and sees challenges as “highly addressable” by 2026. Meanwhile, Medicare Advantage insurers could see relief next year, as the Trump administration’s proposed rate hikes offer a more favorable reimbursement landscape than earlier Biden-era projections.

Hackers steal 1.6 million patient records in major healthcare breach

By Kurt Knutsson - Healthcare data breaches are common for two main reasons. Healthcare organizations are easy targets due to poor cybersecurity practices, and the data they store is extremely valuable. Bad actors can often demand and receive whatever ransom they want for the stolen information. Read Full Article…

HVBA Article Summary

1. Massive healthcare data breach affects 1.6 million individuals: Laboratory Services Cooperative (LSC), a nonprofit lab provider for reproductive health clinics across 31 states, experienced a major cyberattack in October 2024. Hackers accessed highly sensitive data, including medical, personal, financial, and insurance information, raising serious concerns about identity theft and medical fraud.

2. Delayed disclosure and widespread impact: Although the breach was discovered on the day it occurred, LSC notified affected individuals only in April 2025, after months of data review. The breach impacted individuals in multiple states and select Planned Parenthood clinics, exposing a wide range of data from Social Security numbers to lab results and treatment details.

3. Response and risk mitigation efforts underway: LSC is offering free credit and identity protection services, while also enhancing cybersecurity through updated risk analysis, employee training, and system testing. Experts urge affected individuals to take proactive steps—like enabling fraud alerts, using MFA, and monitoring credit and medical records—to guard against long-term fallout.