Trump's DOL cuts benefits enforcement section from 2027 budget proposal

By Allison Bell – The U.S. Department of Labor has trimmed references to civil monetary penalties — and most references to criminal investigations — out of the Employee Benefits Security Administration budget proposal for 2027. The administration of President Donald Trump is asking for $181.1 million in funding for EBSA for the coming year. That's the same amount the Trump administration requested for the agency for 2026. Congress ended up increasing EBSA funding to $191.1 million. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. EBSA Budget Proposal Changes: The 2027 budget proposal for the Employee Benefits Security Administration (EBSA) removes a section included in the 2026 proposal that described the agency’s enforcement program and investigative focus on major cases. In the new request, criminal provisions of the Employee Retirement Income Security Act are mentioned only within a section outlining EBSA’s statutory responsibilities. The change may indicate a shift in how enforcement activities are presented in the budget, although the proposal does not specify whether enforcement levels will change.

2. Examples of Participant Assistance and Dispute Resolution Trends: The proposal highlights several examples of EBSA assistance to benefit plan participants, including helping a patient resolve COBRA coverage confusion before cancer surgery and assisting with a $50,000 air ambulance bill. It also references a $20 million settlement involving allegations that a health plan administrator systematically denied certain emergency room and drug screening claims. Meanwhile, the value of No Surprises Act disputes resolved with EBSA assistance declined from $544 million in fiscal year 2024 to $468.9 million in fiscal year 2025.

3. Federal Budget Context and ACA Program Funding: The administration’s 2027 federal budget proposal projects $5.9 trillion in revenue and $8.1 trillion in spending, resulting in a deficit of about $2.2 trillion. Within health policy funding, the Department of Health and Human Services requested $2.134 billion for programs supporting the Affordable Care Act exchange system and related activities. The request is slightly higher than the 2026 proposal but below the level Congress approved for 2026, while exchange administration spending could increase to $155.8 million from $129 million.

CMS gives Medicare Advantage rates a 2.48% bump for 2027 plan year in final rule

By Paige Minemyer – Following significant industry outcry over a proposal to keep Medicare Advantage rates largely flat in 2027, the Trump administration has bumped payments up slightly in the final policy. The Centers for Medicare & Medicaid Services initially proposed a 0.09% increase in rates as part of the MA and Part D Advance Notice. In the final rule, the increase is instead set at 2.48%, which CMS said equates to about $13 billion in additional payments to plans for the coming plan year. CMS said that the rate increase accounts for the growth in underlying costs, how 2026 star ratings could impact bonus payments and changes to risk adjustment. Read Full Article...

HVBA Article Summary

1. CMS Finalizes Medicare Advantage Payment Increase for 2027: The Centers for Medicare & Medicaid Services (CMS) finalized a rule that increases payments to Medicare Advantage (MA) plans for the 2027 plan year. Officials said the decision aims to balance near-term financial pressures in the program with longer-term goals of maintaining stability and sustainability in MA. The approach also reflects broader federal efforts to monitor insurer practices and address concerns about profit-driven behaviors within the program.

2. Delay of Additional Risk Adjustment Changes: CMS decided to delay proposed updates to the MA risk adjustment model beyond the changes already implemented under Version 28 (V28). Officials said the delay will allow the V28 updates—fully implemented for the 2026 plan year—to stabilize before further modifications are considered. The agency emphasized it will continue monitoring insurer practices that could influence risk-adjustment payments while evaluating the effects of the existing policy changes.

3. Mixed Industry Response to the Final Rule: Insurance industry representatives said health plans will continue focusing on affordability as they incorporate the finalized policies amid rising healthcare costs. Provider groups, however, argued that the payment increase may not keep pace with the real costs of delivering care to Medicare patients. They warned that if reimbursement levels lag behind healthcare expenses, insurers may respond by reducing benefits or withdrawing certain plan offerings.

Proposed FDA budget aligns Makary, Trump behind rivaling China biotech

By Max Bayer – The White House threw its weight behind efforts to help US biotech compete with China, using the administration’s budget proposal to outline FDA policy changes to speed up trials, cut costs for companies that do experimental work in the US, and expedite regulatory reviews. One of the reforms is a new clinical trial pathway that reflects the quicker processes other countries have. The expedited pathway would be for some Phase 1 trials where there are enough existing preclinical data to satisfy regulators. The FDA specifically expects the pathway to help “smaller biotechnology firms,” saying that the US’ existing IND process has fueled growth in China and Australia. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. FDA Budget Proposal Aims to Accelerate U.S. Drug Development: The administration’s budget request proposes regulatory changes intended to speed up the drug development process and encourage more biotechnology investment in the United States. Industry leaders have generally supported the reforms, stating that greater regulatory flexibility could help strengthen the global competitiveness of U.S. biotech companies. The proposal also includes a 3.3% increase to the FDA’s budget, bringing total proposed funding to more than $7 billion, though final allocations will be determined by Congress.

2. Incentives for U.S.-Based Clinical Trials and Increased Global Oversight: The FDA is considering policy changes that would encourage companies to conduct more early-stage clinical trials in the United States, including potentially reducing application requirements and lowering user fees for qualifying drugs with Phase 1 data conducted domestically. At the same time, the agency plans to expand oversight of foreign drug manufacturers and increase inspections of facilities outside the U.S. These measures aim to address concerns about supply chain security and ensure consistent regulatory standards for global pharmaceutical production.

3. New and Existing Review Programs Under Discussion: The budget outlines several regulatory initiatives designed to accelerate drug review timelines and support specialized programs. One proposal involves continuing or expanding priority review voucher programs, including one focused on rare pediatric diseases, while discussions continue around other accelerated review initiatives. The FDA and industry are also negotiating the next five-year user fee agreement for 2028–2032, which may include reduced fees for qualifying applications tied to U.S.-based clinical development.

Healthcare ransomware demands average $18.2M: 7 notes

By Giles Bruce – Hackers demand an average of $18.2 million after a healthcare ransomware attack, nearly six times more than the next-closest industry, according to a BakerHostetler analysis. Here are seven more things to know from the annual Data Security Incident Response Report, which analyzed over 1,250 cyber incidents the law firm handled in 2025 and was released in late March. Read Full Article...

HVBA Article Summary

1. Ransom Demands in Healthcare Exceed Other Industries: Healthcare organizations faced significantly higher ransomware demands than other sectors, with an average initial demand of $18.2 million and an average payment of $1.2 million. In comparison, energy and technology firms experienced lower average demands of $3.2 million and paid about $1.7 million. The largest single demand in healthcare reached $98 million, while the largest ransom payment totaled $5 million, both the highest recorded across industries.

2. Healthcare Sector Experiences High Breach Impact and Recovery Costs: Healthcare accounted for 27% of all data breaches, the highest share among industries, followed by finance and insurance (18%) and business and professional services (15%). On average, 357,020 individuals were notified per healthcare breach, with the largest affecting 3.4 million people. Organizations required an average of 12.7 days to restore data after ransomware incidents, and forensic investigations cost about $39,934 on average.

3. Legal Exposure and Third-Party Risks Are Common in Healthcare Breaches: Healthcare incidents were frequently associated with legal action, representing 31 of the 68 ransomware cases that resulted in lawsuits. The sector also showed greater reliance on third-party vendors, with more than one-third of healthcare breaches originating through these external partners. This rate exceeds the cross-industry average of 25%, highlighting the role of vendor relationships in healthcare cybersecurity risk.

ICHRAs in 2026: How brokers are scaling from first sale to thriving practice

By Jeff Kirchick – ICHRA is undeniably gaining momentum. Over the last five years, adoption has increased by more than 1,000%, with participation tripling between 2024 and 2025. (At Zorro, we saw our user base grow by 3x year-over-year in our 2026 open enrollment alone!) But while demand is growing, many brokers are still working out how to translate that momentum into repeatable, scalable sales. We've heard their questions: How do you sell ICHRA confidently? How do you scale it profitably? And how do you address the objections that keep deals from closing? Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Rapid Growth and Mainstream Adoption: ICHRA adoption has surged in recent years, with a significant increase in both broker participation and employer interest. Nearly half of surveyed brokers are now selling ICHRA, and a growing number of employers—especially those with larger workforces—are considering it as a viable alternative to traditional group plans. This trend indicates that ICHRA is no longer a niche solution but is becoming a standard part of benefits planning.

2. Addressing Broker and Employer Concerns: The main objections to ICHRA center on perceived lower quality of individual market plans, employee fears of benefit cuts, and doubts about employees' ability to choose their own coverage. However, the article highlights that these concerns are often based on outdated information or misconceptions. With proper education, data-driven comparisons, and robust support tools, brokers can help employers and employees understand the value and flexibility of ICHRA offerings.

3. Strategic Opportunity for Brokers: As employers face rising health insurance costs and seek sustainable alternatives, brokers who proactively embrace ICHRA are positioned to lead in the evolving benefits landscape. Success requires brokers to invest in education, strategic partnerships, and objection-handling skills. Those who master these areas can scale their practices effectively and become trusted advisors, offering clients innovative solutions that address both cost pressures and employee empowerment.

When AI meets EQ: the next frontier of digital health

By Marin Hoffman – Artificial intelligence (AI) or when machine learning techniques or algorithms are used to manage tasks or processes more efficiently, has quickly become the backbone of digital health — from nutrition coaching and stress management to chronic condition care. Eighty-five percent of healthcare leaders report exploring or implementing AI, in part to improve personalization and scalability. For employers, that's transformative: helping more people, more often, at a lower cost. But predicting what someone needs is only half the battle. As efficient as AI is, it wasn't designed to completely replace human connection and emotional intelligence (EQ), the ability to recognize and understand emotions of yourself and others. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. AI Supports Engagement but Requires Human Context: Organizations that use AI to strengthen engagement rather than replace human interaction are more likely to improve workforce health outcomes. AI can identify patterns such as inactivity, but it cannot determine whether the cause is stress, travel or exhaustion without human interpretation. This limitation is especially important given findings that OpenAI’s newer models, o3 and o4-mini, hallucinated between 30% and 50% of the time, highlighting the need for human oversight when AI is used in health-related decision-making.

2. Automation Alone Can Lead to Disengagement for Key Employee Groups: The shift toward automated wellness tools—such as chatbots, algorithms and self-guided programs—has improved accessibility but does not always foster the emotional connection that keeps employees engaged. Programs that rely heavily on automation may unintentionally disengage individuals who need occasional human support, those with limited digital or health literacy, or employees who are already emotionally or mentally overwhelmed. Research also shows that people are more likely to follow healthcare guidance when they feel understood and supported, emphasizing the role of empathy in driving adherence and participation.

3. Employers Are Seeking Balanced AI–Human Solutions Amid Rising Costs: Employers are navigating a complex benefits environment as healthcare costs are projected to rise 6.5% this year, partly driven by chronic disease, obesity and increased use of GLP-1 medications. At the same time, 70% of HR leaders say mental and emotional well-being are top organizational priorities, prompting interest in scalable tools like AI. Programs that combine AI-driven insights with human coaching or clinical oversight can deliver personalized support, build trust and help employers improve participation while managing long-term healthcare costs.

As the Affordable Care Act turns 16, experts reflect on its impact and future

By Cassie McGrath – Grab the balloons and light the candles because it’s the sweet 16 of the Affordable Care Act (ACA)—as of March 23, at least! The ACA helped bring the US uninsured rate to a record low of 7.7% by 2023, according to the Department of Health and Human Services with the number of users shooting up during the Covid-19 pandemic. Healthcare Brew asked insurance experts to look back at the law’s impact on not just health plans but also hospitals and in emergencies, as the Centers for Medicare and Medicaid and Census report 2 in 5 people in the US are enrolled in Medicare or Medicaid. Read Full Article...

HVBA Article Summary

1. ACA’s Broad Impact on Coverage and Healthcare Industry: Over the past sixteen years, the Affordable Care Act has significantly reduced the uninsured rate in the United States and strengthened the healthcare market. Experts note that the ACA has driven competition among insurers, improved access and affordability, and introduced initiatives like value-based payment models and no-cost preventive care. Hospitals have also benefited from more predictable payments and fewer closures, as more patients gained insurance coverage.

2. Upcoming Policy Changes and Potential Risks: The One Big Beautiful Bill Act (OBBA) is expected to introduce cuts to Medicaid, which could increase the number of uninsured Americans and place additional administrative burdens on those seeking to maintain coverage. Experts express concern that these changes may reverse some of the ACA’s gains, particularly for vulnerable populations. The projected rise in the uninsured population by 2034 highlights the potential impact of these policy shifts on both patients and healthcare providers.

3. Future of the ACA Hinges on Affordability and Enrollment: While the ACA’s political survival has been a focal point, experts argue that its true legacy will depend on whether people can afford to enroll, stay enrolled, and use their coverage effectively. The sustainability of the ACA is increasingly seen as a matter of enrollment data and economic realities rather than legislative debates. The evolving numbers and trends in coverage will ultimately determine the ACA’s long-term role in the American healthcare system.

A Changing Workforce: Employers Rethink Benefits for a New Era

By James Van Bramer – The American workforce is undergoing a quiet, but profound, transformation. Workers are getting older. Fewer people are participating in the labor force. And across industries, employers are struggling to find workers with the right skills. Artificial intelligence could easily further transform the workforce in time. Together, these forces are reshaping not only hiring practices, but the benefits employers offer. The changes are already reflected in data. Employers worldwide increasingly expect talent shortages to worsen in the coming years, with 42% predicting declining talent availability through 2030, according to a recent global survey by the World Economic Forum. Read Full Article...

HVBA Article Summary

1. Aging Workforce Is Reshaping Retirement Planning: Population aging is accelerating across advanced economies, with projections showing about 52 people age 65 and older for every 100 working-age adults by 2050, up from 33 per 100 today. In the U.S., workforce participation among people 65 and older reached 19.5% in 2024, nearly doubling from 10.8% in 1985, reflecting financial uncertainty and longer careers. These trends are prompting employers to rethink retirement benefits, including phased retirement options, flexible withdrawals, and broader access to retirement plans, especially since 42% of workers currently lack access to employer-sponsored retirement plans.

2. Caregiving Responsibilities Are Increasing Workplace Pressures: As Americans live longer, more employees across age groups—including those in their 20s, 30s, and 40s—are balancing work with caregiving for aging relatives. This responsibility has become a major factor influencing labor force participation, particularly for women, with some workers leaving the workforce to provide care. In response, employers are expanding benefits to include elder care services, referrals, subsidies, flexible work arrangements, and additional paid leave, while proposed federal legislation aims to allow caregivers to contribute to retirement accounts and make catch-up contributions after returning to work.

3. Skill Gaps Are Driving Investment in Training and New Benefits: Skill shortages are now the top barrier to business transformation for 63% of employers, according to the World Economic Forum, and as many as three-quarters of companies report difficulty finding qualified talent in fields such as manufacturing, cybersecurity, and artificial intelligence. To address this gap, employers are increasingly focusing on training and reskilling existing workers, with 85% of employers planning to adopt upskilling strategies, according to the OECD. At the same time, employers are expanding financial wellness benefits—covering retirement planning, emergency savings, and debt management—as companies attempt to support a multigenerational workforce facing both immediate financial stress and long-term retirement challenges.