How Expanded Obamacare Made Premiums Spiral, Americans Dependent

By Lawrence Wilson and Sylvia Xu– Congress responded to the COVID-19 pandemic by passing the American Rescue Plan Act in early 2021. This $1.9 trillion spending bill was intended to provide relief and spark an economic recovery. Among other provisions, the law expanded the availability of government-subsidized health care through the Obamacare Marketplace to help low- to middle-income people maintain health coverage until the economy normalized. Read Full Article...

HVBA Article Summary

1. Expanded Enrollment and Dependency through Enhanced Subsidies: The introduction of enhanced subsidies during the COVID-19 pandemic significantly increased enrollment in Obamacare, nearly doubling participation from pre-pandemic levels. These subsidies eliminated income caps and capped monthly premium contributions based on income, making insurance more accessible. However, this also led to increased dependency on government aid by middle-class Americans and created a financial reliance among both insurers and enrollees.

2. Rising Premiums and Affordability Challenges: Although premiums initially decreased during the early period of enhanced subsidies, they rose again as inflation and health care costs surged—due to factors such as increased hospital fees and costly drugs. Many analysts argue the subsidies contributed to price inflation by masking the true cost of care. As real wages stagnated, the gap between health insurance costs and affordability widened, increasing the need for continued subsidies.

3. Rising Premiums and Affordability Challenges: Although premiums initially decreased during the early period of enhanced subsidies, they rose again as inflation and health care costs surged—due to factors such as increased hospital fees and costly drugs. Many analysts argue the subsidies contributed to price inflation by masking the true cost of care. As real wages stagnated, the gap between health insurance costs and affordability widened, increasing the need for continued subsidies.

Why So Many Young Families Are Stuck Renting, Delaying Kids — and Getting a Cat Instead

By Joey Rettino – The youngest of Millennials will hit 30 years old this year. For them and their older Millennial-counterparts, this is supposed to be the stage of life where people buy homes, have kids and settle into the textbook version of stability. But the reality for far too many Americans is something entirely different. It means delaying marriage, delaying children, delaying homeownership — and adopting pets to save them from college tuitions and pediatric specialists. Read Full Article...

HVBA Article Summary

1. Rising Health Care Costs Are Consuming a Growing Share of Working Families’ Incomes: In 2024, the median working family spent $3,960 on health care, including premiums and out-of-pocket costs. Families with children spent even more—a median of $5,150 per year. Notably, 1 in 10 working families faced annual health care expenses exceeding $14,800. For context, the average Millennial earns about $47,034 a year, making even average health care costs a substantial burden before factoring in rent, student loans, or basic living expenses. For many low-income and rural households, health care now consumes over 10% of their income, leading to tough financial choices like daycare vs. prescriptions or rent vs. deductibles.

2. Medical Debt Is a Key Barrier to Housing Stability and Homeownership: A study published in JAMA Network Open shows that adults with medical debt are significantly more likely to experience housing instability, including evictions, foreclosures, and difficulty paying rent or mortgages. Over 100 million Americans carry medical debt, most of whom actually have health insurance—but still face high out-of-pocket costs due to increasing cost-sharing requirements. This debt negatively impacts credit scores and wipes out savings needed for down payments, making it especially difficult for young people and families to enter or remain in the housing market.

3. Financial Pressures, Not Cultural Shifts, Are Driving Delayed Life Decisions: Rising health care costs are reshaping how people approach major life milestones such as parenthood, homeownership, and even retirement. These costs are increasing faster than inflation and more rapidly than they did for previous generations. As a result, more insured families are skipping prescriptions or delaying care simply due to cost. This trend affects not only Millennials but also Gen Xers and Baby Boomers, some of whom have yet to reach Medicare eligibility. With nearly half of adults unable to afford a $500 unexpected medical bill, financial insecurity—not a fear of commitment—is influencing decisions about starting families or signing 30-year mortgages.

States ranked by ACA enrollment change since 2025

By Jakob Emerson – New Mexico has seen the biggest increase in ACA enrollment from 2025 to 2026, while North Carolina has seen the largest decrease, according to KFF. The ranking below uses preliminary CMS data comparing similar periods during the 2025 and 2026 open enrollment periods. The figures do not include final enrollment totals for either year. Read Full Article...

HVBA Article Summary

1. Slight Decline in Total Enrollment: As of January 3, 2026, enrollment in Affordable Care Act (ACA) marketplace plans totaled nearly 22.8 million individuals. This represents a 3.5% decrease compared to the same period in the 2025 enrollment cycle. While still historically high, this dip suggests a modest reversal of recent growth trends in marketplace participation.

2. Varied State-Level Enrollment Trends: Enrollment changes from 2025 to 2026 varied widely across states, reflecting diverse regional dynamics. Some states saw significant increases, such as New Mexico (+19.5%) and the District of Columbia (+9.7%), indicating strong local uptake. In contrast, several states, including North Carolina (-21.1%) and Ohio (-18.6%), experienced notable declines, pointing to potential shifts in consumer behavior, policy impact, or marketplace conditions.

3. Enrollment Data Cutoffs Differ by State and Marketplace Type: The enrollment totals are based on different reporting deadlines depending on the marketplace structure. Federally-facilitated marketplaces and state-based marketplaces using HealthCare.gov submitted data through January 3, 2026. Meanwhile, fully state-run marketplaces reported data through December 27, 2025. Idaho followed a unique schedule, closing its enrollment period earlier, on December 15, 2025, which may influence comparative analysis.

'Food as medicine': Meal delivery is covered under HSA and FSA plans

By Lee Hafner – Diet makes a huge difference for employees managing chronic conditions like weight and heart health, but they don't always have time, money or easy access to the right foods. According to the CDC, 90% of overall healthcare spend goes toward the treatment of chronic conditions, many of which are caused or exacerbated by poor eating habits. As healthcare and grocery costs rise, the challenges will only get worse. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Partnership Enables HSA/FSA-Eligible Medically-Tailored Meals: Trifecta, a meal delivery service, has partnered with food-tech platform Prado to offer physician-prescribed, medically-approved meals that can be paid for using Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA). Employees with chronic conditions such as cardiovascular disease, obesity, or diabetes can choose from about 120 physician-certified meals. Prado facilitates the administrative process, making it easier for users to apply their tax-free health benefits toward these nutrition-based treatment plans.

2. Potential Health and Cost Benefits: A Tufts University study highlighted in the article projects that integrating medically-prepared meals into chronic care could save approximately $23 billion in healthcare costs in the first year alone. It could also prevent more than 2.6 million hospitalizations annually due to complications from diseases like diabetes, heart disease, and cancer. State-level analysis suggests individual savings of up to $6,299 per patient, underscoring the potential impact of food-based interventions on both health outcomes and financial burdens.

3. Advocacy for “Food as Medicine” in Benefits Strategy: The initiative supports the growing movement of “food as medicine,” encouraging benefits leaders to inform employees that they can use part of the $170 billion in HSA and FSA funds to invest in healthier eating. By removing payment-related friction, this approach makes it more accessible for people to manage chronic conditions through diet. The article positions this as a low-cost way for employers to promote long-term wellness and reduce future healthcare expenses across their workforce.

US healthcare spending soars to over $5 trillion in 2024

By Amina Niasse – U.S. healthcare spending rose by 7.2% to $5.3 trillion in 2024 from $4.9 trillion in 2023, driven by increased health insurance enrollment and a jump in use of medical services, particularly in private health insurance plans, the U.S. Centers for Medicare & Medicaid Services said on Wednesday. Read Full Article...

HVBA Article Summary

1. Healthcare Spending Rose to 18% of GDP in 2024: In 2024, U.S. healthcare spending climbed to 18% of the nation’s gross domestic product, up from 17.7% in 2023. This increase reflects a persistent trend of healthcare costs rising faster than the overall economy, indicating growing financial pressure on both public and private sectors to manage rising healthcare demands and expenses.

2. Government Administration Costs Surged, Driven by Medicaid Policy Changes: Government administrative costs for healthcare programs like Medicaid and Medicare saw the most substantial growth, rising by 14.7% in 2024 compared to a 7.8% increase the previous year. The sharp rise was primarily due to a nearly 20% increase in Medicaid administrative expenses, triggered by the end of COVID-era continuous coverage policies, which led to a wave of redeterminations and added administrative burden.

3. Private Insurance and ACA Enrollment Expanded Significantly: Enrollment in Affordable Care Act (ACA) plans jumped by more than 30% in 2024, increasing from 16.2 million to 21.1 million people. This growth was partly driven by a special enrollment window for individuals who lost Medicaid coverage. Overall, private health insurance enrollment—including ACA and other private plans—grew by 3.5%, covering a total of 214.3 million people, showing increased dependence on the ACA marketplace for coverage access.

Trump admin reinstates cuts to mental health grants after outcry

By Peter Sullivan – The Trump administration late Wednesday reversed course and reinstated as much as $2 billion of mental health and addiction grants that it had cut about 24 hours earlier, prompting an outcry from patient advocates. The big picture: The cancellations had drawn fierce pushback from Congress and advocacy groups, who said the terminations would put vulnerable people's lives at risk and undercut behavioral health efforts. Read Full Article...

HVBA Article Summary

1. Rescinded Mental Health Funding Cuts Following Public Pressure: Health Secretary Robert F. Kennedy Jr. reversed previously announced funding cuts after facing strong public and political criticism. Rep. Rosa DeLauro (D-Conn.), the top Democrat on the House Appropriations Committee, stated that Kennedy had "bowed to public pressure" and emphasized the cuts should never have been issued. The reversal was confirmed by an administration official on Wednesday night.

2. Estimated $2 Billion in Cuts Could Have Affected Hundreds of Programs: The National Alliance on Mental Illness (NAMI) estimated that the now-rescinded cancellations would have impacted hundreds of nonprofits and grantees nationwide, with the total funding losses potentially reaching approximately $2 billion. These cuts threatened a wide range of mental health services, including suicide and overdose prevention programs, treatment initiatives, and public mental health awareness campaigns.

3. Criticism Over Timing Amid Ongoing Public Health Crises: Critics warned the cuts were especially dangerous given current national challenges. Hannah Wesolowski, NAMI’s chief advocacy officer, pointed out that the U.S. is still grappling with the opioid and overdose crisis, lingering mental health effects from the COVID-19 pandemic, and record-high suicide deaths. Despite the administration citing a need to "adjust its discretionary award portfolio" and align funding with evolving priorities, the move was widely viewed as poorly timed and potentially harmful.

GLP-1 Drugs Tied to Lower CRC Risk and Better Outcomes

By Megan Brooks – The GLP-1 drugs widely prescribed for diabetes and weight loss might also help reduce the risk for colorectal cancer and possibly improve outcomes in people who have the disease, according to a series of studies presented at ASCO Gastrointestinal Cancers Symposium 2026. Read Full Article...

HVBA Article Summary

1. GLP-1 Use Linked to Lower Colorectal Cancer Risk: In a large, real-world analysis involving over 280,000 patients from the TriNetX database, individuals using GLP-1 receptor agonists (such as semaglutide, liraglutide, and dulaglutide) had a 36% lower risk of developing colorectal cancer compared to those using aspirin. The risk reduction was even more pronounced—about 42% lower—among people considered at higher risk due to personal or family health history. These findings were consistent across different groups, including those without obesity or diabetes, and were most significant in patients who began GLP-1 treatment before age 45.

2. Potential Safety and Mortality Benefits of GLP-1s: GLP-1 users experienced fewer serious adverse effects, including lower rates of gastrointestinal bleeding, gastric ulcers, and acute kidney injury, compared to aspirin users. However, they did report higher incidences of diarrhea and abdominal pain. In patients already diagnosed with colorectal cancer, GLP-1 use was linked to a 53% reduction in all-cause mortality over 10 years, regardless of age, BMI, cancer stage, or diabetes status. A separate Mayo Clinic study supported these findings, also showing reduced risks of death, heart attack, sepsis, and mechanical ventilation among obese colon cancer patients using GLP-1 medications.

3. Need for Further Research Despite Promising Signals: While the data suggests a potential protective and therapeutic role for GLP-1 receptor agonists in colorectal cancer, both studies' authors and external experts emphasized caution. The observed benefits may indicate effects beyond blood sugar and weight control, possibly related to anti-inflammatory or anti-cancer mechanisms. However, since this research is observational and still in early stages, prospective clinical trials are essential to establish causality, confirm safety, and determine how GLP-1s might be integrated into future cancer prevention or treatment strategies.