AI in health care: 26 leaders offer predictions for 2026

By Ron Southwick – More hospitals and healthcare organizations have been incorporating artificial intelligence into their systems, and many healthcare leaders expect that to accelerate in the year ahead. Many healthcare leaders expect to see greater adoption of AI in the coming year, with some saying the tools should move beyond hype and produce real returns. We’ve gathered projections from 26 healthcare executives and thought leaders about the use of AI in 2026. While they offer many different perspectives, some common themes emerge. Read Full Article...

HVBA Article Summary

1. Intentional and Widespread AI Adoption Expected: Healthcare executives anticipate that AI will be integrated more deliberately across hospitals and organizations in 2026. The focus is shifting from simply adopting AI tools to ensuring they are used effectively, safely, and with clear organizational strategies. Leaders emphasize that successful implementation will require careful planning and alignment with clinical and operational goals.

2. Demand for Measurable ROI and Workflow Integration: There is a growing expectation among healthcare leaders for AI investments to deliver tangible returns, particularly in business, administrative, and clinical functions. Organizations are moving beyond pilot programs and seeking enterprise-scale deployments that streamline workflows, reduce administrative burdens, and improve financial performance. The success of AI will increasingly be measured by its ability to provide measurable value and integrate seamlessly into daily healthcare operations.

3. Collaboration, Trust, and Human-Centered Design Remain Crucial: Experts highlight that the next phase of AI in healthcare will depend on building trust, ensuring transparency, and fostering collaboration between stakeholders such as payers, providers, and technology vendors. AI tools are expected to complement human expertise rather than replace it, with an emphasis on supporting clinical decision-making, improving patient engagement, and maintaining empathy in patient interactions. Organizations that prioritize responsible, transparent, and human-centered AI adoption are likely to lead in the evolving healthcare landscape.

Health policy experts skeptical that proposed ACA reforms could address affordability: survey

By Paige Minemyer – As the debate over how to address rising premiums on the Affordable Care Act's exchanges drags on, a recent survey suggests experts are skeptical of plans to lean on health savings accounts (HSAs). Researchers at Cornell University's Health Policy Center polled a panel of 64 healthcare and health policy experts, and 70% said they believe it would worsen affordability to deposit the value of the recently-expired enhanced premium tax credits into an HSA rather than apply it directly to the premium. Read Full Article...

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1. Diverse Opinions on HSAs and Affordability: Expert panelists expressed a range of views regarding the impact of expanding Health Savings Accounts (HSAs) on the affordability of exchange plans. Only 10% believed such a policy would improve affordability, while 13% thought it would have no significant effect, and 8% offered no opinion. Some experts raised concerns that using HSAs to offset costs for high-deductible plans like bronze or catastrophic tiers might pose financial challenges for lower-income individuals. However, others suggested that allowing HSA funds to be applied toward premium payments could make coverage more manageable, especially if the effects vary based on income, health status, and how affordability is measured.

2. Requiring Minimal Premiums Could Affect Enrollment: The idea of requiring enrollees who currently qualify for fully subsidized plans to pay a small monthly premium (around $5–$10) was viewed by 75% of panelists as likely to reduce overall enrollment in exchange plans. At the same time, more than a third (37%) of respondents said such a policy could decrease fraudulent enrollment. This aligns with ongoing administrative efforts—particularly under the Trump administration—to implement integrity measures targeting suspected fraud in ACA enrollment, which some reports estimate affects millions of enrollees.

3. Concerns About Eliminating Automatic Re-enrollment: A large majority of panelists (81%) anticipated that broadly eliminating automatic re-enrollment for subsidy recipients—currently scheduled to take effect in 2028—would have a substantial negative impact on enrollment levels. Several experts cited growing research on how administrative burdens can hinder benefit take-up and retention, emphasizing the risk that added complexity could deter eligible individuals from maintaining coverage. The findings suggest that policymakers should weigh the trade-offs between enforcing administrative controls and preserving affordability and access.

States facing steepest coverage losses after ACA subsidies expire

By Jakob Emerson – Enhanced ACA premium tax credits expired Dec. 31, with congressional efforts to extend them stalled and no resolution in sight. The enhanced subsidies, introduced under the 2021 American Rescue Plan Act, increased subsidy amounts and expanded marketplace eligibility to households earning more than 400% of the federal poverty level, capping out-of-pocket premiums for a benchmark plan at 8.5% of income. Previously, premium tax credits were available only to enrollees earning between 100% and 400% of the federal poverty level. Read Full Article...

HVBA Article Summary

1. ACA Enrollment Trends and Policy Gridlock: While total ACA marketplace enrollment reached a record 24.3 million in 2025, enrollment in federally run exchanges for 2026 is slightly down year-over-year (15.6 million as of Dec. 23 vs. 16 million in 2025). Legislative efforts to extend enhanced subsidies have stalled in Congress, with both Democratic and Republican proposals failing Senate votes. A House vote may occur after lawmakers return in January. This delay adds uncertainty for millions of Americans who depend on these subsidies to afford health coverage.

2. Coverage and Economic Risks of Expired Subsidies: Without renewed subsidies, an estimated 4.8 million people could lose coverage, with Southern states like Mississippi, South Carolina, and Tennessee facing the highest increases in uninsured rates. The economic impact is projected to be substantial, with state GDPs declining by $34.1 billion and overall economic output dropping by $57 billion. These financial losses could strain state budgets and reduce funding for other public services.

3. Job Losses Concentrated in Healthcare Sector and Key States: The expiration of enhanced subsidies is projected to result in 286,000 lost jobs nationwide in 2026, including 130,000 in healthcare settings. States like Texas, Florida, and Georgia are expected to suffer the largest healthcare job losses and reductions in federal funding, exacerbating regional economic strain. The ripple effect would likely impact patient care access, especially in rural and underserved areas.

Is employer health insurance at risk? A veteran benefits lobbyist weighs in

By Bruce Shutan – Critics of the U.S. healthcare system often argue that working Americans receiving health insurance through work was an unintended consequence of World War II price controls. But there are others who counter that the purchasing power of employers is unmatched and invaluable for helping make healthcare more accessible and affordable. One such individual is Jim Klein, who was the nation's top employee benefits lobbyist for three and a half decades and a vigorous defender of employer-provided group health insurance's tax-favored status. He stepped down at the end of 2024 as president of the American Benefits Council, an employee benefits trade association based in Washington, D.C. representing more than 230 of the world's largest corporations for which he has served since 1988. Read Full Article... ^{_{(Subscription required)}}

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1. Bipartisan Expertise and Pragmatism in Benefits Policy: Klein emphasizes the importance of being a trusted, pragmatic voice across both political parties in shaping employee benefits policy. His team avoids ideological extremes, focusing instead on improving systems like the Affordable Care Act rather than opposing them outright. His work reflects a long-standing commitment to educating lawmakers on complex benefits issues, even amidst high turnover among Capitol Hill staff.

2. Challenges and Misconceptions in Employer-Provided Healthcare: Klein highlights persistent misconceptions among policymakers, particularly the belief that employers prioritize cost-cutting over employee well-being. He argues that large employers invest significantly in quality health plans and face challenges when regulations don’t reflect the complexity of implementing benefit changes. He calls for reforms such as greater transparency and site-neutral payment structures to reduce waste and misaligned incentives in healthcare.

3. Policy Threats to Employer-Sponsored Benefits: Major concerns include potential caps on the tax-favored status of employer-sponsored health coverage and erosion of federal preemption under ERISA. Klein defends the current tax treatment as a cost-effective method of providing healthcare and warns against changes that could destabilize the system. He also underscores the growing importance of maintaining federal preemption to protect employers from a patchwork of state regulations, especially as more companies operate across multiple states.

BCBS Texas sues medical billing company, claiming No Surprises Act 'abuse'

By Elizabeth Casolo – Health Care Service Corp.’s Blue Cross and Blue Shield of Texas filed a lawsuit against medical billing company Zotec Partners Dec. 18, alleging “abuse” of the No Surprises Act’s independent dispute resolution process, according to filings from the Eastern District of Texas’ federal court. The No Surprises Act aims to limit surprise billing, forming the resolution process to address payment disputes between insurance companies and out-of-network providers. Read Full Article...

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1. Allegations of Process Abuse: BCBS of Texas claims that Zotec Partners has misused the independent dispute resolution (IDR) process established by the No Surprises Act. The insurer alleges that Zotec submitted numerous disputes that did not meet eligibility requirements, including providing false information and disregarding legal timelines. These actions, according to BCBS, have overwhelmed the insurer and potentially undermined the intent of the law.

2. Concerns Over Claim Bundling: One of the specific issues raised by BCBS of Texas is the practice of “batching,” where Zotec allegedly bundles multiple claims into a single IDR process. The insurer asserts that this practice results in an average of 66 unique items or services per dispute, making it difficult to manage and respond effectively. This approach is presented as a tactic to pressure the insurer and complicate the resolution process.

3. Zotec’s Response and Broader Implications: Zotec Partners has denied the allegations, stating that their practices are compliant and that the lawsuit is based on differing interpretations of eligibility requirements. The company suggests that such lawsuits may be intended to discourage providers from seeking fair reimbursement through the IDR process. This legal conflict highlights ongoing tensions between payers and billing companies over the application and enforcement of the No Surprises Act.

40 million Americans use ChatGPT for healthcare: Report

By Naomi Diaz – More than 40 million Americans use ChatGPT daily to ask questions about healthcare, according to a new report from OpenAI that highlights how patients and clinicians are increasingly turning to AI to navigate a complex and strained U.S. healthcare system. The report, “AI as a Healthcare Ally: How Americans Are Navigating the System With ChatGPT,” was shared with Becker’s by an OpenAI spokesperson. It is based on anonymized ChatGPT message data and OpenAI-led research. Here are eight key findings from the report: Read Full Article...

HVBA Article Summary

1. Widespread Use of ChatGPT for Healthcare: The report reveals that a significant portion of ChatGPT's user base is engaging with the platform for healthcare-related inquiries. This trend reflects both patients' and clinicians' growing reliance on AI tools to address questions and challenges within the U.S. healthcare system. The data suggests that AI is becoming an integral part of how Americans seek information and support for medical and administrative issues.

2. Increased AI Adoption Among Healthcare Professionals: The findings indicate a notable rise in AI usage among healthcare workers, with a majority of U.S. physicians and nearly half of nurses now utilizing AI for various tasks. These tasks include documentation, administrative work, diagnostic support, and managing burnout. The adoption of AI by professionals demonstrates its expanding role not only for patients but also within clinical workflows.

3. AI Bridges Gaps in Access and Timing: The report highlights that ChatGPT is particularly valuable in rural and underserved areas, as well as during times when traditional healthcare providers are unavailable. Many healthcare-related conversations occur outside normal clinic hours, and usage is especially high in regions classified as hospital deserts. This suggests that AI tools like ChatGPT are helping to fill critical gaps in healthcare access and information.

5 notes on employer-sponsored insurance affordability across the country

By Elizabeth Casolo – Affordability is a persistent struggle with employer-sponsored health insurance, according to 2024 data published in December by the University of Minnesota’s State Health Access Data Assistance Center. The data brief relied on the Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey-Insurance Component to better understand changes in 2024. Read Full Article...

HVBA Article Summary

1. Premium Increases and Geographic Variability: Employer-sponsored family health insurance premiums in 2024 rose to an average of $24,540 (a 3% increase), with Delaware, Illinois, and Rhode Island experiencing the highest increases. In contrast, Nevada had the lowest premiums for both single and family coverage. No states saw a decrease in premiums.

2. Employee Costs and Deductibles on the Rise: While employee contributions overall remained stable compared to 2023, there were notable spikes in specific states—California and North Dakota for single coverage, and Alaska and Montana for family coverage. Deductibles increased across the board, with single coverage deductibles averaging $2,085 (up 8%) and family coverage reaching $4,063 (up 9%).

3. High-Deductible Plans Now a Majority Choice: More than half of employees are enrolled in high-deductible health plans in 2024. These plans typically offer lower premiums but require higher out-of-pocket costs, reflecting a growing shift in the structure of employer-sponsored health benefits.