Senate Republicans have unveiled their version of the 'big, beautiful bill.' Here are 3 things to know

By Paige Minemyer - Republicans on the Senate Finance Committee have unveiled that chamber's version of the "big, beautiful" reconciliation package, which includes notable changes from the House's proposal. The bill will be the subject of intense scrutiny in the Senate, where more moderate Republicans have balked at significant cuts to Medicaid while the party's more conservative wing has pushed for spending reductions to go further. GOP leaders want to push the bill through to the president's desk by July 4, according to The Wall Street Journal. Read Full Article…

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1. Medicaid Faces Major Overhaul with Work Requirements and Funding Reductions: The Senate reconciliation bill introduces work requirements for able-bodied, childless adults on Medicaid and lowers caps on provider taxes for expansion states. It also reduces certain state-directed payments and restricts Medicaid coverage for gender transition services. These changes aim to promote "personal accountability" and curb spending but have raised concerns from healthcare providers about reduced access and hospital strain.

2. Medicare Avoids Deep Cuts but Introduces Eligibility Verification and Regulatory Limits: While significant Medicare cuts were anticipated, the bill largely spares the program from major changes. However, it adds a citizenship or legal residency verification requirement for beneficiaries and blocks federal staffing regulations in long-term care facilities, signaling a shift toward tightening oversight without reducing benefits.

3. Affordable Care Act Subsidies Set to Expire Without Renewal: The Senate bill excludes provisions to extend enhanced ACA premium tax credits that are expiring this year, potentially affecting coverage for millions. It also introduces stricter eligibility checks for subsidies and restricts access for some immigrant groups. Health savings account expansions from the House version were dropped, and reforms to pharmacy benefit managers were limited.

Looking back, forward on the ACA at 15

By Doug Harris - The Affordable Care Act boasts a long list of accomplishments since it was signed into law by President Barack Obama in March 2010. It has driven down uninsured rates and health care costs and expanded coverage – 44 million people enrolled in health coverage last year through the ACA and Medicaid expansion. Read Full Article…

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1. Uncertainty Around ACA's Future: While the Affordable Care Act (ACA) has contributed significantly to healthcare innovation and expanded coverage, its future remains uncertain. A pending federal budget bill in Congress could disrupt ACA enrollment procedures and reduce Medicaid funding by hundreds of billions of dollars, raising concerns among experts that it could function as a “backdoor repeal” of key ACA provisions.

2. Continued Shift Toward Value and Prevention: The ACA has helped lay the groundwork for more innovative, value-based care models and Medicaid expansion programs, such as North Carolina’s Healthy Opportunities Pilots. Panelists at AHIP 2025 emphasized that future efforts in healthcare should increasingly prioritize prevention, evidence-based practices, and holistic approaches that integrate medical and social determinants of health.

3. Policy Leaders Stress Balanced Reform: Healthcare leaders, including AHIP President Mike Tuffin, warned that elements of the proposed budget could erode coverage unless carefully revised. They stressed the need for reforms that focus on affordability and sustainability, and called for maintaining Medicare protections while placing patients and beneficiaries at the center of future policy decisions.

LTC market will face ‘greater strain.’ Are solutions already at hand?

By John Hilton - The long-term care issue is receiving plenty of attention – both from the explosive growth of LTC riders attached to life insurance, as well as several state and federal proposals. Recently, the Senior Issues Task Force met to discuss long-term care trends, issues and long-term prognosis. The task force – a National Association of Insurance Commissioners’ group – is in information-gathering mode, members said. Read Full Article…

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1. Hybrid LTC-Life Insurance Products Are Gaining Popularity, but Clarity Lacks: Sales of life insurance with long-term care (LTC) riders now represent about 25% of all life insurance sales. These hybrid products are increasingly favored over standalone LTC policies due to cost and appeal, especially among younger generations. However, experts like Bonnie Burns warn that these products often lack transparency, leaving consumers unclear about how benefits are triggered and interact.

2. Looming Long-Term Care Crisis Driven by Aging Population: The aging baby boomer generation—soon to be followed by Gen X and millennials—will sharply increase demand for LTC services. Current systems are fragmented and underfunded, with Medicaid programs already strained. Without adequate planning, middle-income retirees risk significant financial burdens when facing LTC needs.

3. Public-Private Partnerships and Legislative Action Offer Hope: States and federal policymakers are exploring solutions, including the WA Cares program and the bipartisan WISH Act. These efforts aim to create more sustainable, inclusive LTC financing through payroll taxes, trust funds, and public-private insurance partnerships, with growing recognition that a coordinated national strategy is urgently needed.

AMA resolution calls for broader access to GLP-1 medications

By Emma Bascom - The AMA passed a resolution to increase access to anti-obesity medications at its annual House of Delegates meeting. The resolution was championed by the Endocrine Society, according to a press release, and builds upon existing AMA policy that advocates for improved access to other obesity treatments, like bariatric surgery. Read Full Article…

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1. GLP-1 receptor agonists are effective for weight loss: Research shows these medications can help adults lose an average of 15–20% of their body weight, offering a powerful tool in the treatment of obesity. However, access remains limited, as Medicare is legally prohibited from covering them, and fewer than 20% of large employers offer insurance plans that include them.

2. AMA resolution advocates for better access: The American Medical Association is working to reduce the administrative burden of prior authorizations and eliminate restrictive insurance requirements. Their resolution aims to allow health care providers to prescribe anti-obesity medications more freely, helping patients avoid unnecessary delays and high out-of-pocket costs.

3. Broader access could improve public health and cut costs: Improving access to GLP-1 medications could benefit the more than 40% of U.S. adults living with obesity and reduce associated conditions like heart disease and diabetes. It also has the potential to lower the country’s $173 billion annual obesity-related medical expenses, though implementation challenges and insurer resistance remain concerns.

Feds schedule 'listening sessions' to combat high drug prices and boost competition

By Allison Bell - Federal agencies have scheduled a series of three web-based "listening sessions" to hear from commenters about issues that might be limiting competition in the U.S. prescription drug market and driving up prices. Regulators scheduled the listening sessions in response to a recent executive order calling for federal agencies to improve competition in the U.S. drug supply chain and hold down prices. Read Full Article… ^{_{(Subscription required)}}

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1. Focus on Drug Competition and Pricing: The upcoming listening sessions, scheduled for June 30, July 24, and August 4, will delve into critical issues surrounding drug pricing. Topics will include how pharmaceutical companies restrict competition from generics and biosimilars, abusive formulary and benefit practices, and actionable regulatory strategies to lower drug costs in the U.S. market.

2. Organized by Key Federal Agencies: These sessions are being coordinated by the U.S. Justice Department’s Antitrust Division in partnership with the Federal Trade Commission, the Department of Commerce, and the Department of Health and Human Services. This collaboration highlights a unified federal effort to address antitrust issues and enhance competition in the healthcare and pharmaceutical industries.

3. Unclear Public Participation: Although the sessions will feature live-streamed remarks from selected practitioners and scholars, the process for public involvement remains vague. Organizers have not specified how individuals can apply to speak or whether the general public will have opportunities to participate, raising concerns about transparency and accessibility in the discussion process.

If We Treated Tooth Decay Like We Treat Heart Disease, We’d Save Billions

By Teresa Dolan - Oral health has an image problem. It’s often dismissed as an afterthought, inconvenience, or cosmetic procedure, a noticeable difference to how we prevent heart disease with wide-scale public awareness campaigns and robust early detection programs. Read Full Article… ^{_{(Subscription required)}}

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1. Dental health is undervalued despite its serious consequences:
   While heart disease garners more urgency due to its immediate risks, dental diseases are mistakenly viewed as non-serious because they develop gradually. However, poor oral health is linked to systemic issues like heart disease and diabetes. The economic toll is significant — dental diseases cost the U.S. over $45 billion annually in ER visits, missed work, and lost school hours, with children losing 34 million school hours each year due to dental issues.

2. Lack of coverage and affordability create major access barriers: Only 73% of U.S. adults have dental coverage, compared to much higher rates for general health insurance. Out-of-pocket costs are disproportionately high: in 2024, they made up 40.3% of dental spending, versus just 10.6% in general health spending. Nearly 24 million Medicare beneficiaries had no dental coverage as of 2019, and adults without insurance are more than twice as likely to forgo dental care, leading to higher rates of severe dental conditions like untreated caries (37.9%) and severe periodontitis (14.3%).

3. Preventive care and public education are critical solutions: Misunderstandings about dental care — such as seeing it as “just a cleaning” — undermine its value as a preventive tool. Improved health literacy has been shown to correlate with better self-reported oral health and communication with providers. Additionally, 11% of avoidable ER visits from 2005–2016 were for dental problems that could have been prevented through routine care. Policies like expanding coverage, public education campaigns, and legislation such as H.R.8599 (which would make toothpaste and floss FSA/HSA eligible) are vital to making preventive dental care more accessible and effective.

Most US employers plan to shift their benefit strategy in coming years, survey shows

By Carolyn Crist - In response to increasing cost pressures, the majority of U.S. employers intend to shift their benefit strategy in the next three years, according to a June 10 report from WTW. Employers said rising medical care costs, in particular, have created greater challenges for delivering their health benefits (44%), well-being programs (44%) and leave benefits (36%). Read Full Article…

HVBA Article Summary

1. Cost Pressures Are Shaping Benefits Strategies: With 90% of U.S. employers citing rising benefit costs as their top concern for 2025—up sharply from 67% in 2023—organizations are rethinking their benefits strategies. Many are shifting focus to cost-effective options that still deliver meaningful value to employees and align with broader business objectives.

2. Shift Toward Personalized, Value-Driven Benefits: Employers are moving away from a one-size-fits-all approach, opting instead to reallocate benefits spending over the next three years toward options that support personalization and value. Key strategies include enhancing mental health services, financial wellness programs, and family support, while also leveraging preferred provider networks and more efficient vendors.

3. Well-Being Remains a Core Focus Despite Rising Costs: Even amid significant healthcare cost increases—partly driven by chronic and autoimmune conditions—93% of employers plan to maintain or grow their well-being offerings in 2025. These initiatives increasingly focus on comprehensive support, including flexible work arrangements, mental and physical health programs, and tools to help employees navigate and utilize benefits more effectively.