AHIP 2025: Insurer coalition vows to fight Trump budget bill to final hour

By Noah Tong - At AHIP's annual conference, the trade group told reporters they oppose the reconciliation bill moving through Congress because of the impacts it would have on Medicaid and the individual market. AHIP executives said they will continue to work with other prominent healthcare organizations to convince lawmakers to protect federal health programs and help Americans remain insured—both by avoiding the harshest cuts and changes to Medicaid and the Affordable Care Act and extending the ACA enhanced premium tax credits. Read Full Article…

HVBA Article Summary

1. Active Advocacy Against the Bill: AHIP, led by CEO Mike Tuffin, is actively working with hospitals, physicians, nurses, and patient advocates to oppose key provisions in the proposed legislation. The organization is engaging directly with lawmakers and Congressional staff to communicate potential negative consequences of the bill, including increased premiums and reduced coverage.

2. Warnings on Market Disruption and Pricing Uncertainty: AHIP leaders, including Executive VP Jeanette Thornton, have raised alarms about how changes to cost-sharing reductions and the lack of clarity around ACA tax credits will destabilize health plan pricing. They caution that these disruptions may result in “sticker shock” for consumers and complicate 2026 premium filings already in motion.

3. Concerns Over Medicaid Changes and Administrative Burden: AHIP argues that the proposed Medicaid provisions go well beyond targeting waste, fraud, and abuse. The organization highlights the significant administrative complexity involved in implementing work requirements and verifying exemptions, warning that these changes could lead to coverage losses and strain both state systems and health plans.

Employer health plans should upgrade life-saving cancer cell testing benefits, a pharmacist argues

By Allison Bell - Employers should make sure their plans cover enough gene sequencing services to ensure that people with cancer get the right treatment. Mike Dovidio, a pharmacist and product manager at Avalon Healthcare Solutions, made that plea in a recent email interview. Human cells use the "nucleotides," or genetic letters, in a special biological thread called "DNA" to build new cells, and they use a similar kind of thread, RNA, to send messages to each other. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Genomics Testing is Underused in Cancer Care: Although DNA and RNA sequencing can greatly improve cancer treatment decisions, it is still underutilized and inconsistently applied. As a result, many cancer patients either do not receive potentially life-saving drugs that match their genetic profile or are given expensive and potentially harmful treatments that are unlikely to help.

2. High Value, But Limited Adoption: Precision medicine powered by genomics testing has demonstrated strong cost-effectiveness and the potential to improve patient outcomes. However, adoption remains limited due to factors like test costs, skepticism from insurers, and concerns that testing might drive demand for expensive drugs that benefit only a small percentage of patients.

3. Significant Cost and Health Benefits When Used Correctly: Research shows that when patients receive genomics-guided treatments, survival improves and healthcare spending drops. In some cases, testing can reduce costs for insurers by over $100,000 per patient, while also ensuring that patients get the most appropriate and effective care based on their unique genetic makeup.

Agent groups condemn United Healthcare eliminating commissions

By Susan Rupe - Professional associations representing the agent community have come out against United Healthcare's recent decision to eliminate agent commissions across more than 100 Medicare Advantage plans in more 20 states. The National Association of Benefits and Insurance Professionals said this move limits access to trusted, licensed guidance for Medicare beneficiaries and threatens the role of independent agents who serve as vital advocates for older Americans. Read Full Article…

HVBA Article Summary

1. Concerns Over Commission Cuts: UnitedHealthcare’s decision to reduce renewal commissions for licensed Medicare agents has sparked strong reactions from several industry associations. These organizations argue that the move may deprioritize long-term client support and could signal a shift in focus from service quality to cost-cutting, raising alarms about potential negative consequences for Medicare beneficiaries.

2. Impact on Seniors and Advisors: Critics emphasize that licensed agents provide essential, year-round assistance to Medicare beneficiaries—helping them enroll in appropriate plans, manage claims, and adjust coverage as their healthcare needs change. By reducing agent compensation, the decision may discourage ongoing advisory support, leaving seniors more vulnerable to confusion, misinformation, and poor plan choices in an already complex system.

3. Calls for Regulatory Action: In response to the changes, advocacy groups such as NABIP, NAIFA, and HAFA are urging lawmakers and federal regulators to take immediate action. Their requests include setting stricter guidelines to prevent abrupt commission changes during the Medicare Annual Enrollment Period and ensuring policy stability. They argue this is critical for preserving consumer access to knowledgeable advisors and maintaining the overall integrity of the Medicare Advantage program.

More employers adopting ICHRAs, giving workers money to buy their own health insurance

By Tom Murphy - A small, growing number of employers are putting health insurance decisions entirely in the hands of their workers. Instead of offering traditional insurance, they’re giving workers money to buy their own coverage in what’s known as Individual Coverage Health Reimbursement Arrangements, or ICHRAs. Read Full Article…

HVBA Article Summary

1. ICHRAs Offer Flexibility and Cost Control for Employers: Individual Coverage Health Reimbursement Arrangements (ICHRAs) let employers—particularly small businesses—contribute a fixed amount toward employees’ health insurance without having to manage a traditional group plan. This approach caps unpredictable insurance costs, reduces administrative burden, and aligns with conservative goals of giving individuals more control over their health care choices.

2. Employees Gain More Choice but Face Complexity: While ICHRAs empower employees to choose from a wide range of insurance options that may better fit their personal or medical needs, they also shift the responsibility of navigating complex coverage decisions to the individual. This can be daunting, especially due to narrower provider networks and unfamiliar terms like deductibles and coinsurance, requiring employers to provide adequate support tools.

3. ICHRAs Are Growing Rapidly but Still Niche: The number of people offered ICHRA-based coverage has grown significantly—up 50% from 2024 to 2025—indicating increasing interest among employers. However, they still represent only a small share of the U.S. employer-sponsored insurance market. Future growth may depend on rising health care costs, potential tax incentives, and the status of government subsidies for individual market plans.

How employers can help employees navigate benefits during life's crises

By Erin Wilson - When employees face a major life event—such as a cancer diagnosis, the sudden onset of a chronic condition or a significant accident—their ability to navigate benefits can directly impact their wellbeing and financial security. Too often, they are left to untangle complex policies during the most stressful moments of their lives. Having navigated a cancer diagnosis myself while starting a new position, I understand firsthand how overwhelming it can be to make sense of benefits during a health crisis. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Make Benefits Support Continuous and Accessible: Employers should treat benefits education as an ongoing initiative rather than a once-a-year event. By offering year-round support—such as webinars, Q&A sessions, one-on-one consultations, and a dedicated benefits team—organizations can help employees better understand their options and feel more confident in using their benefits when needed.

2. Promote Awareness of Underused and Voluntary Benefits: Many valuable benefits, like critical illness insurance, accident coverage, and employee assistance programs (EAPs), are often overlooked. Regular communication—such as quarterly check-ins or targeted messaging—can boost visibility and encourage employees to take advantage of these resources before they find themselves in a difficult situation.

3. Support Employees During Transitions and Crises: Major life changes can cause confusion and anxiety around benefits. Employers should proactively address job security concerns, clarify the limitations and eligibility of voluntary benefits, and provide clear guidance during transitions like job changes or medical leave. Training managers to recognize employee needs and fostering a culture of open communication can greatly reduce stress and prevent coverage gaps.

Is The One Big Beautiful Bill Act An Employee Benefits Crystal Ball?

By Suzanne G. Odom - The goal of the U.S. Senate is to pass One Big Beautiful Bill in a form on which Senators can agree, send it back to the U.S. House of Representatives, who then would have it on President Trump's desk for signature by July 4, 2025. Time will tell whether this accelerated schedule is practical and what ultimately makes its way into federal law. Read Full Article…

HVBA Article Summary

1. Expansion of Employee Health and Fringe Benefits: The BBB legislation proposes significant enhancements to Health Savings Accounts (HSAs) and Health Reimbursement Accounts (HRAs), including broader eligibility and increased flexibility. It also aims to make educational and childcare-related fringe benefits more accessible and tax-favored, potentially easing financial burdens for employees.

2. Changes to Executive Compensation and Tax Policy: The bill introduces modifications to executive compensation rules, particularly expanding excise tax applicability for high earners in tax-exempt organizations and adjusting deduction limits among related public companies. It also seeks to make certain provisions of the Trump-era Tax Cuts and Jobs Act permanent, such as the taxation of moving expense reimbursements.

3. Increased Regulation and Transparency for Pharmacy Benefit Managers (PBMs): BBB outlines stricter regulatory standards for PBMs in federally subsidized drug programs, mandating transparent pricing models, limits on compensation structures, and detailed disclosure requirements. These reforms reflect a broader push for accountability and may extend to employer-sponsored (ERISA) plans.

Senate Finance tax bill section draft leaves out House HSA and HRA provisions

By Allison Bell - Members of the Senate Finance Committee have left health savings account and health reimbursement arrangement provisions out of their proposals for the big federal tax and budget bill. The 549-page PDF file the committee posted Monday does include many provisions from the House One Big Beautiful Act package, such as provisions that would keep the estate tax exemption at the current level and keep it from falling about 50% next year. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Senate Finance Draft Focuses on Tax Rule Extensions, Omits Health Account Reforms: The Senate Finance Committee’s draft legislation primarily aims to extend the 2017 Trump-era tax cuts, positioning this as a way to prevent what Republicans call a historic tax hike. However, it excludes any provisions related to Health Savings Accounts (HSAs), Health Reimbursement Arrangements (HRAs), or the proposed CHOICE arrangements from the House version—potentially making it more difficult for those health-related reforms to be included in the final package.

2. Divergence Between House and Senate on Health Policy: The House version of the tax bill includes several provisions to expand access to and flexibility of health-related savings accounts, such as raising HSA contribution limits and creating CHOICE arrangements to offer workers more options. The Senate Finance draft’s complete omission of these measures highlights a growing policy divide between the two chambers that will need to be addressed during reconciliation.

3. Legislative Uncertainty Remains as Negotiations Continue: Although the current Senate draft omits many health account reforms, the legislative process is still unfolding. Lawmakers, lobbyists, and stakeholders acknowledge that health account provisions could be added during Senate committee markup, floor debates, or in House-Senate negotiations later on. Even if excluded from this package, these proposals could be revived in future standalone legislation or through other legislative vehicles.