GOP hopes to make an employer health package part of Reconciliation 3.0 deal

By Allison Bell – Conservative Republicans in the U.S. House are trying to get health savings account changes and an employer health coverage purchasing coalition provision into any big "Reconciliation 3.0" package that Congress considers. Rep. Eric Burlison, R-Mo., held a press conference today in Washington to propose using his Great American Healthcare Plan bill as the vehicle for ferrying health benefits provisions into Reconciliation 3.0. The plan "gets bureaucrats and middlemen out of the way," Burlison said during the press conference. "It puts Americans in control of their health care dollars." Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Great American Healthcare Plan as Reconciliation Vehicle: Rep. Eric Burlison is positioning his Great American Healthcare Plan as a legislative vehicle for inserting employer-focused health provisions into a potential Reconciliation 3.0 package. The bill has seven Republican cosponsors and no Democratic support, signaling it is currently a partisan effort. Supporters include conservative advocacy organizations as well as employer and HSA-focused industry groups. Backers argue the proposal would shift more control over health spending decisions to individuals and employers.

2. Proposed Expansion of HSA and Employer Flexibility: The bill would allow employers to meet Affordable Care Act shared responsibility requirements through contributions to employees’ HSAs and would ease rules for employer purchasing coalitions by redefining certain marketplace pools as employers. It would also remove caps on direct primary care dues treated as qualified HSA expenses and extend bankruptcy protections to HSA assets similar to retirement accounts. Additional provisions would permit charitable HSA contributions and allow HSA funds to pay for health care sharing ministry memberships. Collectively, these changes aim to broaden how HSAs can be funded and used.

3. Reconciliation Strategy and Broader Health Policy Context: Lawmakers are considering whether to use the Senate’s reconciliation process, which allows passage with a simple majority, to move health care provisions tied to federal spending. Earlier reconciliation efforts included the One Big Beautiful Bill Act and the Secure America Act, and some health account provisions were stripped from prior packages. Recent hearings on health care costs and insurance suggest committees are laying groundwork for further action. Other proposals circulating for Reconciliation 3.0 include high-deductible plan adjustments and new pharmacy benefit manager restrictions.

Florida AG to probe CVS for anticompetitive pharmacy practices

By Paige Minemyer – Florida Attorney General James Uthmeier has issued a subpoena to CVS Health, citing concern about potential anticompetitive practices from the vertically integrated healthcare giant. Read Full Article...

HVBA Article Summary

1. State Investigation Targets Vertical Integration Concerns: Florida’s attorney general has subpoenaed CVS Health to examine whether its integrated structure gives it an unfair advantage in the pharmacy market. The inquiry focuses on whether CVS steers patients to its own retail pharmacies or reimburses them at higher rates than independent competitors. Investigators are also reviewing whether audits and contractual practices disadvantage smaller pharmacies. The probe reflects broader scrutiny of how pharmacy benefit managers operate within vertically integrated healthcare companies.

2. Extensive Document and Testimony Requests: The attorney general’s office is seeking thousands of documents and sworn testimony by July 28 related to reimbursement rates, contracts, rebates and expansion plans. Officials are specifically examining potential differential treatment between CVS-owned stores and independent pharmacies. The breadth of the request signals a comprehensive review of the company’s pharmacy benefit management practices. State leaders have framed the investigation as a step toward ensuring fair competition and consumer access to affordable medications.

3. Part of a Broader National Regulatory Trend: Florida’s action aligns with efforts in states such as Arkansas and Tennessee to limit or regulate PBM ownership of pharmacies. Those laws have faced legal challenges, including federal court intervention and lawsuits from major PBMs and their trade association. Independent pharmacies have long argued that PBM practices threaten their financial viability. CVS, for its part, says it will cooperate with regulators and maintains that drug manufacturers—not PBMs—set prescription drug prices.

UnitedHealth bets $3B on AI to automate American health care

By John Tozzi – At UnitedHealth Group Inc., artificial intelligence reads aloud summaries of medical charts as nurses drive to patients' homes. It listens to millions of customer calls to find the causes of complaints. One trial even has AI agents calling doctors' offices to schedule appointments for patients. The largest US health insurer plans to invest $3 billion in AI over 2026 and 2027. UnitedHealth executives say they're seeing a 2-to-1 return, as AI automates cumbersome manual processes and makes workers more efficient. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. AI as a Cost-Cutting and Growth Strategy: UnitedHealth has positioned artificial intelligence at the center of its turnaround after a profit slump last year, with Wall Street expecting efficiency gains to lift earnings. Analysts estimate insurers and providers spend about $80 billion annually on administrative transactions, highlighting the scale of potential savings. The company also sees revenue opportunities from selling AI-powered products and services to other healthcare organizations. Early tools such as Optum Real have already processed roughly a billion transactions, demonstrating significant operational adoption.

2. Public Skepticism and Regulatory Scrutiny: Despite investor enthusiasm, surveys show 69% of respondents have little or no trust in businesses to use AI responsibly. Health insurers face added sensitivity because many Americans report delays or denials tied to prior authorization requirements. UnitedHealth is defending itself against litigation alleging improper reliance on algorithms to limit care, even as federal oversight reports have found high denial rates later overturned on appeal. These factors create reputational and compliance risks as AI expands in healthcare decision-making.

3. Governance and Internal Oversight of AI Deployment: The company says nearly 99% of its AI applications are administrative rather than clinical and that it avoids deploying diagnostic AI tools. An internal review board that includes ethicists, clinicians, technologists, and legal experts evaluates new AI proposals. UnitedHealth reports having more than 1,000 AI use cases, 20,000 AI engineers, and 117 large language models available to staff. Executives say they monitor systems for unintended behavior and track employee AI usage as part of a broader push to embed the technology across operations.

Some life insurers compete with health insurers on benefits. Here's why

By Anastassia Gliadkovskaya – The past several years have seen strong growth in life insurance, in part thanks to the COVID-19 pandemic, with half of Americans owning a policy today. While life insurance has traditionally been seen as a death benefit—something that offers families financial assurance after a loved one has passed—part of the industry is expanding into wellness benefits for the living. This reflects burgeoning demand: a third of consumers are interested in free mental health and wellness services to go along with their life insurance, trade group LIMRA finds. Nearly a quarter are also interested in gym memberships, health coaching and diet planning. Read Full Article...

HVBA Article Summary

1. Life insurers are aligning financial incentives with longevity: Executives argue that helping policyholders live longer directly benefits insurers, since premiums can be invested over a longer period before a death benefit is paid. John Hancock’s CEO openly acknowledged this dynamic, framing wellness initiatives as both customer-centric and financially rational. Because life insurance policies often last decades, insurers say they can take a long-term approach to behavior change. This extended time horizon differentiates them from health plans that face frequent member turnover.

2. Wellness programs are driving measurable engagement and health outcomes: John Hancock reports that nearly 90% of eligible members have earned premium savings, and many engage with the program frequently each month. The company says half of members with high blood pressure brought it into range, 45% reduced their BMI and 63% improved cholesterol levels. A quarter of policyholders cite the Vitality program as their reason for choosing the insurer, and 70% call it an important factor. These programs include rewards, premium discounts of up to 25% and screenings that have identified previously undetected cancers.

3. Other insurers are expanding into genetics, mental health and dynamic pricing concepts: MassMutual offers free genetic risk assessments and cancer detection tests to certain policyholders, and in pilot programs found behavioral changes after testing as well as newly identified cancer signals. It also provides access to digital tools like an AI-powered mental health app and wearable-integrated activity tracking. Foresters Financial has built a wellness platform with 26,000 monthly active users and is exploring the possibility of more dynamic premium pricing tied to health improvements. Industry observers note, however, that enhanced wellness benefits appeal strongly to some consumers, while others still prefer traditional life insurance products without added features.

Nation's health care tab hit $5.7 trillion last year

By Adriel Bettelheim – Growing demand for medical care and high-cost drugs helped drive up national health spending 7.3% last year, to $5.7 trillion, according to new projections federal actuaries released on Wednesday. Read Full Article...

HVBA Article Summary

1. Health spending continues to outpace economic growth: This marks the third straight year in which health spending increased by more than 7%, underscoring sustained cost pressures across the system. Health care accounted for 18.4% of the U.S. economy last year, up from 18% the year before. Federal actuaries project total spending will approach $9 trillion by 2034, representing 20.6% of GDP. The trajectory is expected to heighten concerns about long-term affordability for households and policymakers.

2. Hospitals and prescription drugs are major cost drivers: Hospital spending remained the largest category, climbing 8.2% to $1.8 trillion. Physician and clinical services rose 6.2% to $1.2 trillion, while prescription drug spending jumped 11.1% to $518.7 billion. Expanded use of GLP-1 medications and cancer treatments contributed significantly to drug outlays. Despite moderate price growth averaging about 2.5%, higher utilization and demand have fueled overall spending increases.

3. Medicare and Medicaid face shifting pressures: Medicare spending is projected to grow at an average annual rate of 9% through 2034, driven by an aging population and greater use of home health services. Provisions in the Inflation Reduction Act are reducing out-of-pocket drug costs for seniors, but more of those expenses are being absorbed by the federal government. Meanwhile, Medicaid spending growth is expected to slow to 4.8% this year, down from 8.3% in 2025, due to new federal limits on state-directed payments and provider taxes. These policy changes are reshaping how public programs bear rising health costs.

HHS, responding to China’s rise, moves to fast-track early drug research

By Jonathan Gardner – U.S. drugmakers have increasingly looked to China to source new experimental medicines, taking advantage of heavy government life sciences investment and a regulatory environment that can enable clinical trials to begin within 18 months of discovery of a new therapeutic molecule. Read Full Article...

HVBA Article Summary

1. Federal Blueprint Aims to Retain Early Research in the U.S.: The Department of Health and Human Services released a plan designed to make it easier for biotechnology companies to initiate clinical trials domestically. The proposal seeks to reduce administrative burdens associated with early-stage research and broaden patient access to studies. It also reflects broader federal concerns about maintaining U.S. competitiveness in drug innovation as more companies look overseas. The effort positions early clinical development as a strategic priority for national health and economic policy.

2. FDA Proposes Streamlined IND and Trial Processes: As part of the initiative, the FDA will clarify what data are required before companies file Investigational New Drug applications, aiming to eliminate unnecessary documentation. The agency is also considering more flexible trial protocols to minimize complex amendments when study designs need adjustments. A pilot program would allow developers to consult with a network of research institutions before submission. In addition, a new rolling submission platform would enable regulators to provide more timely feedback to sponsors.

3. Expanded Patient Enrollment and Use of Technology: The proposal includes measures to increase participation of U.S.-based patients in clinical trials, including evaluating whether stipends could be offered within the bounds of federal anti-kickback laws. HHS is exploring ways to better integrate trials into routine medical practice and help physicians identify eligible participants. The National Institutes of Health will support technologies such as telehealth, remote monitoring, real-world data and artificial intelligence to improve access. These steps are intended to make trials more accessible, particularly for people in rural and underserved communities.

How to support sandwich caregivers over the summer

By Lee Hafner – For the millions of sandwich caregivers in the workforce, managing the needs of older loved ones can become more complicated when their kids are out of school. During this time, specific eldercare support from employers can help these caregivers balance work with family needs. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Summer schedule disruptions increase caregiving strain: School breaks often disrupt established caregiving routines, creating new conflicts between children’s activities and eldercare responsibilities. Changes like camp pickups or altered work hours can prevent family members from maintaining regular check-ins with aging relatives. As a result, demand for respite care and short-term support tends to rise during the summer months. Employers that anticipate these seasonal pressures can better prepare their workforce with targeted assistance.

2. Care coordination and education fill critical knowledge gaps: Many employees navigating eldercare face a steep learning curve around care options and public coverage programs. Understanding distinctions between assisted living, independent living, nursing homes and home care — as well as what Medicare or Medicaid will cover — can be overwhelming. Offering care coordination services as a benefit can help employees make informed decisions more efficiently. This type of guidance reduces stress while improving employees’ ability to stay focused and productive at work.

3. Caregiver benefits support retention and morale: Providing backup care subsidies, access to vetted local providers or caregiver resource platforms can help employees manage temporary gaps in support. Even acknowledging caregiver challenges and opening dialogue can reduce feelings of isolation among workers. Leaders who proactively address eldercare demonstrate empathy and responsiveness to employee needs. Over time, this approach can strengthen retention, workplace culture and overall organizational health.

Oura inks partnership with Eli Lilly's prescription platform

By Ngai Yeung – Wearable company Oura is partnering with LillyDirect, Eli Lilly’s direct-to-consumer telehealth platform, in hopes of helping patients on GLP-1 weight loss medications track changes in their health. LillyDirect customers on GLP-1 medication can receive a free kit to measure their Oura ring size through the partnership. The goal is to help patients better understand the physiological changes they go through when they are on GLP-1 medications, and to introduce the Oura ring as a way to keep track of them, Oura Chief Medical Officer Ricky Bloomfield told Endpoints News. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Oura Expands Support for GLP-1 Users: Oura recently launched a GLP-1 tracking program that allows users to log medication doses, monitor weight changes, track symptoms, and view biometric data collected by the Oura Ring. The new collaboration with Lilly builds on this initiative, reflecting growing consumer interest in tools that support weight management. The partnership represents an extension of Oura’s efforts to enhance its metabolic health offerings.

2. Continued Focus on Metabolic Health: Oura has steadily expanded its metabolic health capabilities over the past year, including the addition of meal tracking and a collaboration with Dexcom to connect glucose data with dietary habits. According to the company, these features have seen strong user interest. The Lilly partnership aligns with Oura’s broader strategy of developing digital tools that support metabolic health management.

3. Partnership Centers on Research and User Support: Oura stated that there is currently no data-sharing agreement with Lilly as part of the collaboration. The company is also conducting studies to evaluate whether Oura Ring users are better able to maintain weight loss over time. While additional details about future plans were not disclosed, the partnership appears to focus on expanding research and user support rather than integrating user data between the companies.