Health costs front and center for employers while U.S. employment holds steady

By Allison Bell – Health benefits costs are high and climbing in the United States, but the job market still looks good, according to executives from Willis Towers Watson. Julie Gebauer, president of Health, Wealth & Career at Willis, said continues to increase its revenue. "We haven't seen softening employment impact our revenue overall," Gebauer said. Employers continue to compete for certain kinds of jobs and skills, she added. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Rising Health Care Costs Remain a Major Employer Concern: Executives from Willis Towers Watson and other firms highlight that health care inflation is a persistent issue for employers. Factors such as increased utilization, technological advancements, and rising prescription drug prices are driving costs higher. Employers are actively seeking strategies to manage these expenses while maintaining competitive benefits.

2. Stable Employment Despite Cost Pressures: Despite the ongoing rise in health care costs, the U.S. job market remains stable according to industry leaders. Companies continue to compete for talent in key roles, and there has not been a noticeable decline in employment or company revenues due to these cost pressures. This suggests that, for now, employers are absorbing higher benefits costs without reducing workforce levels.

3. Broader Economic Implications of Health Care Inflation: Leaders from firms like Marsh McLennan and Brown & Brown note that escalating health care costs may have broader economic effects, potentially impacting the overall U.S. economy. Employers are attempting to balance the need to offer robust health benefits with the imperative to control spending. This ongoing challenge is prompting organizations to tailor benefits and explore innovative cost-containment strategies.

California Signs PBM Law: As Federal PBM Regulation Lags, the States Step Up

By Marissa Plescia – Numerous efforts have been made at the federal level to crack down on the opaque business practices of pharmacy benefit managers, from a lawsuit by the Federal Trade Commission to bills in Congress. But no definitive action has been taken yet. In the absence of federal progress, states are stepping in to fill the gap. Just recently, California Governor Gavin Newsom signed a law (SB 41) that will regulate PBMs. It has several provisions, including banning spread pricing. This is when a PBM charges a health plan more for a drug than it pays the pharmacy and keeps the difference as profit. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. California Passes Aggressive PBM Reform Law (SB 41)
   Governor Newsom signed SB 41, positioning California as a leader in prescription drug cost reform. The law introduces significant changes to how pharmacy benefit managers (PBMs) operate in the state, including banning spread pricing, mandating transparency in rebate handling, requiring licensure through the Department of Managed Health Care, and enforcing a flat-fee payment model to reduce hidden fees and promote price transparency.

2. Growing State-Level Movement Against PBM Practices
   Multiple states, including Massachusetts, Missouri, North Dakota, and Utah, have enacted legislation aimed at increasing oversight and limiting controversial PBM practices, such as rebate opacity and patient steering. While Arkansas’ more aggressive attempt to restrict PBM ownership of pharmacies was blocked in federal court, ongoing legal and legislative efforts suggest a nationwide trend toward tighter PBM regulation.

3. Calls for Federal Action Amid Fragmented Reform Efforts
   Experts and stakeholders agree that while state laws like California’s are impactful, national reform is needed to achieve consistency and long-term drug pricing transparency. Advocates argue that a unified federal framework would prevent regulatory fragmentation across states and support broader use of dynamic pricing technologies to enhance affordability and access.

HRSA launches 340B rebate pilot with 8 drugmakers: 5 things to know

By Ella Jeffries – The Health Resources and Services Administration has approved eight manufacturer rebate plans under a new 340B pilot program set to launch Jan. 1. The initiative will replace upfront drug discounts with post-sale rebates and comes amid heightened tension between hospitals and federal regulators over changes to the 340B program. Read Full Article...

HVBA Article Summary

1. Shift from Upfront Discounts to Rebates: The new 340B pilot program will have drug manufacturers provide post-sale rebates instead of the traditional upfront discounts. Covered entities must now purchase drugs through their 340B wholesaler accounts and submit claims data to receive rebates at the unit level. This change is intended to alter the financial flow between manufacturers and healthcare providers, potentially impacting how quickly providers can access savings.

2. Concerns Over Administrative Burden and Cash Flow: Hospital and pharmacy leaders have expressed concerns that the rebate model could increase administrative workload and create cash flow challenges for safety-net providers. The need to submit detailed claims data and wait for rebates may delay financial relief for hospitals, especially those serving vulnerable populations. An analysis suggests that if the model expands, disproportionate-share hospitals could face significant upfront costs, adding to their financial strain.

3. Political and Industry Pushback: A bipartisan group of lawmakers has called for the Department of Health and Human Services to pause the pilot, citing worries about the rapid implementation and possible legal issues. Hospital advocacy groups argue that the rebate model does not improve patient access to discounted drugs and could harm institutions that rely on the 340B program. The pilot has thus become a focal point for ongoing debates about the future direction of drug pricing and support for safety-net hospitals.

What not to do at open enrollment

By Eric Silverman – With open enrollment top of mind, the emphasis tends to be on what we should do for our employer clients, but sometimes what not to do is just as important — maybe even more so. Let me explain further: One of the biggest misconceptions that I have to address early on is an in-person vs. virtual meeting. If you're like any other client that I've ever onboarded, you're very much used to scheduling a group meeting where you arm wrestle your employees to come into a big conference room or break room. You might do three, four or five of them. You might do them at every location if it's a bigger group, and if you're like most of my clients, it's a pain to schedule and annoying to employees. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Virtual and Hybrid Approaches Are More Effective: The article argues that traditional in-person benefits meetings are often inconvenient for both employers and employees, leading to low engagement and wasted resources. Virtual or hybrid meetings, especially with the option to record and share content, allow employees and their families to access information on their own schedules. This approach increases participation and ensures that benefits decisions are more informed and inclusive.

2. Bite-Sized, Topic-Specific Communication Improves Engagement: Instead of forcing employees to watch lengthy, one-size-fits-all presentations, breaking down benefits information into short, topic-specific video clips makes it easier for employees to find and understand what matters most to them. This method mirrors the way people consume content online, reducing information overload and making the enrollment process more user-friendly. Providing both video and digital documents on a custom benefits website further streamlines access and reference.

3. Shorter Enrollment Windows and Strategic Timing Are Key: The author recommends limiting open enrollment periods to about one week, rather than a full month, to avoid procrastination and last-minute rushes. Additionally, starting enrollment mid-week and avoiding the traditional January 1 effective date can reduce stress for both HR teams and employees. These changes help avoid the year-end holiday crunch and can lead to a smoother, more efficient enrollment process.

How state laws are beefing up health data privacy protections

By Cassie McGrath – When it comes to healthcare data protection, most people probably think of the Health Insurance Portability and Accountability Act (HIPAA). But with the rise of technology, like wearables and telehealth, there’s more patient data out there than ever before. With a lack of movement in Congress (but some at the Federal Trade Commission), at least 26 states including Washington and New York have begun taking data privacy, or personal control of patient information, into their own hands. Read Full Article...

HVBA Article Summary

1. Expansion of State-Level Health Data Protections: States like Washington and New York are enacting laws that go beyond HIPAA to address gaps in health data privacy, especially as technology increases the amount and types of data collected. These laws are designed to give individuals more control over their health information and to regulate how companies collect, use, and sell such data. The shift to state-level regulation is partly due to limited federal legislative progress on updating privacy standards for the digital age.

2. Operational and Legal Implications for Healthcare Companies: The emergence of a patchwork of state privacy laws creates significant operational complexity and legal risk for healthcare organizations, particularly those operating across multiple states. Companies must adapt by overhauling data strategies, improving consent management, and strengthening vendor oversight to comply with varying requirements. This environment compels organizations to invest in robust data governance and to rethink how they collect, store, and share patient information.

3. Motivations and Enforcement Mechanisms Differ by State: The push for stronger health data privacy laws has been influenced by concerns over reproductive rights and high-profile cases of data misuse, such as the sale of mental health data for advertising. Washington’s law allows individuals to sue companies for harm, while New York’s proposed law gives enforcement authority to the state attorney general. These differences reflect varying approaches to enforcement and highlight the evolving landscape of health data protection in the United States.

GLP-1s linked to decline in U.S. obesity rates

By Michael Popke – Obesity is trending downward in the United States, according to Gallup. The analytics and public opinion polling company’s National Health and Well-Being Index indicates that after peaking at a record 39.9% in 2022, the obesity rate for adults dropped to 37.0% in 2025. “This is a statistically meaningful decrease representing an estimated 7.6 million fewer obese adults compared with three years ago,” Gallup notes, before mentioning the bad news. “Meanwhile, diagnoses of diabetes — a lifetime disease that can be managed but not cured — have now reached an all-time high of 13.8%.” Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Obesity Rates Show Notable Decline: Recent Gallup data reveals a significant drop in adult obesity rates in the U.S. between 2022 and 2025. This decline is considered statistically meaningful and translates to millions fewer obese adults nationwide. The trend is based on consistent self-reported height and weight data, which, while potentially subject to underreporting, still provides a reliable measure of change over time.

2. GLP-1 Drug Usage Has Increased Sharply: The use of GLP-1 drugs, such as Ozempic and Wegovy, for weight loss has risen considerably among American adults. The percentage of adults reporting use of these medications more than doubled in just over a year, with higher usage rates among women than men. The largest reductions in obesity were observed in age groups that also reported the highest GLP-1 usage, suggesting a possible link between medication adoption and improved obesity outcomes.

3. Diabetes Diagnoses Reach Record High Despite Obesity Drop: While obesity rates have declined, the prevalence of diabetes diagnoses has reached an all-time high. This suggests that factors beyond obesity, such as genetics or other lifestyle elements, may be contributing to the rise in diabetes. The article also notes that expanding access to GLP-1 treatments through Medicaid and legislative efforts could influence future trends in both obesity and diabetes rates.

Dental Care Is Healthcare

By Edwin Leap – I see a lot of folks with dental trauma and dental pain. Over the years I have become very comfortable doing dental nerve blocks, and occasionally putting displaced teeth back into the sockets. I've also seen those who, thanks to car wrecks or assaults, have had many teeth knocked loose or knocked out. I suppose it is testimony to the growing affluence of medicine itself that many physicians and others seem a little dismissive of dental pain. We often hear, "Dental pain doesn't belong in the emergency department." Admittedly, it's better served in the dental office. But when you're poor, or don't have transportation, or all of the dental offices are full, then that's a pretty tall order. Read Full Article...

HVBA Article Summary

1. Dental Pain and Emergency Care Accessibility: The article highlights that while dental pain is ideally treated in dental offices, many patients end up in emergency departments due to lack of access to dental care. Factors such as poverty, lack of transportation, and full dental offices contribute to this issue. This underscores the need for emergency physicians to have compassion and skills to manage dental pain effectively.

2. Importance of Oral Health to Overall Well-being: Dental care is emphasized as a critical component of overall health. Poor dental health can lead to serious complications such as infections that affect heart valves (endocarditis) and may contribute to coronary artery disease and premature birth in pregnant women. Maintaining good oral hygiene and regular dental visits is essential for preventing these health risks.

3. Consequences of Tooth Loss and Dental Neglect: The article discusses the negative effects of losing natural teeth, including bone deterioration, difficulty chewing, and changes in facial structure and speech. Although dentures and implants can help, natural teeth are preferable and less costly to maintain than to replace. The author advocates for encouraging dental repair over extraction, especially among young people facing dental decay.

Annual Family Premiums for Employer Coverage Rise 6% in 2025, Nearing $27,000, with Workers Paying $6,850 Toward Premiums Out of Their Paychecks

By Gary Claxton – Family premiums for employer-sponsored health insurance reached an average of $26,993 this year, KFF’s annual benchmark health benefits survey of large and smaller employers finds. On average, workers contribute $6,850 annually to the cost of family coverage, with employers paying the rest. Family premiums are up 6%, or $1,408, from last year, similar to the 7% increase recorded in each of the previous two years. This year’s increase compares to general inflation of 2.7% and wage growth of 4% over the same period. Read Full Article...

HVBA Article Summary

1. Premium Growth Outpaces Inflation and Wages: The increase in family health insurance premiums for employer-sponsored plans continues to surpass both general inflation and wage growth. This trend places a growing financial burden on workers, who are responsible for a significant portion of these rising costs. The persistent gap between premium increases and wage growth may impact employees’ ability to afford coverage and other household expenses.

2. Employers Face Pressure from Prescription Drug Costs and New Treatments: Large employers identify prescription drug prices, especially for new medications like GLP-1s for weight loss, as major contributors to rising premiums. Many firms are implementing restrictions or additional requirements for coverage of these drugs due to their unexpectedly high costs. These pressures may lead employers to further limit coverage or increase employee cost-sharing in the future.

3. Coverage Gaps Remain for Part-Time and Low-Wage Workers: Access to employer-sponsored health insurance remains limited for part-time and low-wage workers, with many relying on Medicaid or lacking coverage altogether. Despite policy efforts and new reimbursement arrangements, uptake of alternatives like Individual Coverage Health Reimbursement Arrangements (ICHRAs) remains low. This highlights ongoing challenges in ensuring comprehensive health coverage for all segments of the workforce.