Policy

Reflect on the challenges in health equity, care access, and policy shifts impacting health insurance and clinical research in 2025.

A last-minute push to extend Affordable Care Act subsidies was stopped as GOP leadership prevented an expedited vote, leaving the future of the subsidies uncertain.

Medicaid’s Institution for Mental Diseases (IMD) rule bars federal funding for psychiatric facilities with more than 16 beds, but findings indicate that state waivers allowing treatment of serious mental illness in IMDs do not increase overall psychiatric hospitalizations.

Leaders describe how shared data, theranostics programs, and coordinated clinical trials support independent practices and advance value-based cancer care.

With ACA subsidies expiring, experts warn coverage losses could worsen access to behavioral health care and emergency department strains.

The past year has seen multiple changes in the HIV space that have long-term effects when it comes to ending the epidemic.

Oncology leaders warn that declining reimbursements and policy gaps threaten patient access and drive inequities in cancer care.

Recent political shifts impacting health policy and access to care for millions dominated the news in 2025.

A review of 560 FDA-approved drugs found the FDAAA did not change overall time to first postmarket safety action, but some actions occurred earlier.

As value-based care mandates expand, a new survey highlights documentation burdens and burnout risks.

Democrats move to extend ACA subsidies as enrollment closes, leaving consumers uncertain about premiums, coverage, and alternative health options.

In analyzing 2025 Transparency in Coverage (TIC) files from national insurers, the authors found vast payer-level differences; overall, physician/outpatient data were more complete, and hospital inpatient data were less complete.

ACIP delayed the vote on the hepatitis B vaccine schedule amid ongoing controversy and misinformation surrounding vaccine safety and infant immunization.

Patients with stage I to IIIA NSCLC had lower 2- and 4-year mortality in states that expanded Medicaid coverage.

As open enrollment continues, 77% of surveyed Americans were happy with their options for 2026 health care coverage, although cost concerns surfaced.

A national survey shows high overall trust in scientists, but confidence declines steadily with political conservatism.

Self-pay emergency department prices rose significantly from 2021 to 2023, especially at for-profit and system-affiliated hospitals, highlighting growing affordability challenges for uninsured and underinsured patients.

With ACA subsidies ending in 2025, Ben Light explains how rising premiums may push individuals toward ICHRAs and reshape employer health coverage strategy.

A new study shows fee-for-service care is linked to higher odds of low-value surgery, suggesting salaried models may reduce unnecessary procedures.

This commentary proposes a hybrid drug pricing reform model balancing most favored nation (MFN) benchmarking with domestic negotiation strategies that drive equity-focused valuation frameworks.

New research shows immigrant children face higher odds of unmet medical needs as federal and state coverage rules narrow.

To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.

McKesson's report highlights key trends in community oncology, emphasizing patient-centered care, precision medicine, and the need for innovative clinical trials.

Within the same physician groups, 2-sided risk in Medicare Advantage (MA) was associated with higher quality and lower utilization for dually eligible beneficiaries compared with fee-for-service MA and traditional Medicare.

The expansion of direct-to-consumer (DTC) pharmaceutical manufacturer models and the upcoming TrumpRx launch offer lower costs but create new complexities for patients.