Health Care Cost

This week, the Center on Health Equity & Access covered news from the Trump administration and CMS, Cigna's co-pay cap on weight loss drugs, and perspectives on living with HIV.

The repeal of the federal rule could leave those with mental health and substance use disorders at risk of losing coverage for their treatment.

The immediate impact of the recent executive order aimed at lowering drug prices is likely low, as it may take until 2027 before actions detailed in the order can be enacted.

Evernorth has capped antiobesity drug monthly co-pays at $200 in a move to improve access and affordability amid new drug pricing initiatives.

Veterans primarily receiving care through the Department of Veterans Affairs (VA) similarly used dental and vision services under Medicare Advantage (MA) and traditional Medicare, challenging the justification for full MA capitated payments based on supplemental benefits.

Emma Achola-Kothari, PhD, highlights the need to expand Medigap access for Medicare beneficiaries younger than 65 years and calls for future research connecting access barriers to health outcomes.

The Trump administration could consider all sides of the federal rule before making a permanent decision on its potential repeal.

Emma Achola-Kothari, PhD, explains that younger Medicare beneficiaries without supplemental coverage face high costs, while dual-eligible beneficiaries in Medicare Advantage plans struggle with provider access.

The executive order that President Donald Trump signed to lower drug prices could come under legal challenges by the drug industry.

Ali Khawar, former Department of Labor official, explains the original intent of a federal rule to reinforce the Mental Health Parity and Addiction Equity Act could be under threat as the Trump administration walks back enforcement.

Emma Achola-Kothari, PhD, explains that Medicare beneficiaries younger than 65 years without supplemental coverage face greater financial and access barriers to care, while dual-eligible individuals experience fewer of these challenges.

HHS announces it is taking steps to implement President Trump’s Executive Order on prescription drug pricing. Keep up with the latest moves made in health policy under President Donald Trump's second administration. This timeline will be updated as orders and policy progress.

Proposed Medicaid cuts risk increasing health disparities, leaving millions uninsured and limiting access to essential care for vulnerable populations.

The executive order signed on May 12 has some differences from a previous executive order originally signed by the Trump administration in 2020.

Novel therapies for multiple myeloma (MM), including chimeric antigen receptor T-cell and bispecific antibodies, extend lives but raise concerns about treatment costs and adherence, and they haven't replaced stem cell transplantation, Harsh Parmar, MD, of Hackensack University Medical Center, explains.

A new analysis looked at estimated out-of-pocket costs for etanercept, ustekinumab, and ibrutinib, specialty drugs that often represent a significant cost burden for Medicare Part D beneficiaries and which were selected for 2026 drug price negotiation under the Inflation Reduction Act.

The new executive order contains multiple provisions if pharmaceutical companies do not offer "most-favored nation" pricing on medication.

Robert F. Kennedy Jr’s congressional hearing featured numerous statements from the secretary of HHS, including denouncing claims of cutting down the HHS and the National Institutes of Health.

Investing in patient navigation and clinician incentives ensures colorectal cancer screening completion, improves early detection, reduces disparities, achieves cost savings, and advances population health for all stakeholders.

A new single-use device reduces surgical site infections, improves recovery, and lowers costs after Cesarean (C-section) deliveries.

Larragem Raines, MS, of the Center for Innovation & Value Research, discusses the organization's major depressive disorder (MDD) open-source value model, dynamic pricing, and the future role of artificial intelligence in care.

Covered California and Health Net’s novel data exchange initiative significantly improved quality measurement and potentially reduced costs by more than $640,000.

Proposed Medicaid cuts in the Republican budget proposal hold significant implications for health care access and coverage.

The move would align prescription costs in the US with the costs of other countries, according to the administration.

The Maryland All-Payer Model was associated with an increase in population-based rates of elective major joint replacements, with a more pronounced effect observed in Maryland-only hospitals.