Centene Swings to Loss, Sees Further Membership Declines for Medicaid, Medicare
The managed-care specialist's troubles began in April when its quarterly results were overshadowed by membership declines in Medicaid and Medicare. Centene in July then withdrew its financial guidance for 2025 after warning that its earnings would fall well short of expectations.
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The Hill
8 minutes ago
- The Hill
ACA premiums set to spike
The proposed rates are preliminary and could change before being finalized in late summer. The analysis includes proposed rate changes from 312 insurers in all 50 states and DC. It's the largest rate change insurers have requested since 2018, the last time that policy uncertainty contributed to sharp premium increases. On average, ACA marketplace insurers are raising premiums by about 20 percent in 2026, KFF found. Insurers said they wanted higher premiums to cover rising health care costs, like hospitalizations and physician care, as well as prescription drug costs. Tariffs on imported goods could play a role in rising medical costs, but insurers said there was a lot of uncertainty around implementation, and not many insurers were citing tariffs as a reason for higher rates. But they are adding in higher increases due to changes being made by the Trump administration and Republicans in Congress. For instance, the majority of insurers said they are taking into account the potential expiration of enhanced premium tax credits. Those subsidies, put in place during the COVID-19 pandemic, are set to expire at the end of the year, and there are few signs that Republicans are interested in tackling the issue at all. If Congress takes no action, premiums for subsidized enrollees are projected to increase by over 75 percent starting in January 2026, according to KFF. But some states are pushing back. Arkansas Gov. Sarah Huckabee Sanders (R) on Wednesday called on the state's insurance commissioner to disapprove the proposed increases from Centene and Blue Cross Blue Shield. The companies filed increases of up to 54 percent and 25.5 percent, respectively, she said. 'Arkansas' Insurance Commissioner is required to disapprove of proposed rate increases if they are excessive or discriminatory, and these are both,' Huckabee Sanders said in a statement. 'I'm calling on my Commissioner to follow the law, reject these insane rate increases, and protect Arkansans.'
The Hill
38 minutes ago
- The Hill
Appeals court upholds dismissal of US Chamber challenge to Medicare negotiation
The U.S. Sixth Circuit Court of Appeals on Wednesday upheld a lower court's ruling to dismiss a challenge to the Medicare Drug Price Negotiation Program brought by the U.S. Chamber of Commerce, finding once again that the parties involved did not have standing to sue. Almost exactly one year ago, a federal judge dismissed the Chamber's lawsuit challenging the Medicare negotiation program established through the Inflation Reduction Act. The judge found that the other plaintiffs included in the suit — the Dayton Area Chamber of Commerce, the Ohio Chamber of Commerce and the Michigan Chamber of Commerce — lacked standing to sue on behalf of their members, though it said the U.S. Chamber had standing on its own if it filed a new suit in a new venue. The appeals court largely agreed with the district court's ruling while also clarifying some points that were made. While the court agreed that the Dayton Area Chamber of Commerce's interests are not relevant to the case, it made clear that national organizations are not the only entities that can sue over federal laws that can impact U.S. states and regions. The district court last year had also found that the pharmaceutical companies AbbVie and its subsidiary Pharmacyclics had no direct connections to the business climate of Dayton, Ohio for the chamber to sue on its behalf. But the appeals court clarified that businesses often have interests in places where they aren't headquartered, so a lack of such geographic ties should not be considered 'fatal' to establishing standing. In this case, however, the lack of headquarters combined with a 'lack of any direct connection between the Dayton Chamber's purpose' was enough to disprove associational standing for both entities. Finding again that the Dayton Chamber and the Ohio Chamber lacked standing to sue, the appeals court found that the district court 'did not err' in its initial ruling. 'And because Plaintiffs did not identify an appropriate venue outside of Ohio that the case could be transferred to if the Dayton Chamber and the Ohio Chamber lacked standing, the district court did not abuse its discretion in dismissing this case for lack of proper venue,' the appeals court found. Having lost at the appellate court level, the U.S. Chamber could choose to appeal the case to the Supreme Court. The Hill has reached out to the U.S. Chamber for comment. The advocacy group Patients For Affordable Drugs (P4AD) applauded the ruling. 'This decision marks the 10th court ruling in favor of patients and against the pharmaceutical industry's desperate legal attacks on the overwhelmingly popular Medicare Negotiation Program, which in January will deliver lower prices to more than 9 million patients across the nation,' P4AD Executive Director Merith Basey said in a statement. 'Pharma is spending millions in an attempt to protect its full monopoly pricing power at the expense of patients, but the courts keep rejecting the industry's arguments,' Basey added. 'By upholding the lower court's decision, the U.S. Court of Appeals is siding with American patients who deserve a much better deal against an industry that continues to try to hold them hostage.'
Associated Press
2 hours ago
- Associated Press
North Carolina Gov. Stein signs stopgap budget bill but vetoes tax credit helping school choice
RALEIGH, N.C. (AP) — North Carolina Gov. Josh Stein signed into law on Wednesday a stopgap spending measure while lawmakers remain in a state budget impasse. But he vetoed legislation that would direct state participation in a yet-implemented federal tax credit program to boost school-choice options, suggesting state Republicans acted hastily. The Democratic governor signaled this week he would sign the 'mini-budget' that the GOP-controlled General Assembly sent him last week. But he called it a poor substitution for a full two-year budget that House and Senate negotiators were unable to finalize before the new fiscal year began July 1. Instead, Stein said, the spending plan fails to provide substantive pay raises or the full amount needed to cover increased Medicaid expenses. Health and Human Services Secretary Dev Sangvai said the additional $600 million provided annually for Medicaid is hundreds of millions short and unless addressed would require reducing optional services, provider rates or both. 'This Band-Aid budget fails to invest in our teachers and students, fails to keep families safe, fails to value hardworking state employees, and fails to fully fund health care,' Stein said in a news release. 'Despite these serious reservations, I am signing this bill into law because it keeps the lights on.' The new law does cover anticipated enrollment changes for K-12 schools and community colleges, as well as for experience-based pay raises already in state law for teachers. There is also $800 million for state construction projects and funds for state employee retirement and health care. It also creates a new agency for State Auditor Dave Boliek, who is tasked by year's end to recommend which state offices and positions should be eliminated. Some Republican budget-writers have said that Medicaid spending could be adjusted later during the fiscal year. Stein's veto seeks to block a decision by North Carolina legislative leaders to join the tax-credit program contained in President Donald Trump's tax and spending bill that he signed into law last month. The program provides starting in 2027 a one-to-one credit equal to up to $1,700 for those who donate to certain 'scholarship granting organizations,' with those distributing K-12 private-school scholarships among them. The federal law said each state must opt in to the program, and North Carolina Republicans who have already greatly expanded state-funded scholarships wanted North Carolina to be the first to do so. Stein's veto message aligned with arguments by Democratic state legislators who voted against the state measure last week that the program shifts federal funding away from helping public schools and helps wealthy people who can already afford private school for their children. 'Congress and the Administration should strengthen our public schools, not hollow them out,' Stein wrote. By opting in, North Carolina-based scholarship organizations would benefit while costing state government no revenues. The tax credit program is also designed to benefit organizations that provide aid for services for students who attend public schools. Stein said he would opt in to the program for the state once the federal government issued sound written guidance on program rules because he sees opportunities to 'benefit North Carolina's public school kids.' So, he added, the bill on his desk is 'unnecessary.' The vetoed bill now returns to the General Assembly, where override votes could happen as early as Aug. 26. Republicans are but one House seat shy of a veto-proof majority, and last week lawmakers were able to gain the Democratic support needed to override eight of Stein's 14 earlier vetoes. Two House Democrats voted for the tax credit bill. Republican Senate leader Phil Berger said Wednesday that with the veto Stein is 'attempting to usurp the General Assembly's authority to set tax policy' and anticipated a veto override 'to ensure North Carolina can participate in President Trump's signature school choice initiative.'
