Read today’s Kaiser Health News
In other news:
RFK Jr. Wants to Change a Program That Stopped Vaccine Makers From Leaving the U.S. Market. They Could Flee Again. READ THIS ARTICLE! It explains a lot about the illogical reasoning and self-interest of the HHS secretary.
About health insurance/insurers
Employers face 35% surge in $1M medical stop-loss claims: Self-insured plans were about 4.3 times as likely to receive $1 million claims in 2024 than in 2013, according to Tokio Marine HCC's latest annual stop-loss market report.
The Houston-based stop-loss carrier does not publish the underlying $1 million claim frequency counts, but a broker revealed in 2022 that Tokio Marine HCC reported seeing about 20 $1 million stop-loss claims per 1 million employees. That means it's now seeing a frequency of more than 80 $1 million claims per 1 million employees per year, or about one $1 million claim per 12,500 employees.
Projected Health System and Economic Impacts of 2025 Medicaid Policy Proposals A really good summary of this issue. For example: CBO projections suggest 7.6 million individuals in the US would become uninsured by 2034 due to Medicaid policy changes. This is estimated to result in approximately 1484 excess deaths, 94 802 preventable hospitalizations, 1.6 million people delaying care due to cost, and 1.9 million cases of medication nonadherence annually by 2034.
Why 22 million people may see a ‘sharp’ increase in health insurance premiums in 2026: KEY POINTS
The so-called “big beautiful bill” that President Donald Trump signed on July 4 cut taxes for some households.
However, the law didn’t extend a tax break that has lowered health insurance premiums for millions of Affordable Care Act enrollees in recent years.
The tax break is scheduled to end after 2025, which is expected to raise premiums by an average of 75% and cause about 4 million people to lose health insurance.
Judge dismisses Humana’s case over downgraded Medicare Advantage ratings: A federal judge on Friday tossed out a lawsuit from Humana that attempted to reinstate higher quality ratings to its 2025 Medicare Advantage plans.
The ruling jeopardizes billions of dollars in taxpayer-funded bonuses that Humana gets from the government’s star ratings program. However, Humana said it is considering appealing or refiling the lawsuit, which was dismissed on administrative grounds.
Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2025 A great, current summary of this program.
Survey on health & benefit strategies for 2026 A really good summary of Mercer’s predictions for the coming year. For example: With cost growth accelerating, this year more employers say they are likely to make plan design changes that would shift cost to employees.
About the public’s health
Most US pregnant women, parents of young kids don't plan to accept all recommended kids' vaccines: Only 35% to 40% of US pregnant women and parents of young children say they intend to fully vaccinate their child, per survey results from researchers at Emory University and the Centers for Disease Control and Prevention (CDC).
For the two surveys, published as a research letter this week in JAMA Network Open, the investigators recruited 174 pregnant women and 1,765 parents from a nationally representative panel in April 2024 to answer questions about their intent to have their child receive all recommended vaccines by 18 months.
About healthcare IT
Public Perception of Physicians Who Use Artificial Intelligence:In line with prior research, our results indicate that the public has certain reservations about the integration of AI in health care. While the present effect sizes are relatively small, in particular regarding AI use for administrative purposes, they may be highly relevant as trust in health care practitioners is closely linked to subjective treatment outcomes. Potential reasons for existing skepticism may include concerns that physicians rely too much on AI and that the use of AI could reduce patient-physician interactions as well as concerns about data protection and rising health care costs.6 From the physician’s perspective it thus may be important to transparently communicate the rationale for using AI and to emphasize its potential benefits for the patient.
About healthcare personnel
Trends in Physician Exit From Fee-for-Service Medicare: Over time, physician exit from traditional Medicare has increased. This result is consistent with earlier findings, but exits remained high even after the pandemic, which likely accelerated some physicians’ exit. The findings may reflect multiple factors, including the greater burden of new communication methods (eg, portal messages) and demands for clinical documentation. More rapid growth in exit among small practices likely contributes to consolidated physician markets, given that new physicians increasingly work for large practices. Decreased fees may also play a role but cannot explain the 2014 to 2016 stabilization in exit rates. Variation in exit rates by specialty suggests that concern about inadequate PCP supply may be warranted but requires investigation.