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Medicare Policy & Trends resources-finance

Health Plans Anticipate 14% Premium Hikes for 2027 Amid Rising Costs

Health insurers are preparing to propose a median premium increase of 14% for the 2027 plan year, marking a second consecutive year of double-digit growth, according to an analysis shared by the American Hospital Association (AHA).

While this primarily targets ACA Marketplace plans, Medicare beneficiaries should also brace for ripple effects in Medicare Advantage and Part D supplemental premiums. Insurers cite a combination of pressures driving the hikes: the explosive demand and cost of glucagon-like peptide-1 (GLP-1) weight-loss drugs, broader economic inflation, and ongoing labor shortages in the healthcare sector.

As federal policy changes—including the expiration of enhanced premium tax credits—take effect, seniors and younger enrollees alike will need to shop their coverage carefully during the upcoming fall open enrollment season.

Read the AHA news summary

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Medicare Policy & Trends Research & Data

What’s in the 2026 Medicare Trustees Report?

The Bipartisan Policy Center has published an in-depth summary of the 2026 Medicare Trustees Report, underscoring the pressing financial challenges facing the program. The report projects that the Medicare Hospital Insurance (Part A) Trust Fund will be depleted by 2033.

According to the Trustees, an aging demographic and rising per-beneficiary spending are placing immense pressure on the system. Medicare expenditures are projected to nearly double as a share of the U.S. economy over the next 25 years, rising from 3.9% of GDP to 6.5% by 2050.

Policymakers are increasingly focused on bipartisan reforms to address the $4.2 trillion long-term unfunded obligation before the 2033 insolvency date triggers automatic cuts to provider payments.

Review the Bipartisan Policy Center’s analysis

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Medicare Advantage Medicare Policy & Trends Research & Data

Medicare Advantage in 2026: Premiums, Limits, and Prior Authorization Trends

A recent analysis by KFF provides a comprehensive look at the Medicare Advantage landscape in 2026. While enrollment growth has slightly decelerated, a record 55% of all eligible Medicare beneficiaries are now enrolled in private plans.

For 2026, the average beneficiary has access to 39 different plan options, with 31 of those being zero-premium plans. The average out-of-pocket limit for in-network services sits at $5,421, providing a safety net for enrollees with high medical needs.

Despite concerns over tightening federal payments, the availability of supplemental benefits like dental, vision, and hearing has remained stable. However, prior authorization continues to be universally applied, with 99% of enrollees in plans that require approval for certain services.

Read the full KFF analysis here

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Medicare Policy & Trends Prescription Drugs resources-finance

Medicare Drug Price Negotiations: 15 More Drugs Targeted for 2027 Savings

On the heels of the first successful round of negotiated prices, Medicare has selected 15 additional high-cost drugs for price negotiations, with savings expected in 2027.

The list includes treatments for Type 2 diabetes, HIV, psoriasis, and severe arthritis. Negotiated prices could reduce out-of-pocket costs for millions of seniors who depend on these brand-name medications.

While the actual discounts won’t kick in until next year, beneficiaries should review their plan’s formulary notices this fall to anticipate changes.

Read the Reuters coverage on Investing.com

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Medicare Benefits & Services Medicare Policy & Trends Prescription Drugs

Medicare GLP-1 Bridge Program Launches: $50 Weight-Loss Drugs Now Available

The new Medicare GLP-1 Bridge Program went live on July 1, 2026, giving eligible Part D enrollees access to certain weight-loss medications for a flat $50 monthly copay.

Covered drugs include Wegovy (injections and tablets), Zepbound (KwikPen only), and all formulations of Foundayo. Beneficiaries must have a BMI of 35+ or a BMI over 30 with weight-related comorbidities, and their doctor must submit a prior authorization form to CMS.

The copay does not count toward the Part D deductible or out-of-pocket maximum, but it offers significant savings for those who qualify. The demonstration runs through December 31, 2027.

Learn more at CMS.gov

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Medicare Advantage Medicare Policy & Trends

Assessing Recent Regulatory Action on Medicare Advantage Spending

A new piece in Health Affairs examines the Centers for Medicare and Medicaid Services’ (CMS) ongoing efforts to rein in excess spending within the Medicare Advantage program. The 2027 Advance Notice, released early in 2026, proposed a tight 0.09% payment increase for insurers, signaling a stricter regulatory environment.

One of the most notable proposals is CMS’s intent to remove diagnosis codes captured exclusively through “unlinked chart reviews” when calculating risk scores. Researchers estimate this coding intensity has historically led to billions in overpayments to private plans compared to traditional fee-for-service Medicare.

The article suggests these regulatory adjustments are a necessary first step to ensure the financial sustainability of the $647-billion-a-year program while protecting the quality of care for beneficiaries.

Read the full policy breakdown at Health Affairs

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Medicare Policy & Trends

Trump MD? The Viral Social Media Post Leads to a Real .Gov Drug Pricing Tool

The image made the rounds. But behind the social media moment sits a suite of health policy initiatives that directly affect American patients and Medicare enrollees.

The centerpiece is TrumpRx.gov, a federal platform offering direct to consumer discounts on dozens of brand name drugs. Prices on the site reflect Most Favored Nation agreements with 16 pharmaceutical companies including Pfizer, Novo Nordisk, and Eli Lilly. Monthly costs for Ozempic drop from over $1,000 to as low as $199. Wegovy pills fall from $1,349 to $149 . Patients with valid prescriptions can access these prices through printable coupons or manufacturer channels integrated into the site. For Medicare beneficiaries, HHS has clarified that manufacturers may offer these cash pay options without running afoul of anti kickback statutes, provided the drug is not also billed to Medicare .

Beyond TrumpRx, the administration launched the Make America Healthy Again initiative targeting chronic disease prevention and food quality. Major corporations including Walmart, Hershey, and Nestlé have agreed to eliminate artificial dyes from their products . The Working Families Tax Cuts Act created a $50 billion Rural Health Transformation Program, distributing funds to all 50 states to strengthen hospitals and care access in underserved areas .

The White House has also proposed the Great Healthcare Plan, a legislative framework that would codify Most Favored Nation drug pricing into law, require hospitals and insurers to prominently post all prices, and restructure subsidies to flow directly to patients through health savings accounts rather than to insurance companies .

The white coat got your attention. TrumpRx.gov and these broader reforms are what merit yours.

View the price comparisons at TrumpRx.gov.

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Market Trends medicare Medicare Benefits & Services Medicare Plans Medicare Policy & Trends Medicare Updates & Policy

CMS Proposes Nearly Flat Medicare Advantage Payment Increase for 2027

Federal health officials have proposed only a small increase in payments to Medicare Advantage insurers for 2027. The modest proposed adjustment, far lower than in previous years, could impact plan benefits, premiums, and insurer participation as the government seeks to control federal healthcare spending.

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information medicare Medicare Policy & Trends

Research Highlights Impact of Medicare Advantage Plan Exits

A new research letter in JAMA analyzes the impact of Medicare Advantage plan exits, finding that millions of enrollees are forced to select new coverage when insurers withdraw. The study notes that such disruptions can complicate care coordination, especially for seniors with complex medical needs, fueling debate over marketplace stability.

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information medicare Medicare Benefits & Services Medicare Policy & Trends

CMS Halts Enrollment in Some Elevance Medicare Advantage Plans

Federal regulators have ordered a temporary halt on new enrollments in certain Elevance Health Medicare Advantage plans after identifying compliance issues. The action reflects growing federal scrutiny of private insurers to ensure they meet program requirements and protect beneficiaries.