The financial news that actually matters
Explains Medicare coverage, eligibility, benefits, enrollment rules, and healthcare planning for retirees. It simplifies government healthcare programs for better understanding.
Nine more pharmaceutical companies signed pricing agreements with the White House on August 31, and the administration says the group is committing at least $19.6 billion to new manufacturing inside the United States as part of the deal. The signings raise the number of manufacturers under the administration’s most-favored-nation pricing framework to 26, a group…
A federal projection puts Medicare’s drug-negotiation savings at $1.5 billion this year, a number large enough to lose sight of the person actually standing at the pharmacy counter. Take an enrollee filling a 30-day supply of the blood thinner Eliquis: the 2023 list price ran $521, while the price Medicare negotiated for 2026 is $231,…
The Centers for Medicare & Medicaid Services put a fresh number into circulation on July 28: a $41.33 national base beneficiary premium for 2027, up from $38.99 in 2026. It is not a bill, a specific plan’s quote, or an amount any enrollee is asked to pay directly. It is a single figure buried inside…
Section 71119 of Public Law 119-21, the 2025 reconciliation law known as the Working Families Tax Cut legislation, requires state Medicaid programs to condition eligibility on documented community engagement beginning January 1, 2027, unless a state opts in sooner. The class reached by the mandate is narrow: non-pregnant adults ages 19 through 64 who qualify…
Twenty-six pharmaceutical manufacturers now hold most-favored-nation pricing agreements with the federal government, a group whose products cover 89 percent of the U.S. branded drug market, according to a White House fact sheet published August 31. The latest round added nine companies — Alcon, Astellas Pharma, BeOne Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals…
A hospital’s price transparency file exists so a patient facing a scheduled knee replacement, a diagnostic scan, or a cardiac procedure can look up what a facility typically collects from insurers before ever showing up for treatment. That kind of comparison only works if the numbers posted are real, current, and expressed in actual dollars…
Every state Medicaid program relies on more than federal and state tax revenue to pay its bills. In 49 states and the District of Columbia, officials also collect a special levy on hospitals, nursing homes or other health care providers, then funnel that revenue back into the program to help draw down additional federal matching…
Each September, the Centers for Medicare and Medicaid Services releases a landscape file describing national trends across Medicare Advantage and Part D for the coming plan year: projected enrollment, the average premium change across the country, and how many plan choices exist per county. That document is not the same as the tool an individual…
Janumet and Janumet XR, combination pills that pair metformin with sitagliptin to treat type 2 diabetes, currently list at $526 for a 30-day supply under the pricing benchmark Medicare uses in its drug negotiations. Starting January 1, 2027, that same 30-day supply carries a negotiated price of $80 for people enrolled in Medicare Part D,…
A federal program that has kept pricing steadier for standalone Medicare prescription drug plans is set to lapse at the end of this year, and the government has confirmed it will not renew it. The Centers for Medicare & Medicaid Services says plan sponsors have gathered enough experience pricing under Medicare’s redesigned drug benefit to…