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Friday, May 2 2025

Full Issue

Aetna Is Leaving ACA Marketplace

A million Affordable Care Act enrollees across 17 states will have to find alternate coverage in 2026. Separately, the Centers for Medicare & Medicaid Services now has a center to fight waste, fraud, and abuse. Also, the Milken Institute is creating a Women鈥檚 Health Network to study women's issues.

CVS Health will not sell its Aetna health plans in the Affordable Care Act鈥檚 individual marketplaces in 2026, marking the second time in the past decade that Aetna has given up on ACA coverage. (Herman, 5/1)

In other news about the Affordable Care Act 鈥

The Centers for Medicare & Medicaid Services (CMS) has launched the Fraud Detection Operation Center (FDOC) to fight waste, fraud and abuse, the agency announced this week. Listed on a new webpage are a list of 鈥渞ecent success stories.鈥 They include taking action against improper enrollment in Affordable Care Act (ACA) plans, cracking down on false billing of wound care services and scrutinizing 鈥減roblematic activities鈥 regarding hospice claims. (Tong, 5/1)

麻豆女优 Health News: Covered California Pushes For Better Health Care As Federal Spending Cuts Loom

Faced with potential federal spending cuts that threaten health coverage and falling childhood vaccination rates, Monica Soni, the chief medical officer of Covered California, has a lot on her plate 鈥 and on her mind. California鈥檚 Affordable Care Act health insurance exchange covers nearly 2 million residents and 89% of them receive federal subsidies that reduce their premiums. Many middle-income households got subsidies for the first time after Congress expanded them in 2021, which helped generate a boom in enrollment in ACA exchanges nationwide. (Wolfson, 5/2)

And more updates from the health care industry 鈥

The Milken Institute is launching a Women鈥檚 Health Network chaired by former first lady Jill Biden.聽聽The network will engage research institutions, startups and entrepreneurs, corporations and businesses, investors, payers, policymakers, patient and community organizations, health systems and philanthropists to advance women's health.聽 They aim to make headway on understanding and treating conditions that disproportionately impact women such as Alzheimer鈥檚 disease, menopause, endometriosis and heart disease. (Beavins, 5/1)

The end is near for Delaware County's largest health system. Thursday was the last full day that Crozer-Chester Medical Center in Upland was open. Hallways, patient rooms and operating rooms, are now empty as the hospital prepares to shut down permanently at 8 a.m. on Friday. Patients are trying to figure out where to go now to get care. "It's somber," Melanie McKendry, the lead medical assistant at the gynecologic-oncology unit at Crozer Chester Medical Center, said. "It feels like we're at our own funeral, basically." (Wright and Holden, 5/1)

Walgreens-backed VillageMD is exiting Colorado. Banner Health said Thursday it acquired seven Village Medical primary care clinics and two walk-in sites in the state. Forty-six providers and more than 150 support staff will join Banner, according to a news release. The clinics will be rebranded and integrated into the health system in the coming months, the release said. (Hudson, 5/1)

麻豆女优 Health News: Montana Lawmakers Approve $124M To Revamp Behavioral Health System

Montana鈥檚 frayed behavioral health care system, still recovering from the effects of past budget cuts, will get a shot in the arm after state lawmakers approved sweeping changes to upgrade and expand facilities, increase community services, and revise commitment procedures. Lawmakers backed the bulk of Republican Gov. Greg Gianforte鈥檚 multimillion-dollar vision to bolster and expand the system, which has experienced waitlists for care and has been working in recent years to reverse the loss of community-based mental health services and regain federal certification of the state psychiatric hospital, lost in 2022 after a spate of patient deaths. (O'Connell, 5/2)

You will soon see the name Boston Medical Center on two more hospitals in Massachusetts. Good Samaritan Medical Center in Brockton is being renamed Boston Medical Center - South (BMC South) and St. Elizabeth's Medical Center in Brighton will become Boston Medical Center - Brighton (BMC Brighton). Boston Medical Center Health System made the announcement Thursday. It assumed operations of both hospitals last October after St. Elizabeth's was聽seized by the state of Massachusetts聽using eminent domain. (D, 5/1)

UF Health hospitals and physicians are once again part of the United Healthcare. After months of negotiations, the two sides finalized a new multiyear contract that will restore insurance network access to about 100,000 UF Health patients in Gainesville, Jacksonville and St. Augustine. (Zarran, 5/1)

BayCare Health System broke ground Wednesday on a hospital in north Manatee County, part of a $563 million health care campus that will anchor a 288-acre residential-commercial development. (Mayer, 5/1)

On the slaying of UnitedHealthcare CEO Brian Thompson 鈥

Defense attorneys for alleged CEO killer Luigi Mangione said Thursday in a new court filing that the murder indictment a state grand jury returned against him should be dismissed due to double jeopardy and other alleged violations. The indictment should be dismissed "because concurrent state and federal prosecutions violate the Double Jeopardy Clause, the Fourteenth Amendment's Due Process Clause and Mr. Mangione's constitutional rights against self-incrimination, to meaningfully defend himself, to a fair and impartial jury and to the effective assistance of counsel," defense attorneys wrote. (Katersky, 5/1)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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