Daily edition
Everything The Care Ledger published that day: 3 stories, the news in brief and the figures.
A federal court ruled that the administration narrowed a protection Congress wrote for people with serious health conditions, two months before Medicaid work requirements begin in expansion states.
A Labor Department rule gives large self-insured employers a regular look at the rebates, fees and price spreads their drug benefit managers collect, starting with plan years that begin in mid-2027.
KFF Health News' latest Bill of the Month shows that urgent care centers, which generally fall outside the federal law requiring emergency departments to treat first, can ask for payment before treating a patient in anaphylaxis.
25states and D.C.
the coalition that brought the case
Judge strikes federal limit on Medicaid work rule exemption for medically frail adults
80hours a month
work or community service required of most expansion adults starting Jan. 1, 2027
Judge strikes federal limit on Medicaid work rule exemption for medically frail adults
3.1million to 3.3 million
yearly drop in Medicaid enrollment CMS projected after the first year of work requirements
Judge strikes federal limit on Medicaid work rule exemption for medically frail adults
6months
stay of enforcement on frailty determinations granted to the states
Judge strikes federal limit on Medicaid work rule exemption for medically frail adults
$818.4million a year
estimated transfers from PBMs to self-insured plans and their members through lower drug prices
Labor Department rule makes pharmacy benefit managers disclose pay to large employers
131,102
self-insured group health plans with 100 or more participants covered by the rule
Labor Department rule makes pharmacy benefit managers disclose pay to large employers
72.4million
participants and beneficiaries enrolled in those plans
Labor Department rule makes pharmacy benefit managers disclose pay to large employers
July 1, 2027
plan years beginning on or after this date must receive the new disclosures
Labor Department rule makes pharmacy benefit managers disclose pay to large employers
$400
up-front payment the urgent care required before giving the epinephrine shot
An urgent care asked an uninsured patient for $400 before an epinephrine shot
$605
total bill, including a $40 administration fee and $165 for the visit
An urgent care asked an uninsured patient for $400 before an epinephrine shot
$175
approximate cost of a generic EpiPen, according to GoodRx
An urgent care asked an uninsured patient for $400 before an epinephrine shot
185million
urgent care visits in 2025 across more than 15,000 centers, per the Urgent Care Association
An urgent care asked an uninsured patient for $400 before an epinephrine shot
