Daily recap
The day in a minute
Each day's stories, the news in brief and the figures that matter, on one screen. The last seven days, newest first.
The stories
- Medicare drug plan premiums set to rise 50% for enrollees who stay put, KFF finds The average premium for a stand-alone Medicare drug plan would climb from $34 to $51 a month in 2027 for people who keep their current plan, after federal regulators ended a subsidy that had held premiums down.
In brief
- UnitedHealthcare and NewYork-Presbyterian extend their contract to November 30. UnitedHealthcare said it extended network access to the New York system through November 30, 2026, for most employer, Medicare Advantage and Medicaid plans while the two sides work on a new agreement. Its individual and family plans have been out of network at NewYork-Presbyterian since January 1, 2026.
- Patients report ER bills for urgent care visits at hybrid clinics. STAT reported that patients at hybrid ER and urgent care sites run by private equity-backed Intuitive Health received emergency-level bills for minor visits, including one patient who paid $211 at a urinary tract infection visit and later received a $1,756 bill.
- Kentucky's medical debt relief reaches $153 million. The state program has erased $153 million in medical debt for 67,000 residents, toward a goal of $250 million, using $2.5 million in state money through the nonprofit Undue Medical Debt. Second-round letters are expected around the week of November 9.
By the numbers
- $51 a monthprojected 2027 average premium for stand-alone Part D plans if enrollees keep their current plan, up from $34
- 10.4 millionenrollees without low-income help who would pay a higher premium in 2027, 76% of the group
- 2.4 millionenrollees facing an increase of more than $50 a month, up from 38,000 in 2026
The stories
- ACA open enrollment opens with benchmark premiums up 13% for 2027 Marketplace shoppers face a second straight year of double-digit premium increases, and a higher cap on what they can be asked to pay for care.
In brief
- Baystate completes its takeover of Mercy Medical Center in Springfield, Mass.. Baystate Health closed the $300 million deal with Trinity Health Of New England on Sunday, and the hospital is now Baystate Mercy Hospital. Baystate says patients' insurance coverage does not change; it also owns a health plan, Health New England, with about 160,000 members.
- USA Health and UnitedHealthcare extend talks to Nov. 30 in Mobile, Ala.. UnitedHealthcare commercial and Medicare Advantage members stay in network at University Hospital and Children's & Women's Hospital through Nov. 30. Without a deal, care there may be billed as out of network starting Dec. 1; the system's Providence Hospital has been out of network since Nov. 15, 2025.
- Former patient sues Sen. Roger Marshall's old practice over interest on a medical bill. A class action filed Oct. 29 in Barton County District Court in Kansas alleges that Heartland Regional OBGYN added 18% annual interest to a $3,596 bill for a 2009 delivery, above the 15% cap in Kansas law. Marshall declined to comment to the Kansas Reflector.
By the numbers
- 13%average rise in benchmark silver premiums for 2027, after a 26% rise for 2026
- $704 a monthnational average benchmark premium for a 40-year-old in 2027, up from $625
- $12,000the most a marketplace plan can make one person pay for covered in-network care in 2027
The stories
- Judge strikes federal limit on Medicaid work rule exemption for medically frail adults 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.
- Labor Department rule makes pharmacy benefit managers disclose pay to large employers 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.
- An urgent care asked an uninsured patient for $400 before an epinephrine shot 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.
By the numbers
- 25 states and D.C.the coalition that brought the case
- 80 hours a monthwork or community service required of most expansion adults starting Jan. 1, 2027
- 3.1 million to 3.3 millionyearly drop in Medicaid enrollment CMS projected after the first year of work requirements
The stories
- Medicare raises dialysis payments 2.7% for 2027, and patient coinsurance rises with it A final rule sets next year's per-treatment rate for kidney dialysis, finishes folding phosphate binder drugs into the payment and expands extra pay for low-volume clinics.
By the numbers
- $297.52Medicare's 2027 base payment per dialysis treatment, up from $281.71
- 2.7%estimated increase in total payments to dialysis facilities in 2027
- $50 millionestimated increase in what Medicare patients pay in coinsurance
The stories
- Centene's marketplace membership falls to 3.4 million from 5.8 million a year earlier The insurer lost about 2.4 million exchange members after enhanced federal tax credits expired, and it credited higher prices for improving margins on the people who stayed.
- HCA puts third-quarter cost of patients who lost exchange coverage at $400 million The hospital chain said people who dropped their marketplace plans kept coming for care without insurance, and Tenet reported the same shift two days later.
By the numbers
- 3.4 millionCentene marketplace members on Sept. 30, 2026, down from 5.8 million a year earlier
- 21%drop in Centene's commercial premium and service revenues, to $8.7 billion
- 267,000Molina marketplace members on Sept. 30, 2026, down from 713,000
The stories
- Doctors' offices owned by hospitals can bill 10 times more, Washington Post reports The Washington Post found that routine care in offices bought by hospital systems is often billed at hospital outpatient rates plus a facility fee, raising what patients and their insurers pay for the same service.
By the numbers
- 10 timeshow much higher bills can run when office care is billed at hospital rates with a facility fee
- 57services HCCI compared, every one priced higher in the hospital outpatient setting from 2018 to 2022
- $405average price of a cast billed as outpatient care, compared with $83 in a doctor's office
The stories
- Proposed rule would hold back ACA subsidies until eligibility is verified A federal proposal would stop paying marketplace subsidies while eligibility questions are resolved, starting with 2028 coverage, and officials expect fewer people to enroll as a result.
By the numbers
- 332,500fewer marketplace enrollees each year under the proposal, by CMS's estimate
- $7.6 billionestimated yearly drop in federal advance premium tax credit spending starting in 2028
- $655 a monthaverage advance premium tax credit per enrollee used in CMS's estimate