Health Action Network

22/09/2025

Good news: getting the right care, at the right time, in the right setting is becoming faster and simpler. 🩺✅

Prior authorization works by checking tests, procedures, and prescriptions against clinical guidelines. This helps prevent errors, avoid unproven treatments, and keep care safe. But let’s be honest: there is room for improvement.

In June, health plans made a groundbreaking commitment to streamline the process and make it faster.

Today, many electronic requests are approved in real time, most others within 72 hours, and emergency care never requires prior authorization. New digital tools are also saving doctors time — meaning more focus on patients, less on paperwork.

And to be clear: AI is only being used to speed things up. Licensed clinicians always make the final decisions about denials.

Bottom line: prior authorization is still an important safeguard, but thanks to innovation and new commitments, it’s becoming more patient-friendly than ever.

14/09/2025

AHIP warns 2026 premiums face pressure from medical inflation, drug costs, regulatory shifts & a potential end to enhanced tax credits—with Open Enrollment on Nov 1. Meanwhile, CSRxP: generics/biosimilars saved $467B in 2024. Congress should act.

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Each year, health plans are required to submit proposed premium rates to state and federal regulators based on projected future health insurance costs for…

13/09/2025

Provider consolidation + growing demand for GLP-1s are shaping tomorrow’s premiums. The time to act is today to protect affordability in 2026. Read AHIP’s analysis:

Each year, health plans are required to submit proposed premium rates to state and federal regulators based on projected future health insurance costs for…

12/09/2025

Congress has a window to keep coverage affordable by extending enhanced premium tax credits. Delay means higher 2026 costs for millions of families. Details from AHIP:

Each year, health plans are required to submit proposed premium rates to state and federal regulators based on projected future health insurance costs for…

12/09/2025

Rising medical inflation, soaring Rx prices & regulatory shifts = big pressure on 2026 individual-market premiums. Policymakers must act now to protect coverage affordability. Full AHIP resource:

Each year, health plans are required to submit proposed premium rates to state and federal regulators based on projected future health insurance costs for…

12/09/2025

📢 ⏰ Open Enrollment starts Nov 1. Without action, families could face higher 2026 premiums. Drivers: medical inflation, drug costs, regulatory changes & a possible end to enhanced premium tax credits. Learn more:

Each year, health plans are required to submit proposed premium rates to state and federal regulators based on projected future health insurance costs for…

19/08/2025

$148B in savings. $145B in value. Every year. That’s what PBMs deliver to keep your meds affordable. Without them? Higher costs for everyone.

Founded in 1920, the NBER is a private, non-profit, non-partisan organization dedicated to conducting economic research and to disseminating research findings among academics, public policy makers, and business professionals.

18/08/2025

Tick...Tick...Tick... ⏰ In 75 days, millions of Americans will be slammed with massive health insurance premium hikes unless Congress takes action to prevent health care tax credits from expiring.

There’s no time for gridlock, no room for excuses. Time's running out for Congress to extend those tax credits when they return from recess! >>> https://americanscovered.org/

08/08/2025

🚨 ACA enrollees could face serious sticker shock this fall as notices warn of premium hikes up to 75%. With enhanced subsidies set to expire, millions may see their health costs soar. Congress needs to act now to prevent a massive spike in premiums!

Read more:

Pressure on Congress to renew expiring enhanced Affordable Care Act subsidies is likely to ramp up this fall as notices of 2026 premium increases go out and consumers get their first warnings that huge rate hikes could be coming.

21/07/2025

The numbers don't lie. Medicare Advantage enrollees spent an average of $3,486 less on out-of-pocket costs and premiums in 2022. That’s 46% less than original Medicare enrollees. Smart coverage choices can make a big difference in your savings! Read more here:https://bettermedicarealliance.org/wp-content/uploads/2025/06/2025-Beneficiary-Spending-Report-2.pdf

18/06/2025

Big Pharma can't shift the blame! A former CEO just spoke out against the pharmaceutical industry's attempt to blame pharmacy benefit managers (PBMs) for high prescription drug prices. The truth? PBMs help drive down costs and improve health outcomes.

Read more:

In case you missed it, a former Big Pharma CEO called the pharmaceutical industry’s attempt to shift the blame game for high prescription drug prices onto pharmacy benefit managers (PBMs) a “weak explanation,” and affirmed the cost-reducing value of PBMs. Speaking with Danish news outlet BØRS...

19/03/2025

🚨 Medicare Advantage is under attack! 🚨 Successive years of cuts to the program are driving up premiums and have already forced 1.3 million seniors off their plans. Medicare Advantage saves taxpayers billions while offering vital benefits like dental, vision, and hearing care.🩺 Read more here >>>

Every day, Elon Musk’s Department of Government Efficiency (D.O.G.E.) is turning up new, outrageous government spending.