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A 221% premium spike. Twelve million fewer Marketplace enrollees. Record insurer profits. The three converging shocks hitting American health coverage in 2026–2027 fall hardest on people living with HIV, hepatitis C, and substance use disorder — the populations for whom a coverage lapse is a treatment lapse.

CDC's 2024 Medical Monitoring Project is the last full look at people living with HIV before H.R. 1 reshaped Medicaid and food assistance — and it lands just as the survey infrastructure that produces it may have lost an entire year of data. Here is what the numbers show, what the next cycle may miss, and what policymakers must do before December 11.

Community isn't a talking point — it's a standard of conduct. When a CANN team member's uninsured friend suffered a massive stroke, the organization's response put its own values to the test, and made visible why healthcare access reform can't wait.

Louisiana directed a larger share of its opioid settlement to elected sheriffs than any other state — and required nothing in return. Three years of reporting confirm what that decision cost: millions spent on license-plate readers and defibrillators while the people the money was won for keep dying.

Being alive after addiction doesn't mean the system worked — it often means you got lucky. This National Recovery Month, CANN's Travis Roppolo draws on his own recovery from chemsex and stimulant use to map the gaps in trauma care, behavioral health parity, and stimulant treatment that keep survival a matter of privilege rather than policy.

The instruments to close the HIV and hepatitis C epidemics already exist: SHIELD, MMP, and the HCV clearance cascade have each lit up exactly the stage they were built to see. The gaps that remain aren't failures of science; they're failures of funding, and the December 2026 budget deadline will force a choice about whether we keep the capacity to measure at all.

When public employers adopt alternative funding programs to cut specialty drug costs, they don't erase the bill — they move it to ADAPs and Ryan White, the safety-net programs built for people who have no coverage at all. Workers living with HIV pay the difference in delay, disruption, and risk.

For the first time, federal rules forced insurers to publish prior authorization metrics—and the numbers confirm what patients have long experienced: denials are common, reversals are frequent, and almost no one fights back. The data opens the black box partway. It does not dismantle the barrier inside.

Congenital syphilis has risen for 12 consecutive years — not because we lack a cure, but because the only approved treatment is in shortage, coverage is shrinking in the hardest-hit states, and immigration fear is keeping pregnant people away from the prenatal care where screening happens. The tools exist. The system keeps failing to deliver them.

Formulary cuts, fibrosis staging requirements making a comeback, and the near-disappearance of HCV charitable assistance programs — CANN's Q3 2026 HIV/HCV Co-Infection Watch maps a deteriorating access landscape for people living with HIV/HCV co-infection.

Most people who received an HIV diagnosis had already been sitting in a provider's office in the year before — and left without a test or a PrEP conversation. CDC's SHIELD study maps exactly where the healthcare system had contact and did nothing with it, and the fixes are specific enough to act on now.

Prescription Drug Affordability Boards are operating in states across the country, but their primary tool — Upper Payment Limits — threatens pharmacies, Medicaid programs, and the patients they're supposed to help. The evidence is mounting that UPLs are the wrong solution to a real problem.

More than half of people living with HIV in the U.S. are now 50 or older—a public health success that demands more than good referral networks. Building HIV-inclusive aging organizations means developing real capacity before someone ever needs to be sent somewhere else.

For the first time, a finite course of therapy has produced a functional cure for chronic hepatitis B in large-scale phase 3 trials, but the communities carrying the heaviest burden of this disease are also the least likely to be screened, diagnosed, or insured. Whether this milestone translates into population-level progress is a policy question, not a scientific one.

A proposed OMB rule would let political appointees veto or cancel federal research grants, dismantling the peer-review system and targeting the disparate-impact analysis that maps where HIV concentrates and why. For people living with HIV, that research is the foundation of Ending the HIV Epidemic. The comment period closes July 13.

On April 24, 2026, a nurse in Ituri Province in the Democratic Republic of the Congo (DRC) developed a fever. She died three days later. Her samples were tested locally and returned negative, because...

The Centers for Disease Control and Prevention (CDC) released its National HIV Prevention and Care Objectives: 2026 Update on May 18, 2026, presenting the most recent national picture of the U.S. HIV...

On May 4, 2026, Health Secretary Robert F. Kennedy Jr. closed a daylong Make America Healthy Again (MAHA) Institute summit on mental health and overmedicalization by announcing a federal initiative...

On April 24, 2026, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a Dear Colleague letter that withdraws federal funding eligibility from fentanyl test strips, sterile...

Editor's Note: This article was originally published on April 10, 2026, by Lupus Colorado and is republished here with permission. The Patient Affordability Roundtable discussed in this piece was...