Latest Articles and Analysis

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.

Expiration of enhanced ACA subsidies threatens to increase premiums 75% and reduce marketplace enrollment by millions.

340B program expansion drains billions from state Medicaid budgets while failing to deliver promised drug cost savings.

Pharmacy benefit managers extract billions while adding no value, increasing costs without improving patient access or health outcomes.

Copay accumulator programs exclude patient assistance from deductibles, creating barriers to medication adherence and treatment.

Proposed Medicaid cuts and work requirements threaten coverage for millions including people living with HIV.

FTC enforcement against hospital mergers and implications for costs and access.

Rising medical debt burden among insured Americans and systemic causes.

Healthcare workforce understaffing driven by profit maximization and consolidation.

CMS's $9B remedy to hospitals after SCOTUS 340B ruling lacks enforcement of charitable care requirements.

Hospital price transparency and 340B lack accountability while patients face medical debt.

Only 35% of privately insured and 23% of Medicaid patients initiate HCV treatment due to payer barriers.

PrEP access remains limited by payer practices like prior authorizations despite ACA coverage requirements.

Biden's SOTU addresses harm reduction, endorses MAT Act; limited HIV-specific programming focus.

Medication abandonment disproportionately affects Black patients; PrEP users 41% more likely to abandon.

Copay accumulator programs block patient assistance from counting toward deductibles; HELP Copays Act needed.

FDA extends Cabenuva to 2-month injections but insurance barriers continue to restrict patient access.

Payers restrict HCV treatment through utilization management; patient assistance programs fill the critical gap.

Analyzes CMS marketplace rule changes and Medicaid expansion risks as pandemic emergency declarations end.

Examines CMS's rebate rule on copay accumulator programs that block patient assistance from counting toward deductibles.