Melanie MacEachern, Author at The Hertel Report

Melanie MacEachern

Freelance writer with skills and knowledge in healthcare policy, reproductive justice and art history. Skilled administrative assistant. Graduated from University of Michigan.

Author's Posts

Health Insurers Set To Hike ACA Premiums by Double Digits

National News

Congressional Republicans Hope to Get Democrats to the Table for Healthcare Reform

Senate Republicans are looking to push a bipartisan bill focused on healthcare. The bill would purportedly include pharmacy benefit manager and Medicare Advantage reform, in exchange for the extension of some healthcare subsidies to entice support from Congressional Democrats. Many are cynical that bipartisan dealmaking could be on...

CMS Rules

20 States File Suit Against Trump Administration for ACA Eligibility Rule, Kicking Off Dreamers

Last week, a coalition of Democratic-led states filed suit against the Trump administration's Centers for Medicare and Medicaid Services (CMS), in response to a final rule issued by the agency. The rule adds acute regulations to the Affordable Care Act (ACA) marketplace, which the plaintiffs allege will cause the number of uninsured...

National News

Humana Refiles Case Against CMS; Prior Authorization Scrutiny Continues

Medicare Advantage insurers are having a tough time. Humana was forced to refile its lawsuit against the Centers for Medicare and Medicaid Services (CMS) over inappropriate star ratings awards as it scales back its use of prior authorizations. Meanwhile, the American Hospital Association (AHA) testified in Congress about the problems...

National News

CMS to End Continuous Medicaid Enrollment Waivers, Investigates Double Enrollment

This week, the Centers for Medicare and Medicaid Services (CMS) announced plans to crack down on double-enrollment in Medicaid and end demonstration waivers for continuous enrollment in Medicaid. CMS sent letters to states notifying them that it will end 1115 demonstration waivers that allow people to continuously enroll in Medicaid...

National News

Elevance Punished by Investors for Revising Projected Share Growth

Wall Street thrashed Elevance Health's stock after it cut its profit guidance for the year due to increased healthcare use and issues with government payers. Financial expectations for the healthcare market are low and continue to fall. Elevance executives attempted to delicately break the news that it would need to adjust...

Arizona News

HHS Restructuring Takes Effect Following SCOTUS Ruling - DOGE Impacts IHS Services in Arizona

Firings have resumed at the Department of Health and Human Services (HHS) following a Supreme Court order on July 8 allowing federal restructuring to proceed. Over 10,000 layoffs have remained unclear since HHS Secretary Robert F. Kennedy, Jr. made his announcement regarding the restructuring of the department in March. Employees...

CMS Rules

Proposed OPPS Rule Includes Expansion of Site Neutral Payments

This week, the Centers for Medicare and Medicaid Services (CMS) published its 2026 Outpatient Prospective Payment System (OPPS) proposed rule which would raise reimbursement for hospitals and ambulatory surgical centers (ASCs) by 2.4%. The proposal also puts forward a site-neutral policy, which would allow CMS to reimburse at the same...

CMS Rules

CMS Issues 2026 PFS Proposed Rule

The Centers for Medicare and Medicaid Services (CMS) proposed the first pay boost for physicians in five years in its proposed 2026 Physician Fee Schedule (PFS). The proposed rule also contains means to curb spending and introduces billing codes for behavioral health and chronic disease. Physicians groups have warned for the past five...

National News

Measles Case Count Reaches Worst Level of Spread Since 2000

Measles continues to spread throughout the U.S., reaching its highest level of spread since 2000 due to vaccine skepticism. Measles is preventable through the vaccine, but it isn't treatable in that there is no medication to treat the specific virus, an infectious disease specialist with the Cleveland Clinic explained to WKYC. Kids...

National News

Trump Administration Ends LGBTQ Suicide Prevention Hotline

The Trump administration will end the federal government's contract for specialized suicide prevention support for the LGBTQ community. The suicide prevention hotline was provided by the Trevor Project, an organization that supports LGBTQ youth through free, specialized care. Reuters reports that the White House Office of Management...

Arizona News

Arizona Patients, Providers Worry about OBBBA Fallout

Healthcare providers across the nation and in Arizona are bracing for the potential impacts from Medicaid cuts as lawmakers scramble to clean up the big, ugly mess caused by the One Big Beautiful Bill Act (OBBBA). Although more than two million Arizonans rely on and receive health coverage from the Arizona Health Care Cost Containment...

Arizona News

Trump Signs One Big Beautiful Bill Act, Cutting Health Spending by $1T

Last week, President Donald Trump signed the GOP's One Big Beautiful Bill into law, representing the single largest cut to government health programs in history. The Medicaid cuts will not be evenly distributed and some states will be more significantly impacted than others. Virginia, Louisiana, Nevada, Illinois and New Jersey are...

National News

ISSUE BRIEF: Challenges in the Biologics Market

Last week, the Department of Health and Human Services (HHS) Assistant Secretary of Planning and Evaluation (ASPE) Office of Science and Data Policy published an issue brief on the U.S. Therapeutics Biologics Market. According to the ASPE paper, biosimilars enter the market with less than half of the overall market share and are...

Reports & Surveys

Interactive Map Shows Use and Variation in ACA Stand Alone Dental Plans

Last week, the Center on Health Insurance Reforms (CHIR) published an interactive map based on Centers for Medicare and Medicaid Services (CMS) data on dental coverage across states. Georgetown University CHIR researchers compiled CMS data from the ACA Marketplace in 2024 to find and analyze insurer marketplace participation and...

National News

SCOTUS Allows HHS Restructuring and Firings While Cases Pend

Last month, a lower federal court ruled the Department of Health and Human Services (HHS) must halt its mass firings and structural reorganizations, but the U.S. Supreme Court intervened to allow the restructuring to continue. Last week, U.S. District Judge Melissa DuBose granted a preliminary injunction to the coalition of attorneys...

National News

AAP and Others Sue HHS Secretary Over COVID Vaccine Guidance

Six medical groups, including the American College of Physicians and the American Public Health Association, have filed suit against Health and Human Services Secretary Robert F. Kennedy, Jr. for changes to vaccine recommendations that he personally directed. On May 19, Kennedy tweeted that the COVID-19 vaccine would no longer be...

National News

MA News - HCSC Cigna Rebrand, Alignment Wins Stars Fight & Lawmakers Propose Auto Enrollment

The Health Care Service Corporation (HCSC) has rebranded the Medicare Advantage plans it purchased from Cigna. A federal court rules in favor of Alignment and against the Centers for Medicare and Medicaid Services (CMS). A new bill introduced in Congress would automatically enroll seniors in Medicare Advantage. The new HCSC Medicare...

National News

SCOTUS Rules ACA Preventative Services Task Force Constitutional

In one of its final rulings of the season, the Supreme Court decided 6-3 that the U.S. Preventative Services Task Force continues to hold the authority to determine the preventative services that insurers are required to cover under the Affordable Care Act. The ruling was issued in the case Kennedy v. Braidwood Management, which...

National News

Centene Revokes 2025 Guidance After Projections Tank

Centene threw out its earnings guidance for the year after projections showed that the company will make $1.8 billion less than expected through the exchange risk-adjustment program. In a news release on Tuesday, Centene announced that a report by the independent actuarial firm Wakely found that 22 of the company's 29 Marketplace...

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