The Gist Healthcare Podcast Wednesday, August 27, 2025
Aug 27, 2025
Recent judicial actions have paused changes to the Affordable Care Act exchanges, sparking discussions about healthcare regulations. A concerning trend shows more Medicare patients leaving hospitals against medical advice, raising safety alarms. Meanwhile, trust in Medicare Advantage plans is plummeting, driven by lower satisfaction and engagement. Plus, a pharmacy merger aims to challenge traditional pharmacy benefit managers, signaling shifts in the market landscape. Tune in to explore these pressing health policy issues!
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Court Pauses Major ACA Exchange Changes
- A federal judge paused many provisions of CMS's new ACA rule, blocking stricter eligibility checks, penalties, and coverage loss policies.
- The injunction leaves some technical rate and income-data timing changes intact while the litigation proceeds.
Rule Could Cost Millions Their Coverage
- CMS estimates the full rule could cause about 1.8 million people to lose coverage if implemented.
- Multiple lawsuits from cities and states argue the rule will raise costs and reduce access for enrollees.
Rising AMA Discharges Raise Risk And Costs
- Medicare discharges against medical advice rose nearly 50% from 2006 to 2023 and spiked during COVID-19.
- Patients leaving against advice faced over twice the risk of 30-day readmission or death, increasing costs and harms.