The Gist Healthcare Podcast Wednesday, July 23, 2025
Jul 23, 2025
Over 20 states are taking legal action against the Trump administration regarding contentious ACA enrollment rules. In another development, two major northeastern health systems, Virtua and Christiana Care, are considering a merger that could reshape the healthcare landscape. Meanwhile, Humana is once again in court, challenging Medicare Advantage star rating reductions and their financial implications. All this while listeners get a sneak peek at upcoming discussions on ACA premium increases.
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States Challenge Narrowed ACA Enrollment
- A coalition of over 20 states says the CMS rule will narrow ACA eligibility and enrollment, risking higher uninsured rates.
- Plaintiffs argue CMS exceeded authority by shortening open enrollment, tightening subsidy reviews, and ending a low-income special enrollment period.
Request A Stay To Prevent Coverage Losses
- Seek court relief to pause parts of the CMS rule while litigation proceeds to prevent immediate coverage losses.
- The plaintiffs requested the court postpone implementation of rule provisions scheduled for August 25th.
Two Systems Explore Regional Merger
- Virtua Health and Christiana Care signed a non-binding letter to explore co-founding a regional not-for-profit system spanning four states.
- They will do due diligence, keep operations separate, and seek regulatory approval before any definitive agreement.