"This report provides information on selected health provisions that have expired or are scheduled to expire during the 119th Congress (i.e., calendar years 2025 and 2026). For purposes of this report, expiring provisions are defined as portions of law that are time-limited and will lapse once a statutory deadline is reached, absent further legislative action. The expiring provisions included in this report are any identified provisions related to Medicare, Medicaid, the State Children's Health Insurance Program (CHIP), or private health insurance programs and activities." [R48649 Aug. 27, 2025]  MORE >>

"The lawsuit alleges that the plan's fiduciaries violated ERISA and breached their fiduciary duties by offering employees a medical plan option that provided insufficient value compared to an alternative option offered to employees. The plaintiffs allege that the 'premium' plan option -- which charges higher premiums in exchange for lower deductibles and cost sharing -- is financially dominated by the 'value' plan option because the lower cost sharing does not sufficiently outweigh the higher premium." [Barbich, Lindvall & McFarland v. Northwestern Univ., No. 25‑06849 (N.D. Ill. complaint filed June 20, 2025)  MORE >>

"A federal trial court has temporarily blocked portions of final regulations issued by HHS in June 2025 that were intended to ensure the integrity of the [ACA] Exchanges and the affordability of health coverage.... HHS has acknowledged the court's ruling on its website, confirming the regulatory provisions that will be delayed while the litigation remains pending." [City of Columbus v. Kennedy, No. 25-2114 (D Md. Aug. 22, 2025)]  MORE >>

"[M]ake sure your deliverables are available in multiple formats ... [M]ap out how and when they will be deployed.... Use carrier resources ... After the open enrollment season ends ... Send out an email or newsletter.... Create a survey ... Respond to feedback."  MORE >>

"The cost of health benefits is on pace to increase by 5.8% this year, a sizable jump from the 4.5% rise experienced in 2024 ... This would be the third consecutive year of health care cost growth outpacing overall inflation ... The 5.8% growth rate in 2025 is after accounting for any planned cost-reduction measures. Employers had estimated that their costs would rise by about 8%, on average, if they took no action to lower costs[.]"  MORE >>

"Employers typically finance OPEB obligations through either: [1] a Pay-As-You-Go (PayGo) approach; or [2] prefunding through a dedicated trust. In this article, we will compare these two approaches by highlighting their advantages and drawbacks, and comparing their financial impact through a practical case study. This article is intended to increase awareness in the advantages of prefunding OPEB benefits, while also balancing current budget priorities with long-term fiscal sustainability."  MORE >>

"[R]esearchers from Georgetown University estimate that between 2022 and 2024, the IDR system cost $5 billion to manage. The largest chunk of that is the additional payments from plans to providers, totaling $2.24 billion. That figure also accounts for $1.9 billion in internal costs for payers and providers as well as $656 million in IDR entity fees. Administrative fees were $228 million, according to the analysis."  MORE >>

"Historical experience within and beyond health care teaches that to maximize potential benefits, technological advancements must go beyond point solutions -- that is, tools meant to solve specific, narrow problems -- and occur within systems-level change.... This insight -- that point solutions are likely to underperform their potential without complementary systems redesign -- underscores the need to not only encourage adoption of wearable devices but also reform the systems surrounding their use."  MORE >>

"Kimberly admitted she initialed the distribution terms and didn't claim fraud or any mutual legal mistake. Her objections didn't challenge the substance of the deal -- just side issues. So the court found the agreement binding.... Once material terms are clear, they're enforceable, ... The court didn't hesitate to sanction Kimberly via fee-shifting.... Lawyers aren't helpless just because they withdraw -- they're still owed fair compensation under quantum meruit." [Bennett v. The Prudential Ins. Co. of Am., No. 23-11070 (E.D. Mich. Aug. 26, 2025)]  MORE >>