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The guest host for today's show is Brad Bannon. Brad runs Bannon Communications Research, a polling, message development and media firm which helps labor unions, progressive issue groups and Democratic candidates win public affairs and political campaigns. His show, 'Deadline D.C. with Brad Bannon,' airs every Monday from 3-4pm ET. Brad is first joined by Alex Lawson, Executive Director of 'Social Security Works.' The pair discusses the Trump administration's cut to Medicare Part D plans, status updates on the state of Social Security, and internal ideological struggles within the Democratic party. Then, Brad is joined by Tara Devlin, host of the 'TARABUSTER' podcast. She and Brad breakdown the departure of Karoline Leavitt as Trump's Press Secretary, the dangerous conditions for sailors aboard the U.S.S. Lincoln, mismanagement of the Iran war, and Trump's indifference to the economic suffering of the American people. Brad is on the National Journal's panel of political insiders, is an American political analyst for The Times of India TV, and is a national political analyst for WGN TV and Radio in Chicago and KNX Radio in Los Angeles. Brad also writes a political column every Sunday for 'The Hill.' You can read his new Substack called, 'The Bannon Ballot Blast,' at www.bradbannon.substack.com. His handle on BlueSky is @bradbannon.bsky.social.
Health care feels personal until you try to navigate it and realize how many parts are designed to be confusing. From the Mackinac Policy Conference, we sit down with former Michigan U.S. Senator Debbie Stabenow for a fast, candid conversation about what's working, what's breaking, and what Michigan communities need next.We start with the pressure points she's most concerned about right now: mental health access, Medicaid cuts, and affordability. Stabenow explains why community behavioral health clinics with 24-hour access matter, not just for patients in crisis, but for families, hospitals, and communities trying to keep people out of emergency rooms and jails. We also talk about rural health care in northern Michigan, where hospitals are often the biggest employer and the backbone of local access, yet many are being forced to cut beds, reduce services, or stop delivering babies.Then we zoom out to the national policy fights. Stabenow reflects on the Affordable Care Act, what she would keep, and what she would change, including her push for a public Medicare option to drive real competition. She shares a stark reminder of why “essential health benefits” matter by revisiting the days when pregnancy could be treated like a pre-existing condition and prenatal coverage was far from guaranteed. We close on prescription drug prices, Medicare Part D, and the long-running impact of blocking Medicare from negotiating prices, plus how PBMs add yet another layer of complexity.If you care about Michigan health care, rural hospitals, mental health policy, the Affordable Care Act, Medicaid, and prescription drug costs, this one's for you. Subscribe, share this conversation with a friend, and leave a review so more people can find The Common Bridge.Support the showEngage the conversation on Substack at The Common Bridge!
Broadcast from KSQD, Santa Cruz on 8-13-2026: Dr. Dawn opens by reading an anatomy student's elegy to a body donor, reflecting on how modern medical education has moved away from full cadaver dissection toward pre-dissected specimens and models—and what she believes has been lost in that transition. Dr. Dawn dissects how hospital consolidation has become the primary driver of runaway U.S. healthcare costs. She contrasts a $16,000 knee replacement at Catawba Valley Medical Center with a $40,000 procedure for the same Blue Cross Blue Shield plan an hour away at Asheville's Mission Hospital—a facility formed by the 1998 merger of the town's two acute-care hospitals and later acquired by HCA in 2018. Mission now charges 333% of Medicare rates (versus a 280% benchmark), and state inspectors have issued three "immediate jeopardy" findings since HCA's takeover, consistent with academic findings that hospital care quality drops when competition disappears. She notes that CMS-required price disclosures since 2021 finally make this transparent, and calls for regulatory prevention of hospital mergers—especially not-for-profit to for-profit conversions—in single or two-hospital markets. Dr. Dawn analyzes the 3.1% year-over-year drop in prescription drug prices reported through July—the sharpest decline since 1963. She attributes most of it to Biden's 2022 Inflation Reduction Act, which partially rescinded George W. Bush-era Medicare Part D restrictions that had statutorily prohibited price negotiation, saving taxpayers roughly $6 billion in the first six months of implementation. Additional contributors include GLP-1 compounding competition, blockbuster drugs losing exclusivity, and Bureau of Labor Statistics methodology that swaps generics into the price index six months after brand patent expiration. She calls for consumer-facing apps that help patients shop hospital prices the same way they shop cars. Dr. Dawn covers the emerging science of dormant tumor cells—cancer cells that shed from primary tumors even before diagnosis, hide in bone marrow and lymph nodes, and enter a hibernation state (feeding off cellular residue via autophagy) that shields them from chemotherapy targeting rapidly dividing cells. New York researchers have identified proteins by which lung macrophages actively reinforce dormancy, but immune disruption from COVID-19, influenza, aging, and chronic stress can trigger reactivation. She emphasizes lifestyle protection for cancer survivors: minimal alcohol, Mediterranean diet, and five daily cups of green tea for the EGCG dormancy-maintaining effect seen in cell culture. A caller argues for single-payer healthcare and questions whether Medigap insurance is worth $287 monthly. Dr. Dawn explains the math: for a $100,000 hospital bill, 20% coinsurance is $20,000, making the $2,400 annual premium reasonable catastrophic-risk protection—though skipping it is a defensible bet for very low-utilization patients. She notes those whose income drops to Medi-Cal eligibility often end up with better coverage than middle-class seniors. The same caller then presents a differential diagnosis of himself as likely multiple sclerosis based on ChatGPT consultation, describing balance loss requiring hallway wall-guidance, dramatic vision changes, and fasciculations. Dr. Dawn walks through prompt engineering for medical AI: request differential lists ordered by probability of frequency in the population rather than symptom-fit alone. She notes symmetric symptoms argue against MS, suggests checking electrolytes (particularly calcium), and emphasizes that a physical examination should precede imaging to avoid incidentalomas that trigger cascading invasive workups—cautioning that without a primary care doctor, he lacks an advocate within the system.
Toni explains Medicare Supplements and Medicare Advantage PPO Plans and the benefits each program offers. Toni explains Medicare Part A, Medicare Part B and Medicare Part D. Visit www.tonisays.com for Toni's Medicare information. There's so much good information in this podcast, please be sure to share this podcast with your friends! Recognized by feedspot.com as one of the best Medicare Podcasts in the nation! Write Toni - info@tonisays.com. Toni's book is available at www.seniorresource.com and www.tonisays.com You can call Toni at 832-519-8664 Toni welcomes all Medicare questions. You can find Medicare Moments wherever you find your favorite podcasts, such as: Apple: https://apple.co/44MoguGSpotify: https://open.spotify.com/show/7c82BS4hb145GiVYfnIRsoAmazon Music: https://music.amazon.com/podcasts/884c1f46-9905-4b29-a97a-1a164c97546b/medicare-moments?refMarker=null Toni's new book: Maze of Medicare is now available at www.tonisays.com Combining Scripture with Medicare, it is the only book of its kind. Toni's columns appear weekly in about 100 newspapers across America. If you would like Toni's column to appear in your local paper, or if you would like Toni to speak at an event - contact Toni King at 832-519-8664 Thank you for listening and be sure to tell your friends about Medicare Moments! Blessings!See omnystudio.com/listener for privacy information.
The Medicare Part D Premium Stabilization Demonstration ends in 2027, meaning the temporary cap that kept Part D premiums low will expire and beneficiaries should expect higher, more variable premiums starting with the 2028 plan year. This page explains why the program is ending, who is most exposed, and what steps to take before the change takes effect.
A pilot program has created GLP-1 access for Medicare Part D beneficiaries at a fixed cost of $50. But that's only the first thing to know about how the popular drugs are used for weight loss.
Look Forward breaks down Abdul El-Sayed's hugely contentious primary win in Michigan's Democratic Senate race, a victory for the progressive wing that raises the question of whether centrist Democrats will actually rally behind him or quietly work against their own nominee. Trump is furious at Defense Secretary Pete Hegseth aka "Whiskey Pete" over a missile shortage exposed by the ongoing Iran war, with the military burning through stockpiles faster than they can be replaced.In a stunning diplomatic snub, Iran and Oman are negotiating the future of the Strait of Hormuz entirely without US involvement after Trump spent months treating the region as America's little playground. Medicare Part D subsidies are conveniently set to expire right after the midterms, a timing decision that speaks for itself. Trump is pursuing a nuclear deal with Saudi Arabia despite the kingdom's well-documented terror financing history. Trump Media plans to paywall its API access for Wall Street traders to legalize insider trading.A rare bipartisan housing act became law even though Trump refused to sign it. FCC officials accepted major gifts from Paramount amid merger approval. Trump's own teleprompter operator got caught insider trading on prediction markets. Trump is furious the DOJ dropped a vandalism indictment tied to his Reflecting Pool disaster, and Alabama's favorite MENSA student Tommy Tuberville considers a 30-foot wall around the state to stop immigrants if he's elected governor.Look Forward is a weekly progressive political podcast covering U.S. politics, government policy, Democratic strategy, elections, voting rights, Supreme Court rulings, and political news. Featuring progressive commentary, political analysis, and unapologetic opinions on the fight for democracy. Hosted by Jay and Brad. A TNP Studios production. New episodes weekly on Spotify, Apple Podcasts, YouTube, and all major platforms. For more TNP Studios content, check out The Nerdpocalypse (movie & TV news), Black on Black Cinema (Black film reviews), and Dense Pixels (video game news).
The Friday Five for August 7, 2026: ACA 2027 Certification Updates CY2027 ACA Premium Rate Filings So Far CMS 2027 Medicare Part D Bid Information 2027 Medicare Part B Cost Projections 2027 COLA Estimate Get Connected:
What Party Gets You Closer to the American Dream? Michigan’s primary on Tuesday between a progressive, Abdul El-Sayed, and an establishment candidate, Haley Stevens, mirrors battles that have been playing out across the country. Here’s the question: how left is too left? Maurice Mitchell, National Director of the Working Families Party, joins us to talk about the electability of left-of-left candidates. Him and Angela have a healthy debate about the recent missteps of Seattle’s “far left” mayor Katie Wilson. Join hosts Angela Rye and Bakari Sellers for episode 143 of Native Land Pod. FYSA HEADLINES – Ohio House candidate Max Miller struggles to answer questions about alleged child abuse. – Texas Senate candidate James Talarico answers Angela Rye’s questions about his support for Jasmine Crockett. – The Trump administration is ending the Medicare Part D subsidy in 2027, used to keep prescription drug prices in check. – Forbes has put a list of the 20 “biggest money-getters” in podcasting. No Black women made the list. – Haitians in Ohio have been summoned to DHS field offices and outfitted with ankle monitors. – Microsoft warns travelers about using hotel wi-fi, claiming that Russian hackers are using them to gain access to devices. – Capital One closed hundreds of bank accounts associated with President Trump back in 2021 for “anti-money laundering reasons.” – Darline Graham says she stands with Trump “100%” during South Carolina’s debate for Senate candidates. LINKS AND RESOURCES Haitians Force to Wear Ankle Monitors: https://www.the-independent.com/news/world/americas/us-politics/haiti-tps-ohio-ice-ankle-monitors-b3027284.html Working Families Party: https://workingfamilies.org/ IN THIS EPISODE: 00:00:00 Intro 1:05 Rundown 3:55 FYSA Headlines 31:40 Maurice on Third Parties 35:20 Missouri Primaries 42:10 Michigan Primary Drama 1:02:00 Seattle Mayor’s Missteps 1:12:05 CTAs SUBMIT A QUESTION Have a question for our hosts? Send a 60-second video to @nativelandpod and they may answer it on the show! Tutorial video for submitting questions: http://www.instagram.com/reel/C5j_oBXLIg0/ We are 89 days away from the midterm elections. Welcome home y’all! —--------- We want to hear from you! Send us a video @nativelandpod and we may feature you on the podcast. Instagram X/Twitter Facebook NativeLandPod.com Watch full episodes of Native Land Pod here on YouTube. Native Land Pod is brought to you by Reasoned Choice Media. Thank you to the Native Land Pod team: Angela Rye as host, executive producer, and cofounder of Reasoned Choice Media; Andrew Gillum as host and producer, Bakari Sellers as host and producer, and Lauren Hansen as executive producer; LoLo Smith is our research producer, and Nikolas Harter is our editor and producer. Special thanks to Chris Morrow and Lenard McKelvey, co-founders of Reasoned Choice Media. Theme music created by Daniel Laurent.See omnystudio.com/listener for privacy information.
August 4, 2026 ~ All eyes on the Michigan primary. Taking a closer look at the Medicare Part D subsidy being repealed. President Trump gives Iran a final warning. Lawsuits being filed over Cyclosporiasis outbreak and the day's biggest headlines. Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.
Dr. Juliette Cubanski, Vice President and Director of the Program on Medicare Policy at KFF, joins Lisa Dent to assure listeners that Medicare Part D isn’t ending and explain what changes have actually happened. She clarifies that what ended was extra subsidies, received by certain Part D plans, that helped people with Medicare pay for […]
August 3, 2026 ~ Full Show: Kevin examines major developments at home and abroad, including President Trump's decision to halt additional strikes on Iran, the stunning trade of Tigers ace Tarik Skubal to the Dodgers, and the latest outlook for Michigan's primary elections. The show also features a congressional campaign update from John Goci, a preview of the Brews & Barbecue Festival in Westland, an important discussion about changes to Medicare Part D, and this week's All Talk All Star, Anne Vanker of the Flynn Michael Foundation Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.
August 3, 2026 ~ University of Michigan health policy expert Mark Fendrick explains the Trump administration's decision to end the temporary Medicare Part D premium stabilization program and what the change could mean for seniors and prescription drug costs. Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.
Humana will reduce its Medicare Advantage footprint again in 2027. The Centers for Medicare & Medicaid Services will end a Medicare Part D premium stabilization program. And the American Red Cross has declared a national blood supply crisis. Listen to the latest episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.
Federal officials have announced plans to phase out Biden-era Medicare Part D premium subsidies, shifting policy away from previous administration programs. In this clip from the Rational Boomer Podcast, we break down what Medicare Part D is, why the administration argues current structures favor private insurance carriers, and how these changes could impact your prescription drug costs and out-of-pocket expenses.
Build your pipeline with Lead Heroes' call-verified, exclusive insurance leads and take advantage of the Freedom Sale before it's gone. https://leadheroes.com/ In this episode of Seven Figures Or Bust, Christian Brindle and Glen Shelton separate fact from fiction surrounding the 2027 Medicare Part D subsidy changes and the headlines claiming Part D is ending. They explain what the subsidy actually did, why misinformation has spread so quickly, and what Medicare agents and beneficiaries should really expect heading into AEP. Plus, they break down Humana's announcement that up to 600,000 Medicare Advantage members could be affected by market exits, discuss what it means for the industry, and share their predictions for the 2027 enrollment season. If you want the facts behind the headlines and practical insights for navigating the changes ahead, this episode is one you won't want to miss.
Let's talk about Trump ending Medicare Part D subsidies....
Wednesday, July 29, 2026 Today, Senator Cornyn says he won't vote to advance Todd Blanche's nomination without a written rescission of the Slush Fund and tax immunity; Governor Beshear has written another letter to Mitch McConnell demanding he prove he's fit to serve or resign; the Knight Institute and American Oversight have filed reply briefs with the 11th Circuit in the case of Volume II of Jack Smith's final report; Rep. Max Miller has been credibly accused of assaulting his ex-wife and holding a gun to her head; the Trump administration is trying to get a hold of our personal emergency room medical records while simultaneously ending Medicare drug plan subsidies; new polling shows people don't like Trump's tax bill; Senate Democrats are pressing Todd Blanche on the New York Times subpoenas; newly uncovered grand jury testimony in the Davey Hearn case has led to his legal team demanding the grand jury materials; plus Allison delivers your Good News. Thank You, Upwork.com Visit Upwork.com right now and post your job for free. The Trump Epstein Memorial Bookmobile The Daily Beans is proud to partner with Miles Taylor and our friends at DEFIANCE.org For a limited time, members of the Daily Beans community can receive a FREE 3-month full membership to DEFIANCE.org and gain access to one of the fastest-growing pro-democracy movements in America. Join here: https://www.defiance.org/beans Join The Daily Beans and give a gift today to ensure The Trevor Project can continue its crucial work in the face of continued challenges. Donate to The Trevor Project - Daily Beans Podcast The Latest Breakdown→ DOJ Must Hand Over Internal Emails About NYT Subpoenas StoriesTalarico leads Paxton by 5 points in new poll of Texas' U.S. Senate race | Texas Tribune Blanche vote could be postponed, Cornyn says - Live Updates | POLITICO Senate Democrats Press Blanche on Times Subpoenas | NYT Backlash surges over Trump judge's order to hide secret DOJ files | Alternet.org Kentucky governor tells Mitch McConnell: Prove you can serve or ‘resign' | NBC News MAGA Rep. Allegedly Assaulted Wife, Put Gun to Her Head. Republicans Don't Care | Rolling Stone Trump administration demands hospitals share emergency room records | CNN Trump Administration to End Medicare Drug Plan Subsidy | Wall Street Journal Poll: Even Trump voters aren't very impressed by the GOP's tax overhaul | POLITICO Witness in Reflecting Pool case conceded damage before canoeist touched water | NBC News Good TroubleImpeach Vought Good Trouble - Gov. 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Medicare beneficiaries can get their Part D late enrollment penalty waived, reduced, or appealed — covering the three main routes: qualifying for Extra Help/LIS, proving you had creditable coverage, and filing a formal appeal if an administrative error caused the delay
The Centers for Medicare & Medicaid Services is expanding access to GLP-1 medications through the new Medicare GLP-1 Bridge program. Eligible beneficiaries will be able to receive the medications for $50 a month, though not everyone enrolled in Medicare will qualify. Subscribe to our newsletter to stay informed with the latest news from a leading Black-owned & controlled media company: https://aurn.com/newsletter Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
Can Medicare patients get GLP-1 medications like Wegovy and Zepbound for $50 per month through the new Medicare GLP-1 Bridge Program?In this episode, Zoe is joined by Dr. Matthew Weiner and Deidre, FNP, to break down what Medicare patients need to know about the CMS Medicare GLP-1 Bridge Program. They explain who may qualify, why Medicare Part D coverage matters, and why the process is more complicated than simply getting a prescription.Deidre walks through the eligibility requirements, including BMI, prediabetes, cardiovascular disease, uncontrolled hypertension, sleep apnea, diabetes, and fatty liver disease. She also explains why some patients may not be able to use the Bridge Program if their GLP-1 medication can already be covered through their regular Medicare Part D benefits.They also discuss the two-step prior authorization process, the $50 monthly copay, why that copay may not count toward a deductible, and why documentation for a structured nutrition and lifestyle program is required.Most importantly, the team explains what patients should realistically expect as the program rolls out, why delays and confusion are likely at first, and how Pound of Cure is preparing to help eligible Arizona patients navigate access to GLP-1 medications.
Medicare's new GLP-1 Bridge Program gives eligible retirees access to Wegovy and Zepbound for $50 a month — but there are three financial catches worth knowing before you enroll.In this episode of the Secure Your Retirement Podcast, Radon and Murs discuss one of the biggest Medicare developments of 2026 — the new GLP-1 Bridge Program, launching July 1, which allows eligible Medicare beneficiaries to access popular GLP-1 weight loss medications like Wegovy and Zepbound for a flat $50 copay per month. Joined by Peace of Mind Wealth Management's in-house Medicare specialist Sean Southard, they break down exactly what this program is, who qualifies, how the approval process works, and what the financial implications look like for retirees on fixed incomes.Listen in to learn about the three financial angles every retiree needs to understand before enrolling in the GLP-1 Bridge Program, including why that $50 copay sits completely outside your normal Medicare Part D protections, what happens when the program ends in December 2027, and how GLP-1 medications and Medicare prescription drug coverage fit into a broader retirement planning conversation around healthcare costs, budgeting, and long-term affordability.In this episode, find out:What GLP-1 medications are, why Medicare historically excluded them for weight loss, and what changed in 2026 to make the GLP-1 Bridge Program possibleWho qualifies for the program based on BMI and health conditions, and how your doctor submits a prior authorization request through Medicare's centralized systemWhy the $50 flat copay does not count toward your Medicare Part D deductible or annual out-of-pocket maximum, and what that means for your retirement budgetWhat retirees need to plan for when the program's temporary status ends in December 2027 and costs could jump significantlyThe health considerations and side effects of GLP-1 medications that matter most for older adults, and why this conversation belongs with your doctor and your financial plannerTweetable Quotes:"Retirees need to avoid assuming that this benefit program is going to be permanent forever. Plan for what happens if that $50 copay jumps back up to several hundred dollars a month." — Murs Tariq"This is both a healthcare conversation and a financial planning conversation. Retirees should evaluate long-term affordability, potential future coverage changes, and how chronic disease management fits into an overall retirement plan." — Shawn SouthardResources:If you are in or nearing retirement and you want to gain clarity on what questions you should be asking, learn what the biggest retirement myths are, and identify what you can do to achieve peace of mind for your retirement, get started today by requesting our complimentary video course, Four Steps to Secure Your Retirement!To access the course, simply visit POMWealth.net/podcast.
We break down Medicare's brand-new GLP-1 Bridge Program and explain why headlines are both true and incomplete. We lay out the real eligibility rules, the $50 copay promise, and the smarter questions to ask so you and your clinician can find the right coverage pathway. • why Medicare historically excludes weight loss medications and what changed with modern obesity medicine • what the GLP-1 Bridge Program is designed to do and why it is not universal coverage • the $50 copay detail and why office visits labs and deductibles can still affect total cost • who does not qualify because another Medicare Part D pathway may already apply • the three eligibility “doors” based on BMI and specific risk conditions • which GLP-1 medications are included at the time of recording and the planned program timeline • how to prepare for an appointment and the exact phrasing that helps your clinician pick the right route • why checking CMS and staying current matters as rules evolve You can send us an email, you can find us on Threads, follow us on Instagram, or leave us some fan mail.Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply.Support the showProduction and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RNArtwork Rebrand and Avatars:Vantage Design Works (Vanessa Jones) Website: https://www.vantagedesignworks.com/Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qrOriginal Artwork Concept: Olivia Pawlowski
Stacie Dusetzina is a professor of health policy and of cancer research at the Vanderbilt University School of Medicine. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. S.B. Dusetzina. Access to GLP-1s for Medicare Beneficiaries — A Bridge to Nowhere? N Engl J Med 2026;394:2385-2387.
Summary Most people know Medicare costs money in retirement, but few understand how much their income level affects what they actually pay. In this episode, Wade Borth unpacks IRMAA, the income-related surcharge that can quietly add $162 to $650 or more per month to your Medicare premiums, depending on what you earn. Wade walks through who gets hit, what counts as income in the calculation (including surprises like municipal bond interest and Social Security), and how a single dollar over the threshold can cost you hundreds of thousands of dollars over time. He also explains how properly structured whole life insurance creates an income stream that falls outside the IRMAA calculation, giving retirees a meaningful planning advantage. Key Takeaways IRMAA can add hundreds of dollars per month to Medicare premiums, and a single dollar over the income threshold triggers the full surcharge with no gradual phase-in. Every dollar of the surcharge has a compounding cost. That extra $162 per month, grown at 4% over 20 years, is worth nearly $60,000 in real wealth. Income sources many people overlook in the IRMAA calculation include capital gains, Social Security income, municipal bond interest, rental income, and Roth conversions. IRMAA looks back two years, so a one-time income spike follows you into retirement longer than most people expect. Properly structured whole life insurance, when funded correctly, provides an income stream through policy loans that does not count toward the IRMAA calculation, giving retirees real choices when managing retirement income. Links and Resources Sage Wealth Strategy: sagewealthstrategy.com Keywords IRMAA, Medicare premiums, income-related monthly adjustment amount, retirement planning, Medicare Part B, Medicare Part D, retirement income, whole life insurance, infinite banking concept, IBC, policy loans, capital gains in retirement, Roth IRA withdrawals, 401k withdrawals, Medicare surcharge, retirement mistakes, Wade Borth, Sage Wealth Strategy, wealth erosion retirement, family banking Episode Highlights [00:00:00 - 00:01:32] Wade opens with a lunch conversation where a friend approaching retirement had no idea how IRMAA would affect his Medicare costs. [00:05:15 - 00:08:17] Wade explains the $218,000 joint income threshold and how IRMAA brackets step up in full increments, not gradually. [00:08:18 - 00:09:21] One dollar over the threshold adds $162 per month to a couple's Medicare premium, a 40 percent increase with no phase-in. [00:09:22 - 00:12:24] At a 4 percent growth rate, that extra $162 per month is worth $60,000 over 20 years. At the top bracket, the 20-year cost reaches $238,000. [00:12:25 - 00:17:03] Wade walks through every income source factored into the IRMAA calculation, including capital gains, Social Security, municipal bond interest, and Roth conversions. [00:17:04 - 00:19:35] HSA distributions and Roth IRA withdrawals do not count toward IRMAA, creating real planning flexibility for retirees who hold these assets. [00:19:36 - 00:23:46] Properly structured whole life insurance policy loans fall outside the IRMAA calculation, giving retirees an income source they can draw from without triggering the surcharge.
Turning 65 opens a new season of life—and with it comes some of the most important financial and healthcare decisions you'll ever make. In this episode of Finishing Well, Certified Financial Planner Hans Scheil and co-host Robbie Dilmore continue their Financial Plan Series by exploring Medicare, IRMAA (Income-Related Monthly Adjustment Amount), and how these choices fit into a comprehensive retirement strategy. Hans walks through the key Medicare decisions every retiree faces, including the differences between Original Medicare and Medicare Advantage plans, the importance of Medicare Supplement coverage, and why your initial enrollment period can create opportunities that may never come again. Using the real-life financial planning case of Tom and Susan, listeners will learn how Medicare decisions affect healthcare costs, retirement income planning, tax strategies, and long-term financial security. The discussion also covers Medicare Part D prescription drug plans, common enrollment mistakes, and strategies for managing or potentially reducing costly IRMAA surcharges. Through personal experiences and practical examples, Hans and Robbie highlight how choosing the right Medicare coverage can protect both your health and your retirement savings. Whether you're approaching age 65, already enrolled in Medicare, or helping a loved one navigate retirement healthcare decisions, this episode provides valuable insights to help you make informed choices and avoid costly mistakes. Topics Covered: Original Medicare vs. Medicare Advantage Medicare Supplement (Plan G) coverage Open enrollment opportunities and deadlines Medicare Part D prescription drug plans Understanding IRMAA and Medicare premiums Healthcare planning as part of a complete retirement strategy Real-world retirement planning case study Learn how thoughtful Medicare planning can help you finish well in retirement.
In Episode 136 of DC EKG, Joe Grogan hosts Tom Barker, a top drug-pricing attorney at Foley Hoag and former acting general counsel of Health and Human Services (HHS) under the Bush administration. Tom helped implement Medicare Part D and now advises drugmakers and policymakers on complex pricing issues. The episode traces 20 years of policy: what went right with Part D, what the Inflation Reduction Act (IRA) did, and what effective policy should look like.Tom explains that Part D's success rested on three pillars: private plans only, limited government control over benefit design, and a non-interference clause barring the government from intervening in negotiations among plans, pharmacies, and manufacturers. Competition worked and premiums stayed low, until the government asserted more control and weakened those pillars. The IRA, he argues, was a 16-year Democratic effort to repeal non-interference, creating price controls disguised as negotiations.The Trump administration has taken a different tack, focusing not on the IRA but on MFN and Globe Guard models pegged to other developed countries. Tom also breaks down the 340B program, now the country's second-largest expenditure program, and the fight between manufacturers and covered entities over contract pharmacies.His prescription is simple: let competition work. Speed FDA approval of generics and biosimilars, and trust the marketplace over price controls. He points to hepatitis C, where prices fell sharply once competition entered.In This ConversationThe three pillars that made Part D successful for 20 yearsHow non-interference kept government from setting drug pricesThe IRA as a 16-year Democratic push to repeal non-interferenceWhy Tom calls the IRA price controls disguised as negotiationsThe Trump administration's focus on MFN and Globe Guard pricing340B and the battle between manufacturers and covered entitiesThe Chevron repeal's impact on drug pricing lawHRSA's proposed rebate model and ongoing 340B litigationWhy effective policy means competition, not controlsTom's work helping North Korean defectors and refugeesKey Timestamps1:51 Tom's background at HHS and CMS2:30 The three pillars of Part D's success5:10 Why Democrats wanted to repeal non-interference5:55 Ted Kennedy's compromise and bipartisan votes11:38 The IRA as a 16-year repeal attempt12:03 What the IRA changed in Part D15:02 IRA negotiations vs. real negotiations16:25 How the excise tax makes it no real negotiation21:32 Trump's focus on MFN and Globe Guard25:37 340B's history back to 199128:45 340B as the second-biggest expenditure program29:30 Manufacturer vs. covered-entity acrimony33:18 The Chevron repeal's impact on pricing34:54 HRSA's rebate model, the next step on 340B35:40 The lawsuit over "patient" in 340B38:18 Tom's advice: let competition work39:30 Hepatitis C: competition drives prices down40:34 Competition for gene therapies and CRISPR41:36 Tom's work for North Korean defectors44:49 Sponsoring Free North Korea RadioMedicare Part D, drug pricing policy, Inflation Reduction Act, non-interference clause, 340B program, MFN pricing, Globe Guard pricing, pharmacy benefit managers, covered entities, contract pharmacies, biosimilars, generics, federal drug pricing, government price controls, Tom BarkerAbout the GuestTom Barker is a partner at Foley Hoag in Washington, DC, and one of the country's top drug pricing attorneys. He served as acting general counsel of HHS and chief legal officer at CMS under the Bush administration, where he helped implement Part D from its inception. He is now a go-to expert on drug pricing, and helps North Korean defectors navigate US immigration law.Podcast: DC EKG with Joe Grogan Episode: 136 Guest: Tom Barker Sponsor: Survivors for Solutions - https://survivorsforsolutions.org Executive Producer: John "CZ" Czwartacki, DC EKG Podcast Producer: Stay on Course Studios - https://www.stayoncourse.studio
To mark PQA's 20th anniversary, PQS Managing Director Todd Sega sits down with Laura Cranston, the founding CEO who built PQA from a one-person shop into the most influential pharmacy quality measurement organization in the country.Laura traces PQA's origins to April 2006, just months after Medicare Part D launched, talks about the alliance's growth, the groundwork for what would eventually become the EQUIPP platform, and the broader pharmacy quality infrastructure in use today.The conversation turns to the seismic shift in the CY2027 Final Rule and what it means that pharmacy-accountable clinical measures now command roughly 50% of a Medicare Advantage plan's Star Rating. Laura calls it a game changer, arguing that health plans simply cannot navigate this new environment without doubling down on their partnerships with community pharmacy.The episode closes with a look ahead at where AI and technology are taking quality measurement from faster measure development to the shift from retrospective accountability toward proactive, near-real-time quality improvement.https://www.pqa.org/
Hospitals already have felt some of the effects of the Inflation Reduction Act on 340B savings, but with the IRA set to expand to more drugs in 2027, hospitals also are starting to project how it might affect their bottom lines next year. 340B Vice President of Pharmacy Services and Education Steven Miller joins us to explain how hospitals can be making those projections now.The IRA Will Expand to Another 15 DrugsNext year, an additional 15 drugs will be subject to Medicare price caps under Medicare Part D on top of the 10 drugs that saw caps this year. Steve says this will cut into 340B savings and overall margins even more — with some 340B discounts possibly dropping to their statutory minimums. These reductions also will translate to commercial and cash-pay dispenses, changing the overall financial outlook for hospitals.Hospitals Cannot Rely on Current 340B Savings Levels for 2027Steve says the 2027 changes are key for future budgeting. If hospitals do not adjust how they are budgeting for 340B drugs subject to Medicare price caps, they are likely to be short on their budget projections. He strongly recommends 340B teams have important conversations with finance teams now about how the IRA will affect their hospital or health system next year.Hospitals Can Be Planning NowFor the rest of 2026, Steve recommends hospitals monitor list pricing and 340B ceiling pricing regularly and to increase monitoring of purchases overall, given how drugmaker pricing behavior affects future 340B prices and savings. As the IRA continues to broaden over the next several years, including to Medicare Part B dispenses, he also recommends hospitals consider securing funding or support from other areas for any 340B-funded services that might see negative IRA impacts.Resources:Prepare Your Leadership for 340B Changes From 2027 Medicare Drug Price Caps
MEDICARE PLANNING: WHY MEDICARE COSTS MORE THAN MANY PEOPLE EXPECT Thad Ismart, CFP®, ChFEBC, CEPS Senior Financial Planner Tessa Hall Media and Communications Specialist LAWRENCE M. POST CPA, MST, CFP®, CIMA® Senior Tax and Planning Advisor About This Episode Tessa speaks with BWFA's Larry and Thad about Medicare costs, including premium increases, prescription drug coverage, deductibles, and out-of-pocket expenses. They explain how Medicare pricing changes over time and why many individuals underestimate healthcare costs in retirement. The conversation also covers Medicare Part D plans, IRMAA income adjustments, and why comparing plans each year can help reduce unnecessary expenses. To better understand how healthcare costs fit into your broader retirement strategy, visit our Financial Planning services page. Full Description Healthcare costs play a major role in retirement planning, and Medicare expenses continue to rise each year. In this episode of Healthy, Wealthy & Wise, Tessa speaks with BWFA's Larry and Thad about Medicare costs and what individuals should understand when preparing for healthcare expenses in retirement. They explain how Medicare premiums, deductibles, and prescription drug costs have changed and why many retirees underestimate what they may pay over time. The conversation also explores IRMAA, which stands for Income-Related Monthly Adjustment Amount. Individuals with higher incomes may pay additional Medicare premiums depending on their earnings. Prescription drug coverage is another important topic. The episode highlights why reviewing Part D plans each year matters, since pricing and coverage can vary significantly between providers. The discussion also explains how insurance works from a broader planning perspective. Healthcare coverage involves balancing premiums, deductibles, and financial risk, which means different approaches may make sense depending on individual circumstances. Ultimately, understanding Medicare costs can help individuals make more informed decisions and better prepare for healthcare expenses throughout retirement.
10,000 Nurses on the Edge, a Union Decertification & the GLP-1 Benefit Bomb Landing July 1Three stories in one week that cut across labor relations, trust, and total compensation strategy. Bo, Luke, and ASHHRA Executive Director Jeremy Sadlier break down what every healthcare HR leader needs to act on before July 1st — with ASHHRA26 in Savannah just days away.
TRumpRX joins other programs that can save you money on your prescriptions. Toni explains how best to use these programs. Yes, Medicare Fraud is Real! If you think your Medicare account has bee compromised - visit www.Medicare.gov where you can check claims against your Medicare account Medicare's telephone number: 800-633-4227 - Please call if you suspect that your account has been subject to fraud. Visit www.tonisays.com and receive a 10% discount when ordering an American flag, or the new America 250 flag using the code tonisays10 at checkout! Happy Birthday America! Toni's new Medicare Survival Guide Advanced Edition book is available now - pick up your copy at www.tonisays.com Want more information? Take advantage of Toni's brand new video series now a available at https://tonisays.com Remember - with Medicare it's what you don't know that will hurt you! There's so much good information in this podcast, please be sure to share this podcast with your friends! Recognized by feedspot.com as one of the best Medicare Podcasts in the nation! Write Toni - info@tonisays.com. Toni's book is available at www.seniorresource.com and https://tonisays.com You can call Toni at 832-519-8664 Toni welcomes all Medicare questions. Toni now offers informative Medicare Webinars for all of your Medicare needs at https://tonisays.com You can find Medicare Moments wherever you find your favorite podcasts, such as: Apple: https://apple.co/44MoguG Spotify: https://open.spotify.com/show/7c82BS4hb145GiVYfnIRsoAmazon Music: https://music.amazon.com/podcasts/884c1f46-9905-4b29-a97a-1a164c97546b/medicare-moments?refMarker=null You can find Medicare Moments at: https://podcasts.seniorresource.com/medicare-moments/ Toni's new book: Maze of Medicare is now available at www.tonisays.com Combining Scripture with Medicare, it is the only book of its kind. Toni's columns appear weekly in about 100 newspapers across America. If you would like Toni's column to appear in your local paper, or if you would like Toni to speak at an event - contact Toni King at 832-519-8664 Thank you for listening and be sure to tell your friends about Medicare Moments! Blessings! Toni KingSee omnystudio.com/listener for privacy information.
Senior Associate Editor Steve Hallo discusses his BestWire story detailing how The Centers for Medicare and Medicaid Services intends to suspend enrollment in Elevance Health Inc.'s Medicare Advantage Part D over persistent noncompliance with risk-adjustment data reporting rules.
In Episode 130 of DC EKG, Joe Grogan sits down with Ryan Long to unpack two policy stories that are driving real-world drug costs and healthcare spending: the 340B program and the fallout from Medicare Part D changes under the Inflation Reduction Act. Ryan explains why the current 340B structure can incentivize higher costs, hospital consolidation, and contract pharmacy expansion, while often directing the biggest windfalls toward larger, wealthier systems rather than truly resource-constrained hospitals. They cover contract pharmacies, exposure to diversion and fraud, Medicare Part B reimbursement dynamics, and why reforms need to address the incentives baked into the program. They then turn to Medicare Part D, the shift from copays to coinsurance, premium pressure, the accelerated move into “catastrophic” coverage, and what happens when Washington promises savings that do not materialize. The episode closes with a broader look at fraud, program integrity, and why durable reform requires Congress to act. In This Conversation Why does 340B incentivize higher costs and hospital consolidation Contract pharmacies, diversion risk, and fraud exposure Who really benefits from 340B and why rural hospitals can lose out Medicare Part D premium pressure and the IRA tradeoffs Copays vs coinsurance and what seniors experience at the pharmacy counter Fraud, program integrity, and why limited resources should go to patients who need them Timestamps0:00 Why the 340B structure drives higher costs and consolidation0:37 Ryan Long joins Joe1:13 What has changed in 340B, and why it is getting attention6:57 Payer mix, spreads, and why wealthier systems benefit more11:06 How 340B expanded post-2010 and contract pharmacies16:56 Why contract pharmacy reform alone does not fix the incentives22:11 Medicare Part D and what the IRA changed24:23 Explaining the donut hole28:54 Premium increases, catastrophic coverage, and cost shifting32:26 Copays to coinsurance and unexpected out-of-pocket changes40:37 Fraud exposure and program integrity52:09 Where to find Ryan's work52:38 Outro 340B program, contract pharmacy, hospital consolidation, drug pricing, Medicare Part D, Medicaid rebate, Affordable Care Act, healthcare spending, healthcare costs, fraud exposure, policy impact, legislative reform, patient assistance About Our GuestRyan Long is a Fellow at the Paragon Health Institute and a Scholar at the USC Schaeffer Center. He previously served as health policy lead for Speaker Kevin McCarthy and is a longtime Energy and Commerce veteran focused on drug pricing, Medicare, Medicaid, and healthcare spending reform. Podcast: DC EKG with Joe GroganEpisode: 130Guest: Ryan LongSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio
In Episode 130 of DC EKG, Joe Grogan sits down with Ryan Long to unpack two policy stories that are driving real-world drug costs and healthcare spending: the 340B program and the fallout from Medicare Part D changes under the Inflation Reduction Act. Ryan explains why the current 340B structure can incentivize higher costs, hospital consolidation, and contract pharmacy expansion, while often directing the biggest windfalls toward larger, wealthier systems rather than truly resource-constrained hospitals. They cover contract pharmacies, exposure to diversion and fraud, Medicare Part B reimbursement dynamics, and why reforms need to address the incentives baked into the program. They then turn to Medicare Part D, the shift from copays to coinsurance, premium pressure, the accelerated move into “catastrophic” coverage, and what happens when Washington promises savings that do not materialize. The episode closes with a broader look at fraud, program integrity, and why durable reform requires Congress to act. In This Conversation Why does 340B incentivize higher costs and hospital consolidation Contract pharmacies, diversion risk, and fraud exposure Who really benefits from 340B and why rural hospitals can lose out Medicare Part D premium pressure and the IRA tradeoffs Copays vs coinsurance and what seniors experience at the pharmacy counter Fraud, program integrity, and why limited resources should go to patients who need them Timestamps0:00 Why the 340B structure drives higher costs and consolidation0:37 Ryan Long joins Joe1:13 What has changed in 340B, and why it is getting attention6:57 Payer mix, spreads, and why wealthier systems benefit more11:06 How 340B expanded post-2010 and contract pharmacies16:56 Why contract pharmacy reform alone does not fix the incentives22:11 Medicare Part D and what the IRA changed24:23 Explaining the donut hole28:54 Premium increases, catastrophic coverage, and cost shifting32:26 Copays to coinsurance and unexpected out-of-pocket changes40:37 Fraud exposure and program integrity52:09 Where to find Ryan's work52:38 Outro 340B program, contract pharmacy, hospital consolidation, drug pricing, Medicare Part D, Medicaid rebate, Affordable Care Act, healthcare spending, healthcare costs, fraud exposure, policy impact, legislative reform, patient assistance About Our GuestRyan Long is a Fellow at the Paragon Health Institute and a Scholar at the USC Schaeffer Center. He previously served as health policy lead for Speaker Kevin McCarthy and is a longtime Energy and Commerce veteran focused on drug pricing, Medicare, Medicaid, and healthcare spending reform. Podcast: DC EKG with Joe GroganEpisode: 130Guest: Ryan LongSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio
In Episode 130 of DC EKG, Joe Grogan sits down with Ryan Long to unpack two policy stories that are driving real-world drug costs and healthcare spending: the 340B program and the fallout from Medicare Part D changes under the Inflation Reduction Act. Ryan explains why the current 340B structure can incentivize higher costs, hospital consolidation, and contract pharmacy expansion, while often directing the biggest windfalls toward larger, wealthier systems rather than truly resource-constrained hospitals. They cover contract pharmacies, exposure to diversion and fraud, Medicare Part B reimbursement dynamics, and why reforms need to address the incentives baked into the program. They then turn to Medicare Part D, the shift from copays to coinsurance, premium pressure, the accelerated move into “catastrophic” coverage, and what happens when Washington promises savings that do not materialize. The episode closes with a broader look at fraud, program integrity, and why durable reform requires Congress to act. In This Conversation Why does 340B incentivize higher costs and hospital consolidation Contract pharmacies, diversion risk, and fraud exposure Who really benefits from 340B and why rural hospitals can lose out Medicare Part D premium pressure and the IRA tradeoffs Copays vs coinsurance and what seniors experience at the pharmacy counter Fraud, program integrity, and why limited resources should go to patients who need them Timestamps0:00 Why the 340B structure drives higher costs and consolidation0:37 Ryan Long joins Joe1:13 What has changed in 340B, and why it is getting attention6:57 Payer mix, spreads, and why wealthier systems benefit more11:06 How 340B expanded post-2010 and contract pharmacies16:56 Why contract pharmacy reform alone does not fix the incentives22:11 Medicare Part D and what the IRA changed24:23 Explaining the donut hole28:54 Premium increases, catastrophic coverage, and cost shifting32:26 Copays to coinsurance and unexpected out-of-pocket changes40:37 Fraud exposure and program integrity52:09 Where to find Ryan's work52:38 Outro 340B program, contract pharmacy, hospital consolidation, drug pricing, Medicare Part D, Medicaid rebate, Affordable Care Act, healthcare spending, healthcare costs, fraud exposure, policy impact, legislative reform, patient assistance About Our GuestRyan Long is a Fellow at the Paragon Health Institute and a Scholar at the USC Schaeffer Center. He previously served as health policy lead for Speaker Kevin McCarthy and is a longtime Energy and Commerce veteran focused on drug pricing, Medicare, Medicaid, and healthcare spending reform. Podcast: DC EKG with Joe GroganEpisode: 130Guest: Ryan LongSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio
In 2026, FSBP changed its High Option prescription drug benefits. The result: many people are paying more out of pocket for their drugs. For those enrolled in Medicare Part A and/or Part B, there is an option available to save money: the FSBP-Express Scripts Medicare Prescription Drug Plan (PDP). We revisit this program in today's episode with Tavares Johnson from Evernorth/Express Scripts. Tavares began his career at Express Scripts in 2008 as a Patient Care Advocate, where he gained valuable experience supporting members, pharmacists, and physicians. His dedication and problem-solving skills led to a promotion to Resolution Team Lead, a role in which he partnered closely with account management and clients to resolve complex member issues.In 2013, Tavares was promoted to Senior Account Manager, where he began working with Medicare Part D clients and deepened his expertise in Medicare products and services. His comprehensive understanding of both member and client needs has been instrumental in driving successful outcomes.In 2024, Tavares was promoted to Senior Manager on the EGWP Market Strategy team, where he leads strategic initiatives to support Employer Group Retiree plans. His leadership and industry insight continue to make a meaningful impact across the organization.To learn more about the PDP and opt in to the program, please visit www.afspa.org/pdp. To review PDP drug pricing, please visit: https://www.express-scripts.com/frontend/medicare-open-enrollment/fsbp. To review High Option drug pricing, please visit: www.express-scripts.com/fsbp Join us for AFSPA Live on March 26 at 11 am. You can submit your questions in advance, here: https://forms.office.com/r/wM8t8HqvDMRegister for other upcoming events at www.afspa.org/events.
Learn how to sponsor the Seven Figure Medicare Agent Summit:https://sevenfiguremedicareagentsummit.com/ In this episode of the Seven Figures or Bust Podcast, the hosts are joined by Bill Hepsher of the Canadian Med Store to discuss the rising cost of prescription drugs and how it has shaped the Medicare landscape over the past two decades. Bill shares his personal journey into the industry, the impact of major policy changes like Medicare Part D and the Affordable Care Act, and how gaps in coverage continue to create challenges—and opportunities—for agents helping clients afford their medications.
Four of the six major programs run by the Centers for Medicare and Medicaid Services saw their improper payment rate increase in fiscal 2025. Medicare Part C, Medicare Part D and Medicaid all saw upticks in how much money went out the door that shouldn't have. While not all improper payments are considered fraud, CMS is planning an all out effort to reign in fraud specifically, and improper payments more broadly. For more on how CMS will take on this systemic challenge, Federal News Network executive editor Jason Miller joins me now.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Don't miss the 2nd round of Medicare Part D negotiated drug prices. Get the details on the prescriptions and savings for Medicare beneficiaries in 2027. Read the text version Get Connected:
On this episode of Astonishing Healthcare, Lloyd Fiorini, General Counsel & Chief Compliance Officer at Judi Health, returns to the studio for a discussion about the barrage of regulatory changes shaping the pharmacy benefit manager (PBM) landscape in early 2026. Within just two weeks, the Department of Labor announced new proposed rules, the Consolidated Appropriations Act of 2026 became law, and the FTC's announced a settlement with Express Scripts. Then, to top it all off, TrumpRx went live.Lloyd offers clear, helpful explanations of the key takeaways from each of these concurrent reforms aimed at improving transparency and how PBMs operate and interact with the other stakeholders in the supply chain, from independent pharmacies to patients and plan sponsors (employers). Whether you're responsible for a self-funded plan or overseeing a Medicare Part D plan, this episode provides the detail and insights about where the puck is going that you need. As Lloyd said, "I think we've made a great step forward, but the work isn't done."It's also worth giving a shoutout to previous guest Jim Winkler, as "Change is Imminent" is in the title of AH090!Episode HighlightsThe Department of Labor's historic proposed rules on PBM disclosures fills a gap left by the CAA of 2021The Consolidated Appropriations Act of 2026 redefines the financial alignment of pharmacy benefits beyond just Medicare Part Patient/plan member protection seems to be what the FTC's recent settlement was all aboutTrumpRx signals a broader shift toward transparent, cost-plus pricing models, but it's just for cash-paying customers, at least for nowDelinking and efforts to block vertical integration are hotly contestedRelated ContentAH095 - What's in Store for the New Year? A Special Round-Robin Episode of Astonishing HealthcareHow to obtain Rx data and what to do with itAH096 - A Quick Government Programs Update: The IRA & MPPP, Managing D-SNPs, and More, with Jason BarrettoSigns it is time to change your PBM vendor, and how to overcome common hesitationsReference LinksUS Department of Labor proposes historic pharmacy benefit manager fee disclosure rule (January 29)PBM Reforms Signed Into Law, Reshaping Medicare Part D Drug Pricing Transparency (February 3)FTC Secures Landmark Settlement with Express Scripts to Lower Drug Costs for American Patients (February 4)TrumpRx Launches (February 6)For more information about Judi Health and this episode, please visit Judi Health - Insights.
340B Insight wants to make our podcast the best it can be. To help us succeed, we'd like to hear your thoughts. Please take just a few minutes to complete our listener survey, and we will enter you in a drawing to win a $100 gift card! To participate, please go to 340bpodcast.org/survey.For the third year in a row, we consulted 340B Health's experts on our staff to answer our listeners' most pressing 340B questions. As 2026 gets underway, we answer your questions about the CMS drug acquisition cost survey, what states are doing on 340B this year, and more. Some of the topics we cover:CMS Drug Acquisition Cost Survey Not MandatoryEarlier this year, the Center for Medicare & Medicaid Services (CMS) launched a new survey focusing on hospitals' outpatient drug acquisition costs, which could lead to Medicare Part B payment cuts for 340B drugs. Some hospitals recently saw materials suggesting they are required to complete the survey. Amanda Nagrotsky, vice president of legal and policy for 340B Health, notes that a CMS rule states there are no penalties under the Medicare statute for hospitals that choose not to respond. 340B Health and other groups sent a joint letter asking for the language to be corrected, citing the confusion it has caused.State Legislatures Are Becoming Major Battlegrounds for 2026Just over one month into 2026, statehouses are already shaping up to be one of the biggest venues to debate various aspects of the 340B. Two broad categories of bills are emerging: legislation protecting access to 340B pricing — including protections for contract pharmacy arrangements — and state-level reporting mandates. 340B Health Senior Vice President of Government Relations Tom O'Donnell says the proposed reporting mandates mirror other states' recently enacted requirements, and he argues they can be misleading, burdensome, or modeled on frameworks promoted by large drug companies.Medicare Announces More Drug Price Caps for 2028Medicare is phasing in maximum fair pricing – or MFP – for high-spending drugs over several years. CMS recently announced the next group of 15 drugs that will be subject to these types of price caps in 2028, adding to the 2026 and 2027 drug lists. Starting in 2028, these price caps will apply to both Medicare Part D and Part B drugs, including those purchased through Medicare Advantage. 340B Health Senior Manager of Pharmacy Services Gilda Yeboah says this means hospitals will see reduced 340B savings on certain drugs as Medicare prices move closer to existing 340B ceiling prices. Yeboah says the issue is complex and evolving, and 340B Health is working to share concerns about MFP implementation with federal agencies.Resources340B Health and Allies Urge CMS Contractor To Correct Statement Suggesting Hospitals Must Respond to OPPS Drug Cost SurveyStates Introduce New 340B Legislation in 2026 SessionsMaine Federal Court Rejects Drug Company Challenge to State 340B Contract Pharmacy LawMedicare Expands List of Drugs Subject to Price Caps, Decreased 340B Savings Starting in 2028Manufacturer Notices to Covered EntitiesHRSA Releases 340B Purchase Data for 2024FY 2025 Manufacturer Audit Results
In this week's episode of Medicine: The Truth, hosts Dr. Robert Pearl and Jeremy Corr look closely at the stories and controversies shaping U.S. healthcare at the start of 2026. From a severe flu season and resurgent vaccine-preventable diseases to drug pricing, autism research and the growing role of AI in medicine, the episode offers a data-driven look at where American healthcare is headed. The show opens with warnings about infectious disease. A dangerous H3N2 flu strain is driving hospitalizations, particularly among children, while measles and whooping cough outbreaks continue to spread among unvaccinated populations. To Dr. Pearl, these trends do not appear random. They reflect falling vaccination rates, weakened public-health messaging and growing political interference at federal agencies tasked with protecting the public. From there, the conversation turns to vaccine policy itself. Recent changes at the CDC (including a sharply reduced childhood vaccine schedule and new recommendations against universal newborn hepatitis B vaccination) raise serious concerns. Pearl explains why comparisons to countries like Denmark (with its reduced vaccine schedule) are deeply misleading, and why abandoning universal vaccination in a fragmented U.S. healthcare system risks reversing decades of progress. Here's a look at other must-know stories from this episode of Medicine: The Truth: Positive vaccine evidence: New CDC data show significant reductions in emergency visits among children who received COVID vaccines, reinforcing their safety and effectiveness. Pandemic lessons for children: Pediatric obesity rose during COVID lockdowns, while mental health outcomes improved after schools reopened, underscoring the tradeoffs of prolonged closures. Drug pricing deals with manufacturers: The administration's agreements with pharmaceutical companies apply narrowly to government purchases and exclude many high-cost drugs, limiting their overall impact. First oral GLP-1 approved: The FDA cleared the first pill version of a GLP-1 weight-loss drug, offering convenience but likely remaining unaffordable until prices fall closer to $200 per month. Autism research update: Rising autism prevalence is driven largely by broader diagnostic criteria and awareness. Large studies continue to show no link to vaccines or acetaminophen, while new research points to strong genetic factors and distinct autism subtypes. ACA exchange subsidy uncertainty: Congress has yet to prevent looming premium increases for millions of exchange enrollees. Pearl argues for avoiding coverage cliffs and capping household contributions as a share of income. Polypharmacy in seniors: One in eight Medicare Part D beneficiaries now takes eight or more medications, increasing the risk of side effects, falls and hospitalizations in a fragmented system. New dietary guidelines: Federal recommendations now emphasize animal protein alongside stronger warnings against sugar and ultra-processed foods, a shift that may conflict with earlier public-health messaging. AI's expanding role in healthcare: OpenAI's tools increasingly integrate health data from electronic records and consumer apps, signaling how quickly generative AI is becoming part of medical decision-making. Medicare and AI oversight: Traditional Medicare is moving toward AI-assisted prior authorization for certain procedures, a response to fraud and low-value care that Pearl says is inevitable as costs continue to rise. Tune in to Medicine: The Truth for more fact-based coverage and analysis of healthcare's biggest stories. * * * Dr. Robert Pearl is the author of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine” about the impact of AI on the future of medicine. Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn. The post MTT #102: Vaccines under fire, rising disease & the cost of politics in medicine appeared first on Fixing Healthcare.
In this Episode of the Secure Your Retirement Podcast, Radon and Murs discuss why Medicare 2026 is shaping up to be one of the most impactful years for retirees and those approaching retirement. With major Medicare updates, rising Medicare costs 2026, and several Medicare new rules taking effect, understanding how these changes affect your overall Retirement Planning is more important than ever. From prescription drug reforms to premium increases and income-based adjustments, Medicare is not something you can afford to “set and forget” when you're planning retirement and working to secure your retirement.Listen in to learn about how Medicare Part B premium 2026 increases, IRMAA surcharges, and Medicare income limits 2026 can directly impact your cash flow in retirement. Radon and Murs also explore how Medicare planning fits into a comprehensive strategy to help you retire comfortably, avoid costly surprises, and align your healthcare decisions with your long-term retirement checklist and broader financial plan.In this episode, find out:How Medicare drug price negotiations and Medicare Part D changes 2026 are lowering costs for certain prescriptionsWhat the new Medicare out of pocket cap means for retirees with high prescription drug expensesWhy the increase in Medicare Part B premium 2026 matters for your monthly retirement incomeHow IRMAA surcharges and income from strategies like Roth conversions can affect your Medicare premiumsWhat Medicare does not cover, including the difference between a Medicare wellness visit and a traditional physical, plus updates on Telehealth MedicareTweetable Quotes:“Medicare isn't separate from your financial plan—it's interconnected with your taxes, income, and investment strategy.” — Radon Stancil“One decision, like a Roth conversion, can trigger higher Medicare premiums if you don't account for IRMAA.” — Murs TariqUnderstanding Medicare 2026 is a critical part of Retirement Planning, whether you're already enrolled or just beginning to plan for retirement. Staying informed about Medicare updates, knowing your coverage gaps, and proactively planning can make a meaningful difference in how confidently you approach Retirement.Resources:If you are in or nearing retirement and you want to gain clarity on what questions you should be asking, learn what the biggest retirement myths are, and identify what you can do to achieve peace of mind for your retirement, get started today by requesting our complimentary video course, Four Steps to Secure Your Retirement!To access the course, simply visit POMWealth.net/podcast.
If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: https://www.eseniorinsurance.com✅ Call us: (801) 255-5340
Just one month after Congress moved to strengthen legislation around the hemp industry, a recent White House executive order supports marijuana research. The Trump administration says the drug may be an underlooked treatment for chronic pain. Healthcare experts say 2025’s Affordable Care Act open enrollment period was more confusing and stressful than usual. An estimated 400,000 Pennsylvania seniors are expected to save money on common drugs for diabetes, heart disease and cancer this year. Lower prices for 10 medications covered by Medicare Part D plans are going into effect in 2026. Pennsylvania lawmakers approved a number of new laws in 2025. Some of those new laws are taking effect in January. And a deeper dive: Political candidates are leaning on artificial intelligence to take increasingly pointed — and sometimes misleading — shots at their rivals. WITF’s Jaxon White reports as the technology gets more realistic, experts say voters will have to work harder than ever before to figure out what’s real. Lancaster County Commissioners passed a 2026 budget, on Christmas Eve, that includes a 10% property tax increase. York County Commissioners are disbursing more than $3 million to local organizations. The money is from the latest round of opioid settlement grants. Throughout the holiday season, there have been several stories of goodwill here in central PA. And the first federally funded electric vehicle charging station is now open along the Pennsylvania Turnpike. In uncertain times, our community counts on facts, not noise. Support the journalism and programming that keep you informed. Donate now at www.witf.org/givenow. And thank you! Support WITF: https://www.witf.org/support/give-now/See omnystudio.com/listener for privacy information.
Hi. It's Part Two of our George W. Bush series! This week, we look at No Child Left Behind, Medicare Part D, Surveillance, and how Bush's butchering of the law allowed Trump to be Trump. Fool me you can't get fooled again. Hosted by Cody JohnstonExecutive Producer - Katy StollDirected by Will GordhWritten by Thomas ReimannProduced by Jonathan HarrisEdited by Gregg MellerPost-Production Supervisor / Motion Graphics & VFX - John ConwayResearcher - Marco Siler-GonzalesGraphics by Clint DeNiscoHead Writer - David Christopher BellPATREON: https://patreon.com/somemorenewsMERCH: https://shop.somemorenews.comYOUTUBE MEMBERSHIP: https://www.youtube.com/channel/UCvlj0IzjSnNoduQF0l3VGng/join#somemorenews #GeorgeWBush #donaldtrumpFor a limited time, save on the perfect gift by visiting http://auraframes.com to get 35 dollars off Aura's best-selling Carver Mat frames – named #1 by Wirecutter – by using promo code MORENEWS at checkout.Pluto TV. Stream Now. Pay Never.Sign up for your $1/month trial and start selling today at https://shopify.com/morenewsSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Facing mounting financial pressures, insurance companies are changing the prescription drug coverage available to many consumers in Medicare Part D.Guests:Stacie Dusetzina, Professor of Health Policy, Vanderbilt UniversitySteven Hadfield, Medicare beneficiaryMark Newsom, Managing Director, Avalere HealthErin Trish, Co-Director, USC Schaeffer CenterCindy Trish, Medicare beneficiaryLeslie Walker, Senior Reporter, TradeoffsLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift. Hosted on Acast. See acast.com/privacy for more information.
Politicians argue about subsidies while families face premiums that can top $26,900 and deductibles big enough to delay basic care. We step past the slogans to map how the ACA exchanges actually work today—standardized benefits that reduce real choice, narrow networks that hide access problems, and a pricing spiral that subsidies struggle to catch. Along the way, we unpack ghost networks in mental health, why out-of-network showdowns hit consumers hardest, and how pharmacy benefit manager rebates can reward drug utilization even as patients fight for approvals.With Nate Kaufman of the Healthcare Bridge, we press on a practical blueprint: unify tax-funded programs into one baseline plan for everyone legally here, financed on a progressive scale. Then let private insurance sell optional add-ons that prove their value on access and outcomes, not marketing gloss. We argue for opening Medicare Part D-style drug purchasing to all, so payers and manufacturers compete in a fair arena. And we make a crucial point often skipped in policy talk: if clinicians aren't paid enough to say yes, coverage is a promise that collapses at the front desk. Raise rates for high-value services, shrink bureaucracy, and hold networks to transparent, enforceable standards.This conversation is candid, nonpartisan, and focused on patients and physicians rather than lobby talking points. If you've ever felt like the “chump at the table” in healthcare—paying premiums to an insurer incentivized to deny and taxes to a system that can't align incentives—you'll find both clarity and a path forward here. Dive in, share with a friend who's wrestling with open enrollment, and tell us: what's the first fix you'd make to rebuild access, quality, and affordability? Subscribe, leave a review, and help more listeners find the Common Bridge.Support the showEngage the conversation on Substack at The Common Bridge!
Drug pricing in America is a shell game where patients always lose. Healthcare Bridge host Nathan Kaufman and his guest Richard Helppie pull back the curtain on why Americans pay drastically more for the same medications than patients anywhere else in the world.At the heart of this problem lies a fragmented system where the United States—effectively operating the world's largest health insurance company—somehow lacks the ability to negotiate bulk purchasing deals. While pharmaceutical companies claim high prices fund critical research, the conversation reveals how your money primarily finances the endless parade of drug advertisements dominating television commercial breaks.The journey of a pill from factory to patient passes through multiple profit-extracting entities: manufacturers, wholesalers, and pharmacy benefit managers (PBMs). With three PBMs controlling 80% of drug distribution—all owned by insurance companies—conflicts of interest are baked into the system. Through revealing personal anecdotes, the hosts demonstrate how the same medication can cost $5 with one insurer, $330 with another, yet only $20 through Mark Cuban's pharmacy. Many Americans find it cheaper to purchase medications from Canadian pharmacies despite industry warnings about "dangerous" reimported drugs—even when those medications come from identical manufacturing facilities.Recent policy proposals offer potential paths forward. The Biden administration's efforts to cap Medicare drug expenses met immediate legal challenges from pharmaceutical companies, while Trump's "most favored nation" pricing concept aims to standardize global medication costs. Medicare Part D represents a partial success story by forcing drug companies to negotiate with insurers, maintaining 95% subscriber satisfaction while running 40% below projected costs.Healthcare policy requires informed leadership, but few politicians truly understand the system's complexities. If you or someone you love needs medical care, finding an insider who understands healthcare's nuances isn't just helpful—it could save your life. Subscribe to the Healthcare Bridge for more conversations that bridge gaps in our healthcare system and work toward solutions that benefit patients first.Support the showEngage the conversation on Substack at The Common Bridge!
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