News

People aged 65 or more years accounted for 10.2%, or 9.6 million, of the 94 million people enrolled in Medicaid in 2023, according to a new profile of Medicaid beneficiaries released Friday by the Centers for Medicare & Medicaid Services.

Virginia lawmakers will face a record $3.2 billion increase in state funding for Medicaid over three years and an additional $964 million to support K-12 public education, as the state elects a new governor amid rising costs and economic uncertainty.

Open enrollment began on Nov. 1 and Virginians will face health insurance premiums rising between 43% and a shocking 202% unless Congress acts to extend the enhanced premium tax credits (EPTCs) set to expire at year’s end. These credits have made coverage affordable for hundreds of thousands of working families across the commonwealth and their loss would be felt not just by those directly affected, but by our economy as a whole.

The only thing that Susan Swan, Lucas Fritz and Melissa Greenfield know for sure about their health care insurance next year is that their current policies won’t exist on Jan. 1.

If you’re in the market for health insurance, it’s important to compare prices, benefits and restrictions and make sure you find a product that meets your individual needs.

Time is running out on expiring federal subsidies for health insurance, but Virginians won’t know how much they’ll pay in monthly premiums next year until the end of this month.

Over the years, we have watched the commonwealth make tremendous strides in expanding access to affordable, quality health care. With the help of the federal government, we’ve expanded Medicaid coverage, established our own state health insurance marketplace, and hundreds of thousands of Virginians have been able to afford health insurance through the enhanced premium tax credits (EPTC).

But today, these hard-won gains are under attack.

The Virginia Health Care Foundation has launched It Takes a Village (ITAV), a new statewide program offering low- or no-cost maternal mental health counseling to pregnant and postpartum Virginians, available in English and Spanish through in-person and telehealth options. Funded by the Commonwealth’s 2025 MOMnibus package, ITAV connects moms with behavioral health therapists across Virginia, including those with Medicaid, commercial insurance, or no insurance.

Elevance Health is integrating its food as medicine program for Medicaid members in community health centers, the insurer announced Monday.

UnitedHealthcare explores Medicaid MCOs in its latest whitepaper.

Medicaid managed care organizations (MCOs) play an important role in delivering high-quality, cost-effective health care to millions of individuals across the country. By increasing access to essential services, improving the consumer experience and managing costs effectively, MCOs help consumers, state partners and providers alike.

This report explores the fiscal and programmatic impacts that a switch to a prescription drug carve-out model, where the pharmacy benefit would be managed under a single-payer system within Medicaid using the fee-for-service payment methodology, would have on Virginia’s Medicaid program (Cardinal Care). Our key recommendations for the Medicaid program include preserving the current pharmacy carve-in, preserving the common core formulary (i.e., the preferred drug list), enhancing reimbursements to critical access pharmacies, increasing MCO policymaking representation, and exploring potential revisions to capitation rates for the pharmacy component.

Bon Secours Mercy Health (BSMH) has deployed a deeply concerning new tactic in
its recent negotiations with Anthem Blue Cross and Blue Shield.