HealthCare, Medicare, Medicaid, and Social Security

[phkrause]

Tiny patients, big fight: NICU parents win leave in 2 states and push for more Colorado became the first state to adopt paid neonatal intensive care unit leave. Illinois will soon guarantee unpaid leave for NICU parents. Read more.

Why this matters: Parental leave for parents with newborns in intensive care often doesn’t account for the time their newborns spend in the NICU. Many choose to keep working while the baby is in the NICU to save parental leave for when the baby comes home. While advocates want more states to adopt NICU leave, a major focus now is galvanizing support for a federal bill to add NICU leave to the Family and Medical Leave Act.

RELATED COVERAGE ➤ Mom of a preemie crochets colorful yarn octopi for tiny tots at Detroit hospital NICU

[phkrause]

💊 Obesity drug overload

Illustration: Aïda Amer/Axios. Stock: Getty Images

Next month's launch of a Medicare program providing weight-loss drugs for $50 a month could become one of the biggest drug rollouts ever, Axios' Tina Reed writes. Why it matters: It's expected to unleash pent-up demand for Wegovy, Zepbound and other blockbuster treatments — and create new bottlenecks at doctors' offices. The new program is part of a deal President Trump struck with Eli Lilly and Novo Nordisk to cut prices for their diabetes and anti-obesity drugs in exchange for access to more patients. Providers are bracing for an onslaught beginning July 1, with roughly 14 million Medicare beneficiaries overweight or obese, according to KFF. Keep reading.

[phkrause]

Medicare for All gets new life

Illustration: Sarah Grillo/Axios

The success of Democratic socialists and progressives in this year's primaries is a sign of new enthusiasm for Medicare for All, Axios' Maya Goldman writes. Why it matters: Frustration with the medical system is fueling appetite for big-government fixes to drug prices, premiums, and long-term care costs. Zoom in: Melat Kiros, a 29-year-old DSA-backed attorney, unseated 15-term Rep. Diana DeGette in Colorado, accusing her of being too cozy with pharma and insurers despite DeGette's own support for Medicare for All. Brad Lander and Claire Valdez beat establishment favorites in NYC primaries the week before. Lander leaned on his fight, as NYC comptroller, against shifting retired city workers onto a privatized Medicare Advantage plan. Valdez ran explicitly on Medicare for All. Before that, Illinois Lt. Gov. Juliana Stratton and Maine's Graham Platner touted their support for a single-payer system in winning Senate primaries over more moderate opponents. Keep reading ...

[phkrause]

Obamacare rolls shrank dramatically in many states over the past year, new federal data shows

NEW YORK (AP) — States across the country saw steep drops in the number of people covered by the Affordable Care Act over the past year, with Ohio and Oklahoma each losing nearly one-third of enrollees, according to new federal data that provides the first complete 50-state breakdown of sharp enrollment declines following the January expiration of enhanced subsidies.

https://apnews.com/article/affordable-care-act-obamacare-enrollment-subsidies-trump-189b9b197edbc3c6883d77691dd894b7?

Mapped: Obamacare enrollment plummets

Data: Centers for Medicare & Medicaid Services. Map: Danielle Alberti/Axios Ohio, Oklahoma, Arizona, South Carolina and Minnesota have suffered some of the deepest losses in Obamacare coverage since beefed-up federal subsidies expired this year, Axios' David Nather writes from state-by-state federal data. Why it matters: The coverage losses are hitting deep-red states as well as blue ones after Congress let the subsidies expire. 🧮 By the numbers: Ohio and Oklahoma each lost nearly a third of their Obamacare enrollment since last year, according to the state breakdown, first reported by AP. Coverage in Arizona, South Carolina and Minnesota dropped by more than a quarter. Interactive map, with state-by-state data ... Keep reading.

[phkrause]

Obamacare premiums surged this year. A new analysis shows it’s likely to happen again in 2027

NEW YORK (AP) — Middle-income Americans straining to pay for Affordable Care Act health insurance are unlikely to get relief next year, according to a new analysis that shows insurers in the marketplace are proposing a second straight year of double-digit premium hikes.

https://apnews.com/article/affordable-care-act-obamacare-health-insurance-premiums-a2b6e95cea6555f12b992346245e2a2c?

[phkrause]

Democrats say Social Security boss’ message pushed misleading statements on Trump tax law’s benefits

Some Democrats are squaring off with President Donald Trump’s administration over one of the most potent political issues in the country ahead of this year’s midterm elections: Social Security.

https://apnews.com/article/social-security-bisignano-message-taxes-democrats-bb6a1a4f0c9d18f5ece322068c920f8b?

[phkrause]

Social Security FAQ

Social Security turns 90 this year. Despite its popularity and exemplary record of never having missed a payment—even after the 9/11 terror attacks and Hurricane Katrina—misperceptions persist about many fundamental aspects of this universal program.

https://www.epi.org/publication/social-security-faq/?

[phkrause]

What health care should look like

Illustration: Aïda Amer/Axios. Stock: Getty Images

Axios CEO Jim VandeHei devoted this weekend's Axios C-Suite newsletter to the challenges he and his wife, Autumn, have faced in navigating America's health care system — and their glimpse of medical nirvana: My wife, Autumn, has spent nearly a quarter of the past four years in ERs and hospitals, untangling and battling three chronic conditions — and a shamefully broken U.S. medical system. We live in Washington, D.C., with top-rated hospitals in our backyard. Yet her experience has been eye-opening and often horrifying, especially for a nation that spends twice as much on medical care as our rivals. And we're the lucky ones, with blue-chip insurance, a sophisticated understanding of the system and resources to attack problems. Most patients don't have those things. All of this left us infuriated and hopeless — until we landed in a small Minnesota city and glimpsed medical nirvana: the Mayo Clinic in Rochester. It was like discovering a foreign land — or seeing a future that could and should be. The best part: I soon discovered AI could easily help unlock the best of Mayo for everyone. Dr. Gianrico Farrugia, a gastroenterologist who's president and CEO of the Mayo Clinic, told me he's racing to show the federal government and other hospitals how to replicate the Mayo magic. 🩻 How it works: Mayo doctors work as teams. They're paid to heal, not to operate or medicate. Nurses handle four or so patients — fewer than we've experienced at even some of the best hospitals back home. Everyone is kind and talented. Rooms are clean. Every appointment begins on time. Imaging and blood tests get scheduled immediately, not after months of anxious waiting. Results land instantly in your online portal. But the real difference-maker: Doctors and patients leverage massive databases of medical information, sorted and analyzed by AI, then channeled into 500 different algorithms to help find cures and better serve patients. Consider cases like Autumn's: She has several different things wrong requiring expertise across many domains. Few, if any, humans could piece together this puzzle alone. This is where AI could make a big impact — now. Mayo recently signed a deal with Microsoft to expand and expedite its own frontier AI model to further scale and refine this work. Both Mayo and Microsoft are fine-tuning the AI with hopes of sharing it broadly. Dr. Gianrico Farrugia, Mayo Clinic president and CEO. Image via Mayo Clinic "None of this works unless health data is arranged maximally for humans and AI agents," Farrugia told me. "What makes it work or scalable is organizing all the knowledge so doctors can use it optimally and so agents can use it optimally, so we get the best data to help patients." The catch: "I could give this to every hospital — and they can't use it." That's because most hospitals lack the technology, money, systems and focus to use health data drawn from patients and broader pools. ⬇️ Jim's column continues below.

[phkrause]

📈 Part 2: Scaling Mayo

Illustration: Aïda Amer/Axios. Stock: Getty Images

It's the power of AI that could make the biggest difference and scale this further, the fastest, Farrugia argues. Mayo's scarcest asset — coordinated diagnostic brilliance based on real data, cases, lab results and patients — is exactly what AI is getting good at. Mayo knows it, running more than 12,000 clinical studies and building its Mayo Clinic Platform to digitize its expertise. 🤖 Testing technology: Before we tried Mayo, Autumn's coordinating doctors asked to use AI-assisted recording and transcription. I did the same for the AI agent I built to tackle Autumn's case using Claude. Both of us fed this into systems to make better data-informed calls. To this day, my personal AI agent has proven smarter than every doctor, other than Mayo's. Think about what Mayo data changes: A community hospital in Oshkosh, Wisconsin, will never recruit 4,000 Mayo-caliber specialists. It doesn't need to. It could tap into Mayo's expertise and data to instantly help tens of millions of patients. The harder-to-implement components of scaling Mayo — the talent, the brand, the destination economics — matter far less if the intelligence itself can be tapped by all doctors and patients. A new health care goal could be Mayo-quality care for everyone. This moves us beyond government-run health care versus free markets. The bottom line: American health care is the most expensive, bureaucratic, seemingly unfixable program on Earth. But smart policymakers, working with experts at Mayo and beyond, could spare millions of Americans Autumn's health care hell. Shame on us if we don't. ⬇️ Jim's column continues below.

[phkrause]

🤯 Part 3: The future, reimagined

Illustration: Aïda Amer/Axios. Stock: Getty Images

The only way to pull or push people to a different place or worldview is to show them what better looks like. So Jim sketched this out, based on Autumn's experience and what Mayo is building: How it could/should work: Imagine the response once Autumn started getting sick. (Her earliest symptom was pericarditis, inflammation around her heart.) Instead of going to a random doctor with scant understanding of her condition, she gets routed to someone with true expertise, who taps into a pool of data on other women with pericarditis. She hops on a Zoom with this person — who could be anywhere worldwide with access to her health data. Her vitals are easily checked at home beforehand and fed into the data. The doctor and Autumn decide together if an in-person examination is warranted. Now, imagine Autumn is actively sick and needs to go to the hospital. She lands in what Mayo calls a neighborhood: imaging, labs, procedures, consults and recovery all co-located for complex patients, instead of a scavenger hunt across buildings and appointment desks. Her costs are clear and flagged. The room itself feels healthy: controls for sound, lighting, temperature and TV. An electronic screen shows today's schedule and exactly what has to happen before she goes home. Family can easily Zoom in to chat and see her. Robots run supplies and meals, so nurses spend their hours on Autumn, not chores. AI stays in the background: sequencing appointments across specialists, transcribing and summarizing conversations, catching conflicts in a brutal medication regimen. The machines absorb the paperwork. The humans focus on Autumn. The bottom line: None of this requires an invention. Every piece of it exists right now, somewhere. What's missing isn't technology. It's the will to rebuild care around the patient — the opposite of our existing mess.

[phkrause]

📈 Another year of health insurance pain

Illustration: Aïda Amer/Axios

Employer health costs are set to rise sharply for a fourth straight year, Axios' Adriel Bettelheim writes from new projections by benefits consultant Aon. Why it matters: Companies and their workers are locked in one of the most sustained periods of health care inflation in decades. Rising demand for health services, more chronic disease and increased use of drugs like GLP-1s will help drive up employer health costs 9.5% next year — to more than $19,000 per employee, Aon said. Workers this year are expected to pay an average of $5,297 for health coverage. That's $388 more than in 2025.