State Policymakers Act to Reform Health Plans' Downcoding Practices Reducing Physician Payments

• The Environmental Protection Agency has classified microplastics and antidepressants as drinking water contaminants, responding to advocacy from the MAHA movement and public health concerns. • The classification marks a significant regulatory step in addressing emerging contaminants in U.S. water supplies that have raised concerns among health experts and environmental advocates. • The designation may prompt future regulatory actions to establish drinking water standards and treatment requirements for these substances.

• Le géant de l'assurance Cigna a annoncé son retrait du marché individuel de l'Affordable Care Act en 2027, une décision impactant 369 000 membres alors que des rapports indiquent que des millions de personnes abandonnent la couverture Obamacare en raison de l'augmentation des coûts à long terme. • Les responsables d'État et les analystes du secteur soulignent que la flambée des primes entraîne une baisse des inscriptions, ce qui aggrave les problèmes d'accès pour les assurés restants. • Cigna a fait état d'un bénéfice de 1,65 milliard de dollars tout en annonçant ce retrait, mettant en lumière les tensions entre la rentabilité et la viabilité du marché.

• L’American Heart Association a publié un avis présidentiel le 30 avril 2026, déclarant que l’accessibilité financière des soins de santé aux États-Unis a atteint un point de crise en raison de l’augmentation des coûts liée aux maladies chroniques. • Les coûts contraignent les Américains à retarder ou à renoncer aux soins, ce qui aggrave les résultats en matière de santé et augmente la dette médicale ; un sondage Gallup montre une inquiétude généralisée concernant l'accès à des soins abordables. • Un sondage de McLaughlin & Associates a révélé que 51 % des électeurs citent l’assurance maladie comme leur principale préoccupation, suivie par les factures d’hôpital (11 %) et le coût des médicaments (10 %).

• L'administration Trump a déposé un recours mercredi soir contre la décision du 16 mars d'un juge fédéral du Massachusetts qui bloquait la refonte du calendrier vaccinal infantile national par le secrétaire à la Santé, Robert F. Kennedy Jr. • Le juge Brian Murphy avait statué que Kennedy avait remplacé le comité consultatif sur les vaccins du CDC de manière « illégale » et avait suspendu toutes les décisions prises par le comité. • Cet appel signale l'intention de l'administration de poursuivre la restructuration du processus consultatif sur les vaccins malgré les contestations judiciaires concernant son autorité.

• The Department of Justice announced last week it loosened legal restrictions on medical marijuana, aiming to expand research and treatment options across the US. • This policy shift is expected to facilitate more clinical studies and access for patients in states with medical programs. • The change addresses longstanding barriers to federally approved marijuana research, potentially accelerating therapeutic developments.

• South Carolina health officials ended the nation's largest measles outbreak after six months, with 997 infections and 21 hospitalizations but no deaths. • The outbreak concluded Sunday following over a month without new cases. • This marks a significant public health milestone amid rising national vaccination concerns.

• Backers introduced over three dozen bills in statehouses to expand raw milk access, despite public health warnings and at least five outbreaks in the past year. • Current E. coli outbreak linked to raw milk cheddar cheese from California-based Raw Farm has sickened nine people, half children under 5, with one developing lifelong kidney complications. • Public health officials warn unpasteurized milk harbors risky germs, alarming experts as more states legalize sales.

• Nearly two-thirds (64%) of U.S. adults worry about affording health care costs, with 30% very worried, topping affordability concerns over gas prices. • Health care affordability remains the public's primary worry despite other economic pressures. • Poll highlights ongoing financial strain on households amid rising medical expenses.

• Investigators from Ann & Robert H. Lurie Children’s Hospital analyzed over 3.9 million hospitalizations to estimate sepsis in 1.3% of pediatric cases, equating to more than 18,000 U.S. occurrences yearly. • Sepsis carries a 10% mortality rate, resulting in over 1,800 child deaths annually, with no significant change in incidence or mortality from 2016 to 2022. • 72% of cases began before hospitalization, highlighting risks to otherwise healthy children and the urgent need for better prevention strategies.

• Connecticut Governor Ned Lamont signed HB 5044 into law on April 28, 2026, expanding the state health commissioner's authority to issue vaccine recommendations independent of federal guidance. • The bill includes provisions clarifying the state's Religious Freedom Restoration Act (RFRA), which had sparked significant controversy during legislative debates. • The law also prevents insurance companies from penalizing clinicians who treat patients declining vaccines, protecting physician practice autonomy.

• A new report from Harris County Public Health reveals Houston has the highest tuberculosis rates in Texas, highlighting urban transmission risks. • The data shows elevated cases linked to dense populations and socioeconomic factors in the Houston area. • Rising TB incidence demands targeted screening and treatment expansions to curb spread in high-risk communities.

• Medicare underpayments to hospitals totaled more than $100 billion in 2024, according to testimony provided to the House Ways and Means Committee by the American Hospital Association. • Hospitals are managing significant cost pressures while treating a sicker, more medically complex, and aging patient population, with persistent misalignments between care provision and reimbursement rates. • The financial strain reflects broader healthcare system challenges as providers struggle with inadequate government reimbursement alongside rising operational costs.