V-BID Update: Healthcare Costs Climb as Coverage and Access Challenges Grow

In this Issue:

• Health Care Costs Emerge as a Top Voter Concern Ahead of 2026 Midterm
• Bipartisan INSULIN Act Would Extend $35 Monthly Cap to Private Insurance
• Cost Confusion is Keeping Americans from Cancer Screening
• Social Isolation and Financial Hardship Linked to Lower Preventive Care Use
• Medicare Part D Coverage Denials for Branded Medicines Rise Sharply
• Medical Debt System Extracts Billions from Patients, Report Finds
• Bronze Plan Enrollment Surges
• ACA Coverage Drops as Rising Costs Push Enrollees Out
• Healthcare Costs Rise as Multiple Pressures Shape 2026
• 2026 Virtual V-BID Summit Recording

Health Care Costs Emerge as a Top Voter Concern Ahead of 2026 Midterms

A new KFF issue brief finds that health care affordability has risen to voters’ top economic concern as of early 2026, with the cost of care now ranking ahead of food, housing, and utilities in public opinion polling. While Democrats currently hold an advantage over Republicans on voter trust to address health care costs, roughly one in four voters and four in ten independents say they trust neither party to handle the issue.

Bipartisan INSULIN Act Would Extend $35 Monthly Cap to Private Insurance

A bipartisan group of senators has introduced the INSULIN Act of 2026, which would cap out-of-pocket insulin costs at $35 per month for Americans with private and employer insurance, extending a cap already in place for Medicare beneficiaries. It would also establish a pilot program to provide affordable insulin to uninsured patients. The bill, which would take effect in plan year 2027, reflects growing congressional momentum to reduce patient cost barriers for a high-value, lifesaving medication.

Cost Confusion is Keeping Americans from Cancer Screening

The Prevent Cancer Foundation’s 2026 Early Detection Survey finds that 73% of U.S. adults are behind on at least one routine cancer screening, with cost now rivaling fear of diagnosis as a top barrier, cited by 34% of respondents. Notably, many routine cancer screenings are fully covered by insurance with no out-of-pocket cost, suggesting that confusion about coverage, rather than actual cost, is a key driver.

Social Isolation and Financial Hardship Linked to Lower Preventive Care Use

A study published in the Annals of Family Medicine finds that social and physical isolation, along with financial hardship, are associated with lower uptake of recommended preventive services, including cancer screenings and vaccinations. Financial hardship explains part of the relationship between isolation and preventive care use, highlighting the importance of addressing social and financial needs together when counseling patients about prevention.

Medicare Part D Coverage Denials for Branded Medicines Rise Sharply

A new analysis finds that nearly half (47%) of all attempts to fill a new branded medicine through Medicare Part D were initially denied in 2025, up 10% since 2021, with 14% of new-to-brand claims never receiving approval within a year. The findings highlight how utilization management tools such as prior authorization and step therapy are creating significant access barriers for Medicare beneficiaries.

Medical Debt System Extracts Billions from Patients, Report Finds

A recently released report analyzes the U.S. medical debt landscape, arguing that billing, financing, and collection practices can convert medical bills into long-term financial obligations that contribute to patient financial hardship. The report highlights how providers frequently pursue unpaid bills through lawsuits and third-party collectors, sometimes years after care is delivered. Researchers also note that nonprofit hospitals account for about 53% of medical debt lawsuits, while some systems filing large numbers of suits report comparatively limited spending on charity care.

Bronze Plan Enrollment Surges as Consumers Trade Coverage for Lower Premiums

New data show a growing shift toward Bronze-tier Marketplace plans as rising premiums and reduced subsidies push consumers to prioritize lower monthly costs. In most state-based Marketplaces, a higher share of enrollees selected Bronze plans for 2026, often switching from more comprehensive Silver or Gold coverage. While these plans offer lower premiums and new HSA eligibility, they carry significantly higher deductibles (often $7.5k or more), exposing enrollees to greater out-of-pocket risk.

ACA Coverage Drops as Rising Costs Push Enrollees Out

Nearly 1 in 10 Affordable Care Act enrollees dropped coverage in 2026 due to rising premiums after enhanced federal subsidies expired. About 80% of enrollees reported higher costs, with many cutting spending on essentials or switching to lower-tier plans to stay insured. National enrollment declined by over 1 million people compared to last year, reversing several years of growth. Experts warn continued affordability challenges could lead to further coverage losses and reduced access to care.

Healthcare Costs Rise as Multiple Pressures Shape 2026

Healthcare costs in 2026 are being driven by several converging trends, including higher spending on prescription drugs, increased use of healthcare services, and rising provider prices. New high-cost treatments such as specialty and weight-loss drugs are a major contributor, alongside growing demand tied to an aging population. Labor shortages and wage growth in healthcare are also pushing up provider costs, which are passed on through higher prices.

In Case You Missed It: 2026 Virtual V-BID Summit Recording Available

Thank you to the speakers, sponsors, and over 300 participants who joined us for the 2026 virtual V-BID Summit, Employing Innovative Technology to Enhance Quality & Lower Spending. If you were unable to attend or would like to revisit the discussion, the full summit recording is now available, along with AJMC coverage and recordings of each individual Summit session.

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