^{DeSantis highlights partisan rift over health insurance}

Florida Gov. Ron DeSantis (R) offered a reminder of the political parties' starkly different attitudes toward health insurance when he downplayed the importance of comprehensive coverage last week.

"Most people, particularly under 50, what they really need is a catastrophic plan that's affordable, where then they can pay whatever they're doing out of a health savings account," DeSantis said Friday at a Hoover Institution event moderated by former Secretary of State Condoleezza Rice.

Florida Politics first wrote about DeSantis' comments.

That distaste for comprehensive coverage is partly to blame for the prolonged government shutdown, as Democrats demand an extension of expiring enhanced ACA premium tax credits in return for funding the government. Some Republicans say they're willing to discuss an extension, but only after reopening the government. Neither side, so far, has budged.

As I reported last year, insurance is conspicuously absent from the Republican tool chest for making America healthy again. Since that story came out, Republicans passed a bill that will reduce federal spending on Medicaid by about $1 trillion over a decade to help pay for tax cuts.

Democrats' main answer to better health care is to shoot for universal insurance coverage with heavy government subsidization, then incentivize insurers and doctors to keep people healthy. They also say enrolling younger, healthier people helps keep costs lower for those who need more health care.

The proponents of MAHA say that hasn't worked, the public is getting sicker, and people wouldn't need insurance as often if they were to adopt healthier lifestyles. More traditional Republicans like DeSantis say government subsidies for insurance have made health care more expensive and encouraged provider consolidation.

"The bigger government gets, the more intertwined it gets, that facilitates what we see with consolidation, where the hospitals will hire all of the physicians," DeSantis said.

insurance

$27,000

That's the cost of an employer-provided family health insurance plan, Tara Bannow reports. The number comes from KFF's annual survey of more than 1,800 small and large employers. It found that family premiums grew 6% in 2025, which is 1% slower than the rate in the previous two years.

KFF CEO Drew Altman said GLP-1s, increases in hospital prices, and tariffs contributed to the increase.

Also, the average deductible for an individual plan is now almost $1,900, and climbing.

Read more about how employers can become better insurance shoppers.

dtc sales

PBM light

Elaine Chen has a fascinating story about entrepreneurs finding a business opportunity in the trend of selling drugs directly to cash-paying consumers.

Conceptually, it's a simple pitch: startups are telling employers they can help cover the cost of drugs that their employees are buying directly from drugmakers without insurance. Right now, many are focused on GLP-1 weight-loss drugs.

But that sounds a lot like what PBMs already do for companies. Read more to figure out whether this is a new business idea, or more of the same.

cdc

Nonprofits to the rescue

Scientists are losing trust in the CDC's Morbidity and Mortality Weekly Report, so the New England Journal of Medicine and the Center for Infectious Disease Research and Policy are launching a rival to the agency's flagship publication.

Anil Oza got the scoop by listening to a recording from a conference of infectious disease specialists. HHS said the agency "is committed to the MMWR as the nation's trusted, science-driven source for timely and accurate health information."

An NEJM spokesperson said the plan is to publish alerts, free of charge, in a new section of its NEJM Evidence journal. Read more for the details.

hiv drugs

It's always about the price

A CVS Caremark executive sent an unusually frank email to an AIDS patient advocacy group about why it has yet to cover an expensive new HIV prevention drug, Ed Silverman reports.

While President Trump publicly bullies drugmakers into slashing prices, insurance companies are still circumspect in their statements, even in private, about drug coverage. It's for that reason that the CVS email criticizing the price of Yeztugo is noteworthy.

Gilead Sciences' Yeztugo has an annual price of $28,000, and doesn't work better than older, significantly cheaper versions of PrEP. But the older drugs must be taken daily, while Yeztugo is taken twice a year, lowering the chance of missed doses. Read more.

drug pricing

Bad timing, and a change of heart

Ed also has an update to a story about price hikes for the HIV drugs that Gilead sells to state AIDS Drug Assistance Programs.

Gilead recently said it planned to boost prices in the high single digits for HIV drugs. That announcement put states on edge because Congress this summer made big cuts to federal Medicaid spending, and the Trump administration has also sought reductions in federal funding for HIV prevention programs.

Gilead has now backed off, saying it will not raise prices. Read more.

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