Health Plan Weekly

2026 ACA Exchange Rule Aims to Increase PrEP Access, Battle Bad Brokers

  • Oct 11
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    Oct 11, 2024

    When CMS on Oct. 4 proposed the 2026 omnibus regulation for Affordable Care Act exchange plans, the agency heavily emphasized the rule’s new safeguards to protect consumers from fraudulent changes to their health care coverage. Although those provisions are indeed noteworthy, policy experts say there are other interesting proposals — and omissions — to digest in the voluminous Notice of Benefit and Payment Parameters (NBPP). 

    Emily Donaldson, a principal at Avalere Health, says she expects the health insurance industry and patient advocates alike to have much to say about CMS’s proposal to incorporate HIV pre-exposure prophylaxis (PrEP) services into the 2026 risk adjustment models “as a new, separate factor.” 

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    • Leslie Small

    Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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Managing Editor, Radar on Specialty Pharmacy and Spotlight on Market Access

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Managing Editor, Health Plan Weekly and Radar on Drug Benefits

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Reporter, Health Plan Weekly and Radar on Drug Benefits

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Reporter, Radar on Medicare Advantage and Spotlight on Market Access

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