A Minnesota Senate subcommittee on Wednesday heard testimony from hospitals, insurance experts and business owners on the anticipated changes to the state’s health insurance landscape in 2026.

“This week, Minnesotans who purchase insurance on the individual market are beginning to shop for the plans they’ll use next year,” said Sen. Lindsey Port, DFL-Burnsville, chair of the Subcommittee on the Federal Impact on Minnesotans and Economic Stability. “And they’re getting hit with the sticker shock at the prices that they’re seeing.”

One of the biggest changes the subcommittee discussed was the enhanced advance premium tax credit, which is set to expire at the end of 2025. This tax credit reduces the cost of monthly premiums for those making more than 400% of the Federal Poverty Guidelines. (Other tax credits, which are still active, apply to those making less than 400% FPG.)

Roughly half of the 187,000 Minnesotans who purchase their health insurance through the individual market will be affected by the tax credit’s expiration, said Grace Arnold, commissioner of the Minnesota Department of Commerce.

“Minnesota (is) estimating that 90,000 Minnesotans will see a cost increase averaging $2,000 a year,” she said.

This change coincides with a 21.5% average increase in individual market plan premiums for 2026, Arnold said.

Because some younger, healthier adults are expected to become uninsured due to these higher costs, Arnold said the overall health insurance will have a higher proportion of sicker, older enrollees who utilize more health care services, leading to rate increases.

“Many individuals and families with incomes below that 400% threshold will see cost increases,” said Libby Caulum, CEO of MNsure, the state’s independent health insurance marketplace.

Caulum used the example of a family of four living in Freeborn County. Their household income is $105,000, or 325% of the Federal Poverty Guidelines.

“In 2025, they pay $143 per month after their tax credits,” she said. “If they select the same plan for 2026, they will still receive some tax credits, but their net premium will more than triple to $490 per month.”

The hearing took place one day after MNsure shoppers could begin previewing their 2026 plan options. Open enrollment begins Nov. 1.

Caulum, Arnold and other testifiers also spoke to the projected impact of federal Medicaid changes — passed into law through President Donald Trump’s One Big Beautiful Bill Act — on health care costs.

“There’s some estimates that Minnesota could lose up to $154 million just in fiscal year 2026,” said Lynn Blewett, a professor at the University of Minnesota’s School of Public Health, “and an estimated increase of uninsured of 170 (thousand) to 180,000 individuals could lose coverage, and those are primarily from work requirements … and new verification requirements.”

The effects of higher health insurance costs go beyond individual payers — hospital leaders and business advocates shared with the subcommittee how they will be impacted.

With reduced Medicaid enrollment, the Minnesota Hospital Association estimates that the state’s hospitals will collectively lose, per year, $354 million in lost Medicaid payments, and will pay $269 million more in charity care — financial assistance for low-income patients.

“The nonprofit hospitals and health systems in Minnesota are already in a pretty precarious position,” said Mary Krinkie, vice president of government relations at the MHA. “We know that we will be forced to close additional services if these cuts come to full fruition.”

For Zander Abbott, president and CEO of Northfield Hospital and Clinics, service line closures at other rural hospitals in the area will result in higher demand at remaining facilities.

“We’re not going anywhere,” he said. “We’re going to be around to serve the people in our communities, but this is making it harder and harder.”

In her closing comments, ranking minority member Sen. Carla Nelson, R-Rochester, made the case for focusing on how Minnesota can respond to rising health care costs, referencing previous state budget surpluses that weren’t directed toward health care and the millions of dollars lost to recent fraud events.

“We want to point our finger at Washington, D.C. and, well, we don’t have that control there,” she said. “I want us to focus on those things that we can control right here in Minnesota.”

Nelson also advocated for federal lawmakers to end the government shutdown and renew the enhanced tax credit.

After the hearing, subcommittee DFL members addressed the federal government shutdown; the core issues underlying the shutdown, for U.S. Senate Democrats, are the enhanced tax credit renewal and undoing the Medicaid cuts passed earlier this year. A continuing resolution to fund the government needs 60 votes in the Senate to pass.

“When you need the votes, you have to earn the votes,” Port said of Senate Republicans. “You have to talk with people, you have to compromise.”

The subcommittee, formed within the state Senate’s Committee on Rules and Administration, had its first hearing on Oct. 1, centered on federal cuts to the Supplemental Nutrition Assistance Program, or SNAP. No other hearings are scheduled as of Wednesday.

 

“The next mayor will undoubtedly hear plenty from the business community about their priorities. But New York’s homeless population deserves a voice in City Hall that’s just as loud and just as urgent.”

The city’s homeless outreach teams in 2019. (Michael Appleton/Mayoral Photography Office)

New York’s most powerful and influential business leaders are eager to get their priorities heard by the new mayor, whoever he may be. Real estate executives and Wall Street partners have met with Zohran Mamdani and stumped for Andrew Cuomo. Our next mayor will have no illusions about the issues facing the city’s elite and that elite’s proposed solutions.

What is more urgent, though, is what the next mayor will do for the thousands of homeless New Yorkers who share the city with those business leaders.

The numbers tell a stark story. New York’s homeless population is increasing at an alarming rate. In calendar year 2024, the number of New Yorkers in shelters—excluding new arrivals—increased by roughly 12 percent to more than 73,000. The fundamental issue driving that increase is a lack of housing. The vacancy rate for apartments sits at a historically low 1.4 percent. This past June, rent prices surged 7 percent year-over-year, marking the seventh consecutive month of rising housing costs.

As someone whose organization works across both ends of this problem—directly with New York City’s homeless population and helping develop new supportive and affordable housing to increase supply—I’ve seen firsthand what city government is capable of accomplishing when it moves with purpose and urgency. But to do that, the next mayor will need to address three bureaucratic bottlenecks to help move people from the streets to stable housing. 

First, we must dramatically accelerate the creation of new housing. The incoming mayor should launch an executive-led initiative to fast-track affordable housing approvals within the first 100 days. This means directing city agencies to expedite environmental reviews and waive certain fees for 100 percent affordable and supportive housing projects. Removing red tape and adopting “by-right” zoning for affordable housing can significantly accelerate New York’s housing pipeline.

The mayor should also empower a deputy mayor for housing and homelessness within City Hall—a leader authorized to take a big-picture view of what’s driving our homelessness crisis and implement a city-wide plan to build new housing, particularly affordable and workforce housing. 

Additionally, we need an immediate initiative to rapidly convert underutilized office buildings into residential units citywide. This goes beyond existing state-level tax incentives to dramatically increase housing stock where it’s needed most.

Getting people off the streets and into shelter is the crucial second pipeline. This means expanding our existing street and subway outreach teams while building on current relationship-based approaches, like the successful Safe Options Support (SOS) program. We must take down barriers to shelter intake processes that currently leave people cycling between the streets and dead ends. Better coordination between outreach teams and the shelter system will enable faster and more effective intakes, ensuring that when someone is ready to come inside, we’re ready for them.

And finally, we need to move folks from shelter to permanent housing faster. It takes far too long for shelter residents to secure permanent housing, and the new administration must attack this bottleneck head-on. 

The mayor can mandate a top-to-bottom review of the approval process for supportive housing and CityFHEPS housing vouchers, with clear instructions to eliminate unnecessary steps. In practice, this means reducing paperwork burdens, streamlining eligibility interviews, and pre-qualifying shelter clients for housing subsidies much faster. The city has already made recent improvements, allowing more flexible documentation and expanded voucher access—we need to build on that momentum aggressively.

Long-term, the city should invest in substantially more housing vouchers and incentivize landlords through signing bonuses or tax breaks to accept homeless tenants. Many shelter residents awaiting supportive housing require state approval or matching to a provider. The mayor can establish a joint task force with the state to eliminate these backlogs. By cutting through bureaucracy, residents ready for housing could move out of shelters months earlier.

Success would mean shelter populations declining not because we’ve pushed people back to the streets, but because we’ve moved them into permanent housing. It would mean construction cranes building affordable units as quickly as luxury towers. It would mean outreach workers who can promise a clear path forward, not just a temporary bed.

The next mayor will undoubtedly hear plenty from the business community about their priorities. But New York’s homeless population deserves a voice in City Hall that’s just as loud and just as urgent. Their lives depend on it, and our city’s future does too. 

Perry Perlmutter is the CEO of Services for the UnderServed (S:US)

The post  Opinion: The Next Mayor’s Real Test? Ending New York’s Homelessness Crisis appeared first on City Limits.

By ALI SWENSON, MICHELLE L. PRICE and LAURA UNGAR

WASHINGTON (AP) — Drugmaker EMD Serono will reduce the cost of a common fertility medication through a deal struck with the Trump administration, President Donald Trump said Thursday while also unveiling new federal guidance he said will encourage employers to offer fertility coverage.

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The new guidance will allow companies to offer fertility benefits separate from major medical insurance plans, like they do with dental and vision plans, Trump said.

“We want to make it easier for all couples to have babies, raise children and start the families they have always dreamed about,” Trump said.

Dr. Mehmet Oz, who heads the Centers for Medicare and Medicaid Services, said that as a result: “There are going to be a lot of Trump babies. I think that’s probably a good thing,”

The Oval Office announcement offers a first glimpse at how Trump plans to follow up on his executive order earlier this year aiming to reduce the cost of in vitro fertilization, a medical procedure that helps people facing infertility build their families. But it falls far short of his promise as a candidate to make IVF treatment free. It marks the third deal the administration has made with pharmaceutical companies to cut drug prices in recent weeks.

EMD Serono’s Gonal-f is among several drugs frequently used by patients going through IVF treatments — which involve using hormones to trigger ovulation, producing multiple eggs that are retrieved from the ovaries to be fertilized or frozen. The drugs can be expensive, often costing patients thousands of dollars for a single IVF cycle. Many patients trying to get pregnant through IVF go through more than one cycle.

The White House and EMD Serono said the drug, along with all its other IVF medications, will be available at a discount on TrumpRx, a government website where patients will be able to buy drugs directly from manufacturers. The Trump administration contends that the new website, which is expected to be running in 2026, will cut pharmaceutical costs by allowing people to buy them without a middleman.

Trump said the Food and Drug Administration will also be working with EMD Serono to expedite approval of another one of its fertility drugs available in Europe, called Pergoveris.

Thursday’s announcement comes after Trump issued a February executive order pledging to make IVF more affordable. During his campaign last year, Trump pledged that if he was elected, he would make IVF treatment free.

Centers for Medicare & Medicaid Services administrator Dr. Mehmet Oz listens as President Donald Trump speaks in the Oval Office of the White House, Thursday, Oct. 16, 2025, in Washington. (AP Photo/Alex Brandon)

“Under the Trump administration, your government will pay for — or your insurance company will be mandated to pay for — all costs associated with IVF treatment,” he said at an event in Michigan. “Because we want more babies, to put it nicely.”

That pledge came in the wake of growing pressure after his Supreme Court nominees helped overturn the right to abortion in Roe v. Wade that kicked off an effort in GOP-led states to impose new restrictions, including some that have threatened access to IVF by trying to define life as beginning at conception.

Roger Shedlin, CEO of the fertility and family building benefits company WIN, on Wednesday expressed excitement about what he called “steps in the right direction.”

“Any initiative that addresses the cost of drugs will have a material positive impact on the overall cost of the fertility cycle,” he said.

Corinn O’Brien, 39, of Birmingham, Alabama, said anything to lower the costs of IVF would be “huge for families.”

O’Brien said she underwent three rounds of IVF and gave birth to a daughter in June. Each time, the drugs would cost anywhere from around $1,000 to $5,000.

She said covering the whole IVF cycle “ultimately would be a game changer for families,” but helping with the cost of drugs “is progress and is much appreciated.”

O’Brien added it would be great if more employers would cover fertility services because, for many, “this is their only chance to expand their family.”

Swenson reported from New York. Ungar reported from Louisville, Kentucky.

By CHRISTOPHER WEBER

LOS ANGELES (AP) — Gov. Gavin Newsom said Thursday that California will begin selling affordable insulin under its own label on Jan. 1, nearly three years after he first announced a partnership to sell state-branded generic drugs at lower prices.

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But California won’t be the only state making lower-cost insulin available. The nonprofit Civica said it will also distribute its economical diabetes medication to pharmacies nationwide. California began partnering with Civica in 2023 for its “CalRx” brand of insulin and put $50 million toward its development, the company said.

Starting in the new year, insulin pens will be available at a recommended price of $11 per pen, or a maximum of $55 for a five-pack, Civica said.

“You don’t need a new prescription,” Newsom said at a news conference in Los Angeles. “It’s access on the basis of affordability.”

It is one piece of California’s effort to lower prescription drug costs by offering generics as a cheaper alternative. Newsom announced in April that the state will sell the overdose medication Naloxone. The drug, available as a nasal spray and in an injectable form, is considered a key tool in the battle against a nationwide overdose crisis.

For the insulin development, the state entered a 10-year deal with Civica and Biocon Biologics in early 2023. Officials said then that they hoped California’s emergence as an insulin-maker would prompt prices to collapse.

The new pens will be interchangeable with glargine, the generic alternative for more expensive once-a-day injections that regulates blood sugar. As a comparison, the equivalent of a five-pack of Eli Lilly’s Rezvoglar sells to pharmacies for more than $88, according to data compiled by the governor’s office, but consumers may pay a different price based on their insurance.

About 38 million Americans — and roughly 3.5 million Californians — have diabetes, according to the American Diabetes Association.

Chris Noble, organizing director of Health Access California, a statewide consumer health care advocacy group, welcomed Newsom’s announcement, saying efforts by California and others to develop a competing generic will bring relief to patients who have seen drug prices spike in recent years.

“California consumers need relief now, so health advocates are relieved to see CalRx moving quickly to lower insulin costs for the people of California while continuing to pursue other needed prescription drug cost solutions,” Noble said in a statement Thursday.

There could be risks. State analysts have warned that California’s entry into the market could prompt other manufacturers to reduce the availability of their drugs, a potential unintended consequence.

State lawmakers approved $100 million for the project in 2022, with $50 million dedicated to developing three types of insulin and the rest set aside to invest in a manufacturing facility.

According to state documents from 2023, the proposed program could save many patients between $2,000 and $4,000 a year. In addition, lower costs could result in substantial savings because the state buys the product every year for the millions of people on its publicly funded health plans.