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The Healthcare Labyrinth

The Healthcare Labyrinth

By: Marc S. Ryan
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 Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare. Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.2023 Hygiene & Healthy Living Social Sciences
Episodes
  • 92. My Biggest Worry … Erosion of Coverage

    92. My Biggest Worry … Erosion of Coverage
    Sep 12 2025
    A combination of events come together to create a worrisome erosion of coverage in the next decade, driving up both the uninsured and underinsured counts. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare. Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name. Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare. Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America. About The Episode: On this episode, Marc discusses a worrisome erosion of coverage in the next decade, driving up both the uninsured and underinsured counts. Key Takeaways: Two forces are coming together to further erode coverage in America. They are surging utilization and the OBBBA. Some of the surging utilization can be explained – a return to normal post pandemic utilization, increased expensive drug introductions, aging and more. But some of it cannot. While healthcare actuaries anticipate a slowing of annual healthcare growth in a few years, I think we could be in a new era of even more robust annual growth. When utilization spikes, as much as employers try to protect employees, more costs are foisted upon them or coverage evaporates. While the GOP says no one will lose coverage unless it is fraudulent or they want to be tossed, we know this is far from the truth. With the expiration of Exchange premium enhancements, 15 million will lose coverage in Medicaid and the Exchanges. We have seen very low uninsured rates due to coverage expansion. That will increase dramatically through 2034. The bigger problem could be the rise in the underinsured rate. Surging utilization, costs, and the fallout from the OBBBA will mean more and more fall into the ranks of the underinsured. Latest statistics say about 8% to 9% of adults are uninsured, 12% had a gap in coverage over the past year, and 23% were underinsured (they had coverage for a full year that didn’t provide them with affordable access.) We are in a crisis. It is clear that the uninsured and underinsured rates will rise because of misguided policies and the lack of true healthcare reform. Connect With Marc: Marc on LinkedIn Marc on Twitter THL Podcast Resources: THL’s Newsfeed THL’s Blog The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance
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    15 mins
  • 91. What Will Happen to Medicare Advantage in 2026?

    91. What Will Happen to Medicare Advantage in 2026?
    Sep 5 2025
    Given the major MA retrenchment in 2025, many are asking what will happen to offerings, geographies, and growth in 2026. I tell you. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare. Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name. Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare. Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America. About The Episode: On this episode, Marc discusses what will happen to offerings, geographies, and growth in Medicare Advantage in 2026. Key Takeaways: Since January 2020, MA enrollment has grown from 23.93 million to 35.44 in July 2025, a growth of 11.51 million. From January 2020 to January 2024, average growth was 10%, ranging from 6% to 11%. Growth from January 2024 to February 2025 did come down considerably to 4.4%. Since February, MA continues to grow at a healthy pace overall. Between February and July, almost 500,000 lives were added to the MA rolls. We are likely in store for a rate of growth from 2025 to 2026 that is similar to 2024 to 2025. It is clear that the major retrenchment by MA plans in 2025 impacted overall growth. But a great value proposition compared with the traditional program sustains growth. 2025 brought a reduction in some added benefits, a major contraction of the Preferred Provider Organization (PPO) product, and geographic contraction. While many plans pulled back, national MA plans struggled the most in terms of benefit cuts, contraction, and growth. While Individual MA plan offerings declined by 6.54% in 2025, SNP offerings increased 8.5% in 2025. And SNPs have grown considerably since January 2024. In the end, robust competition remained, $0 premiums prevailed, and most enrollees could find very favorable plans. Some analysts are speculating that contraction of benefits, products, and geographies could be robust again this year. But will it be as big as 2025? I do not expect the enrollee impacts to reach what we saw in 2025. But based on recent announcements from United and Aetna, we can say the contraction in benefits, products, and footprint could again be sizeable in 2026. Connect With Marc: Marc on LinkedIn Marc on Twitter THL Podcast Resources: THL’s Newsfeed THL’s Blog The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance
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    22 mins
  • 90. What Explains The Insurer Meltdown?

    90. What Explains The Insurer Meltdown?
    Aug 29 2025

    While outside forces contributed, health plans, especially the big ones, can blame their own mismanagement on the insurer meltdown.

    About The Podcast:

    Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.

    Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.

    Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.

    Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.

    Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.

    Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.

    About The Episode:

    On this episode, Marc discusses the financial crisis of health plans. While outside forces contributed, health plans, especially the big ones, can blame their own mismanagement on the insurer meltdown.

    Key Takeaways:

    Outside forces contributing to the meltdown were high utilization and government actions that reduced rates and revenue and limited cost-savings opportunities.

    But health plans generally and the big plans specifically missed the financial mark.

    Big plans were over-zealous and had a severe lack of financial discipline.

    In Medicare Advantage, health plans ignored lower rates, lower Star performance, risk adjustment reform demands, and prior authorization limits.

    In Medicaid, plans grew too much, ushered on by what were temporary rules expanding growth and reimbursement.

    In the Exchanges, insurers did not plan for the eventual phaseout of enhanced premium subsidies.

    In the employer and commercial world, health plans did not respond to demands for cost-savings and greater transparency by insurers.

    The current trends, including the budget reconciliation bill, likely would have meant further retrenchment in all lines of business.

    But it is equally true that the lack of financial discipline by most of these plans in the last several years complicates their recovery.

    Connect With Marc:

    Marc on LinkedIn

    Marc on Twitter

    THL Podcast

    Resources:

    THL’s Newsfeed

    THL’s Blog

    The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance
    Show More Show Less
    23 mins
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