State Healthcare Regulations, ACA Shifts, Hospital Funding Loopholes | Last Month In Healthcare

Welcome back to Last Month in Healthcare! This month, Spencer and Nathaniel sit down without a guest to unpack the biggest healthcare headlines and regulatory shifts from April 2026.

From state-level crackdowns on PBMs to a surprising loophole that allows urban hospitals to siphon rural hospital aid, the guys dissect the policy changes and market moves that are actively reshaping the industry. They also discuss the affordability crisis driving a 26% surge in ACA Bronze plan enrollment, Amazon's aggressive new play into the GLP-1 and primary care market, and why CMS is finally (and officially) killing the fax machine by 2028.

Plus, Spencer plays a game of "Blind Ranking," attempting to properly order the top 10 best practices and features of a modern self-funded health plan (including pass-through PBMs, cash-pay surgery networks, and pharmacogenomics) without knowing what's coming next.

Thank you to this year's sponsor, Walk On Clinic!

If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text.

Chapters:

(00:00:00) Intro & Sponsor Shoutout: Walk On Clinic

(00:01:42) Bipartisan State Healthcare Regulations & PBM Oversight

(00:04:40) ACA Shifts: The Rise of Bronze Plans & HSA Eligibility

(00:08:38) The FTC's Vague New Healthcare Task Force

(00:10:10) The Rural Hospital Aid Loophole Exploited by Urban Hospitals

(00:11:27) Amazon Launches a $149/mo GLP-1 & Primary Care Program

(00:15:18) CMS is Finally Ending the Fax Machine (Saving $781M)

(00:16:48) Game: Blind Ranking the Best Self-Funded Plan Features

(00:24:45) PSA: Watch Out for These Hidden Carrier Contract Clauses