Hey y’all,
It's Friday and winter weather is headed our way this weekend. Perfect timing to settle in and catch up.
MLK Day was Monday, and one of his quotes keeps hitting me: "Of all the forms of inequality, injustice in health care is the most shocking and inhumane." This week's roundup shows exactly what he meant. Congress held hearings on healthcare costs. Plenty of blame to go around, but nothing got solved. North Carolina fixed a problem by making financial assistance automatic for 2.5 million people instead of making them fill out paperwork. The contrast is pretty stark.
Let's get into it.
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Weekly Roundup
Insurance CEOs testified before Congress on Thursday. Lawmakers questioned insurers about costs and coverage. Insurers pointed to broader system issues. No clear path forward emerged.
What happened: UnitedHealth, CVS Health, Cigna, Elevance, and Blue Shield of California CEOs faced back-to-back grillings from House Energy and Commerce (morning) and Ways and Means (afternoon).
The numbers driving the outrage:
Average family plan costs $27,000 annually
Obamacare premiums up 80% in 10 years
One in five medical claims denied
Three largest insurers rake in nearly $1 trillion in annual revenue
What lawmakers said: Republicans blamed "Democrats' failing Obamacare policies." Democrats blamed "Republicans sabotaging our nation's health care system." Both parties blasted CEO compensation packages while Americans face doubled premiums.
What insurers said: UnitedHealth CEO Stephen Hemsley called insurers "a symptom, not a cause." Premiums reflect rising costs elsewhere in the system (hospitals, drugs). Insurers "compete aggressively" but can't control what providers charge.
The context: Enhanced ACA subsidies expired. Enrollment dropped 1.4 million people. Premiums doubled from $888 to $1,904 on average. Congress has no deal and just went into recess.
The bottom line: This was political theater, not problem-solving. When everyone's blaming everyone else, the infrastructure problem stays broken.
Weekly Roundup
Federal health data infrastructure is breaking down.
What's happening: Last week we wrote about disappearing health data systems. Now the story is getting wider attention.
Federal News Network reported on delays, discontinuations, and fragmentation across federal health datasets. The CDC Data Project published timelines documenting disruption inside the CDC. Perspectives vary on what's happening and why, but external concern about data stewardship is growing.
Why it matters: Funding can't sustain innovation if the underlying data infrastructure is unstable. Longitudinal, reliable data enables evaluation, accountability, and scale. That's especially true for AI, population health, and value-based care models.
The infrastructure problem: Health tech depends on data pipelines that are now at risk. If federal datasets become unreliable or disappear, the evidence base for innovation disappears with them.
What this means for innovators: Map your data dependencies now. Figure out what redundancy, partnerships, or advocacy you need to protect the evidence pipelines your products rely on. This isn't a public health problem. It's a business continuity problem.
Read more: We wrote about why data continuity matters for scalable, equitable health innovation in our 1/15 Bonne Fire post.
Weekly Roundup
North Carolina just erased medical debt for 2.5 million people and changed how hospitals handle financial assistance going forward.
What happened: All 99 hospitals agreed to stop collecting debts dating back to 2014 and automatically discount care for qualifying patients (families of four earning under $96,000). No application required.
How they did it: The state tied additional Medicaid dollars for hospitals to debt relief. Health Secretary Kinsley crafted the plan after hearing stories from people who gained Medicaid coverage in 2023 but still carried old debt.
Why it matters: When financial assistance requires applications, people don't get help. When hospitals automatically apply discounts, the friction disappears.
The broader context: States are taking different approaches. Oregon and Illinois screen patients for assistance. Colorado and New York ban medical debt from credit reports. The federal government recently rolled back similar protections.
The coming challenge: Trump's healthcare policies are expected to leave 14 million more people uninsured. Looming Medicaid cuts mean hospitals are bracing for more unpaid care. Princeton's Heather Howard: "Your ZIP code is going to determine the protections you have."
The bottom line: North Carolina proved that automatic assistance works better than asking people to apply for help they already qualify for.
Weekly Roundup
Other health innovation news
Amazon rolls out 24/7 personalized Health AI: Amazon One Medical’s new AI assistant taps member clinical records to answer questions, book visits, interpret labs, and even help manage medications—bringing a more proactive, personalized layer to primary care.
More Medicaid cuts proposed: House Republicans push for second reconciliation bill with additional cuts to federal Medicaid funding, including penalties for states that use their own money to cover immigrants, elimination of coverage during citizenship verification periods, and site-neutral hospital payment requirements
The U.S. officially exits the World Health Organization: Public health experts have criticized the withdrawal from the WHO saying it will put the U.S. at a disadvantage when it comes to responding to health crises at home and abroad.
Congress eyes stability for virtual care models: New funding proposals would grant multiyear extensions for Medicare telehealth flexibilities and the hospital-at-home program, signaling bipartisan support for sustaining alternate care delivery.
Patient engagement tools poised for explosive growth: The global patient engagement solutions market is projected to surge at a ~21.3 % CAGR, exceeding $229 billion by 2035 as demand for digital touchpoints accelerates.
Upcoming Events
January Happy Hour
January 29th | 5:30pm
You know the drill. This is our usual, no frills, monthly happy hour. We’ll be at Krog Street Market, right on the beltline. RSVP
This is just a snapshot of what’s coming up. Check out the events calendar on our website to stay up-to-date on our upcoming events!
Thought Leadership
Designing Health Where Life Happens
Communities that lack affordable, nutritious food typically lack primary care, preventive services, and proactive health infrastructure too. We talk about these as separate problems. But people don't experience them that way.
Policy and system design create these gaps, not individual choices or community deficits. The solutions need to be systemic too.
The solution might be community food and health centers—places that combine food access, clinical care, education, and local economic activity. Not as a pilot program. As infrastructure.
Health doesn't start in the exam room. It starts in neighborhoods and kitchens.
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Thanks for being here!
This newsletter works because people share what they're building, not what they're announcing. If you're solving a problem that doesn't make headlines but should— I want to know about it.
And if you know people doing real work in health innovation who should know each other, connect us. That's what this is all about.
Stay warm this weekend,
–Nadine