Gist Weekly: July 10, 2026

In the News

What happened in healthcare recently—and what we think about it.

1. ACA enrollment drops as new data point to affordability pressures. Affordable Care Act (ACA) marketplace enrollment is falling, according to new federal data published late last month. The new data come as insurers seek another round of substantial premium increases, adding to concerns about the affordability of coverage. The Department of Health and Human Services estimates that marketplace enrollment fell to 19.2 million in February, down about 2.6 million people from a year earlier. Government analysts attributed the drop to a crackdown on improper or fraudulent enrollments, but the decline also follows the expiration of federal premium enhanced tax credits last year. At the same time, insurers in 16 states and the District of Columbia have requested a median 14% premium increase for 2027 following a median 20% increase for 2026, a Peterson Center on Healthcare-KFF data analysis published this week found. Insurers cite rising healthcare costs, increased utilization, inflation, regulatory changes and the expiration of enhanced subsidies as key drivers. Final rates will be set by state regulators later this year.
   • The Gist: The combination of shrinking enrollment and rising premiums points to growing affordability pressures in the individual insurance market. If the trends continue, more consumers may forgo coverage, move to lower-cost plans with higher cost sharing, or cycle in and out of insurance—with consequences on both access to care and provider reimbursement. That could translate into changes in payer mix, higher uncompensated care, and more patients delaying treatment because of cost. The trends also increase pressure on states to pursue their own affordability initiatives, potentially creating wider variation in marketplace performance across the country. Taken together, the new data suggest affordability is becoming the No. 1 issue facing the ACA marketplaces.
2. Life expectancy on track to reach record high. The U.S. age-adjusted death rate fell to 689.2 deaths per 100,000 people in 2025, down 4.6% from 2024 and the lowest rate ever recorded, according to provisional data from the Centers for Disease Control and Prevention (CDC) published last week. This would qualify as the lowest mortality rate recorded in more than 100 years of tracking. Death rates declined across all age groups, with heart disease, cancer, and unintentional injuries remaining the three leading causes of death. The report follows last month’s CDC data showing infant mortality also fell to a provisional record low in 2025. Cancer mortality is part of that story: a report published last month found that the overall cancer death rate has fallen 35% since 1991, translating to more than 4.8 million fewer cancer deaths. But the gains remain uneven, with Black and American Indian/Alaska Native populations continuing to experience the highest overall cancer death rates, and rural residents falling behind in medical and cancer screenings, a survey published late last month found.
   • The Gist: National mortality improvement is real, but it is not self-sustaining. Keeping the numbers up depends on the unglamorous blocking and tackling of prevention, screening, follow-up, care coordination, and trust-building, especially in communities where access is thin. That is where the rural screening data merits attention: only 48% of rural adults reported a routine medical visit or cancer screening in the past year, compared with 56% of urban and suburban adults, and 39% of rural respondents said they were behind on screenings because they could not afford them. Hospitals cannot treat their way out of late detection. The systems that will sustain these gains will be those that make prevention easier to complete, use navigation to close gaps after abnormal findings, and bring screening closer to patients through primary care, mobile services, home-based tests, and community partnerships.

And—stories we’re following.

• The CDC raised its Ebola response to the highest level as the outbreak continued to spread late last month.
• U.S. healthcare spending spiked 7.3% to $5.7 trillion and is expected to hit $9 trillion, or 20.6% of the GDP, by 2034, according to newly published data from the Centers for Medicare & Medicaid Services (CMS).
• A new charter for the CDC’s Advisory Committee on Immunization Practices refocuses the committee’s responsibilities.
• A scheduled meeting of U.S. Preventive Services Task Force, which reviews evidence and makes recommendations about prevention, was delayed; it has not met in person since early 2025.

Plus—what we’ve been reading.

3. The real AI disruption is how quickly it’s becoming routine. Published last month in The Atlantic, this article suggests AI’s “Uber moment”—the point at which using it becomes broadly easier than not using it—is at hand for hospital operations. This comes long before most experts believe the evidence base is settled. The piece points to a recent study showing ChatGPT outperforming physicians on complex diagnostic cases, while noting that even the study’s authors cautioned against rushing AI into routine clinical practice. But the warning may already be too late. Just as rideshare services disrupted the taxi industry by becoming widely used before regulators could fully respond, AI tools are embedding themselves in healthcare workflows faster than academics and ethicists can address questions about safety and oversight. The article argues that hospitals are unlikely to pause adoption while waiting for definitive evidence, setting the stage for AI to become a de facto standard through widespread use rather than validation.
   • The Gist: When IBM’s Deep Blue defeated grandmaster Garry Kasparov at chess in 1997, it was a milestone for artificial intelligence. It marked the moment many people realized machines could outperform humans at tasks once thought to require uniquely human judgment. It appears hospitals are approaching a similar spot. A highly publicized contest is one thing, but the technology wins the day when it becomes the most convenient way to complete everyday work. Patients are already there, and the Centers for Medicare & Medicaid Services is proposing a new Medicare payment category for AI-enabled diagnostic software. Two strategic questions remain: first, is your hospital ready for AI (because the question of whether AI is ready for your hospital is already settled)? And second, are you considering AI as a means to achieve transformation, or merely as a tool to automate routine tasks?

Graphic of the Week

A key insight illustrated in infographic form.

Adults use social media for health advice but don’t fully trust it

Most U.S. adults who use social media engage with health-related content, including sharing health information, according to a study published last month in JAMA. This includes joining online health communities and sharing personal or general health information, with more than one in five adults making health decisions based on what they see online. However, many adults also doubt the accuracy of health information on social platforms. This suggests a public health problem: social media has become a major health information channel, but one built for engagement rather than reliability. This comes as healthcare organizations explore “influencer engagement” as a way to introduce credible information into spaces where patients already are, and where trust is being shaped.

This Week at Kaufman Hall

What our experts are saying about key issues in healthcare.

The Rural Health Transformation Program presents a once-in-a-generation opportunity for rural providers to redesign care delivery, improve access, and build long-term sustainability. But achieving lasting transformation will require focused action and “big bets”—and not just a series of small pilots.

A new article explores how providers can use the Rural Health Transformation Program to drive meaningful, measurable changes in the care they provide for their communities.

On Our Podcast

The Gist Healthcare Podcast—all the headlines in healthcare policy, business and more, in 10 minutes or less every other weekday morning.

The Gist Healthcare Podcast is on hiatus until mid-July. The show will return with more conversations and more healthcare business and policy news then. In the meantime, you can subscribe on Apple, Spotify, Google, or wherever podcasts are available.

You can subscribe on Apple, Spotify, Google, or wherever podcasts are available.

Thanks for reading! The Gist is on hiatus next week. We will return July 10. In the meantime, check out our Gist Weekly archive for past editions. We also have all our recent Graphics of the Week available here.

Best regards,
The Gist Weekly team at Kaufman Hall