July put the structural machinery of healthcare on the table at once. The 340B program crossed 100 billion dollars, a state audit caught a PBM running a shell game, physician pay fell again, and advocacy fought to stay in the room while employer coverage buckled.
CMS proposed cutting 340B outpatient reimbursement from ASP plus 6 percent to ASP minus 33 percent in its 2027 OPPS rule. The bipartisan House SECURE 340B Act and Senator Cassidy’s Senate draft mark the first serious attempt to modernize the program since 1992.
The Patients First Act would tie Medicare physician reimbursement to inflation for the first time, and two Medicare Advantage bills cleared House Ways and Means 42 to 0 on electronic prior authorization and revenue disclosure.
A federal judge blocked Colorado’s Prescription Drug Affordability Board from enforcing its upper payment limit on Amgen’s Enbrel, freezing the boldest state price-cap experiment in the country.
HRSA reported that 340B purchases hit 100 billion dollars in 2025, up from 16.2 billion in 2016 and now more than 16 percent of US drug spending.
An Iowa Medicaid audit found a major PBM generated more than 100 million dollars in profit through accounting built to circumvent the state’s ban on spread pricing.
A JAMA study of more than 2 million first-time brand-drug fills found insurers rejected 32 percent of initial attempts, while ACA insurers proposed a median 14 percent premium hike for 2027.
North Carolina built a healthcare affordability commission and seated hospitals, insurers, employers, and agencies, but no patients.
Since 2000, 743 acute-care hospitals closed while hundreds opened, but the closures cluster in low-income counties.
Bristol Myers Squibb published a white paper on early patient engagement, documenting how it moved patient voice into clinical development.
Oncologists called Revolution Medicines’ daraxonrasib the biggest pancreatic cancer advance in decades.
Former LifeMD employees told STAT that providers were expected to review roughly 25 cases per hour across a base of 365,000 subscribers.
Anthropic announced it will develop its own drugs and released Claude Science aimed at biopharma R&D.
Every story this month traced back to the same structural truth. The machinery that decides whether a patient gets care operates almost entirely out of the patient’s view, and July pulled it into the light.
Originally published in The Archo Advocate Brief.
