On the Margins -- Mar 31: Alabama bans breast imaging cost-sharing in 2027
On the Margins
Your daily health economics & actuarial brief
Tuesday, March 31, 2026
What's happening today
| ■ | Alabama enacted Act 26-190, banning cost-sharing for diagnostic and supplemental breast imaging in state-regulated plans starting Jan. 1, 2027. |
| ■ | Infosys buys Optimum Healthcare IT for $465M. |
| ■ | FDA approves Rocket's Kresladi for severe LAD-I. |
Key Stories
Alabama bans breast imaging cost-sharing in 2027
Alabama enacted HB300, now Act 26-190, barring deductibles, copays, and coinsurance for diagnostic and supplemental breast exams in state-regulated plans starting Jan. 1, 2027. Covered services include diagnostic mammography, MRI, ultrasound, contrast-enhanced mammography, and molecular breast imaging. The fiscal note says SEHIP and PEEHIP costs could rise by an undetermined amount, depending on utilization, molecular imaging coverage, and network rules. Small mandate, predictable direction of travel on trend.
Infosys buys Optimum Healthcare IT for $465M
Infosys said it will acquire Optimum Healthcare IT for $465 million in an all-cash deal to expand its healthcare capabilities. This is a services-scale bet, not another AI press release. The deal puts real capital behind payer and provider implementation work, but the financing read-through is too indirect for a lead slot.
FDA approves Rocket's Kresladi for severe LAD-I
FDA granted accelerated approval on March 26 to Rocket's Kresladi, the first gene therapy for severe LAD-I in pediatric patients without an HLA-matched sibling donor. The decision relied on neutrophil CD18 and CD11a expression from a single-arm study and came with a Rare Pediatric Disease Priority Review Voucher. Rocket said launch is slated for Q4 2026 at a small number of specialized centers, with price still undisclosed. For now, the voucher may be easier to model than product revenue.
Significant Digit
As Medicare shifts toward outpatient care and drugs, more of the program is being financed from general revenues, not payroll taxes.
MedPAC says an amount equal to 16% of federal income taxes was used to finance Medicare Part B and Part D in 2024. That is a useful reminder that Medicare's fiscal pressure is no longer just a Hospital Insurance trust-fund story; it is increasingly a general-revenue and premium story, which means outpatient utilization, Part B drugs, and Part D policy now hit the broader federal budget faster.
Other Relevant Headlines
Payer Operations
| Centene puts $2M into Winston-Salem housing rebuild | prnewswire.com |
| ACA premium spike funnels more consumers into high-deductible plans: CMS | Healthcare Dive |
| 4 senators push CMS to tackle Medicare Advantage upcoding: Bloomberg | Becker's Payer |
| Payers' prior authorization denial rates go public: 5 notes | Becker's Payer |
Pharmacy & Drug Pricing
| CVS Caremark, BCBS overcharged federal employee health plan $615M: Audit | Becker's Payer |
ICYMI (Recent Key Stories)
- AHIP sells affordability through chronic-condition management -- AHIP is promoting chronic-disease management as a way to lower healthcare costs. (2026-03-30)
- Judge lets MA broker-kickback suit against Aetna, Humana, Elevance proceed -- A court allowed a lawsuit over alleged Medicare Advantage broker kickbacks to continue. (2026-03-27)
- KFF finds 19% in-network denial rate in 2024 HealthCare.gov plans -- KFF reported that 19% of in-network claims were denied in 2024 HealthCare.gov plans. (2026-03-26)
- CMS pairs Minnesota Medicaid fix with tougher federal fraud funding threat -- CMS tied a Minnesota Medicaid funding fix to a stricter warning over anti-fraud funding. (2026-03-25)
- Sutter's Allina acquisition creates a $26B nonprofit across three states -- Sutter's acquisition of Allina would form a $26 billion nonprofit health system in three states. (2026-03-24)
- Klomp floats automatic Medicare Advantage enrollment as policy option -- Klomp suggested automatic enrollment into Medicare Advantage as a potential policy approach. (2026-03-23)
- Providence puts its health plan on the block, or close to it -- Providence is exploring a possible sale of its health insurance business. (2026-03-20)
- NIH tells House appropriators it will spend its full-year budget -- NIH told House appropriators it plans to use its entire budget for the fiscal year. (2026-03-19)