Inside TRS-ActiveCare: Subsidy, Erosion, and Deferred Deficits
TRS-ActiveCare: What the February 12, 2026 Board Materials Actually RevealOn February 12, 2026, the Texas Retirement System (TRS) presented its annual health benefits update to the TRS Board. Beginning on page 141 of the February board book, TRS leadership walked through the financial condition, cost structure, and ...
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Why Loss Ratios Have Been Lying to Employers
The End of Rebate Sorcery: Why Point-of-Sale Rebates Change Everything for EmployersA policy brief on pharmacy rebates, employer leverage, and the FTC’s recent intervention into PBM economics.Executive ContextIn February 2026, the Federal Trade Commission issued a Decision and Order against Express Scripts, ...
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Rerouting The Battlefield
Rerouting The BattlefieldWhen Texas passed House Bill 711, commonly dubbed the "Tier & Steer Bill", the reaction in parts of the benefits world was predictable. In all honesty, most probably ignored it. But some hailed it as a long-overdue check on hospital power. Others quietly hoped it would finally loosen the ...
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Visibility Isn’t Reform. Execution Is.
Visibility Isn’t Reform. Execution Is.Healthcare is experiencing a surge of transparency. Prices are published, machine-readable files are released, data is scraped, mined, indexed, and sold. On paper, it looks like progress.But it isn’t.......at least not yet.Transparency makes everything uncomfortable, ...
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How a Stable Health Plan Became a Shock Event
AISD: What Happened To The Health PlanOver the past few years, employees in many public-sector health plans, as well as private plans, have been told a familiar story: healthcare costs are rising, prescription drug costs are rising, nothing can be done, and difficult changes were unavoidable.But sometimes these ...
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If Doctors Were Angels: What James Madison Would Say About Prior Authorization
Josh Butler - President Butler Benefits & High Plains Health PlanIn Federalist No. 51, James Madison famously wrote:"If men were angels, no government would be necessary. If angels were to govern men, neither external nor internal controls on government would be necessary."Of course, he was speaking about the ...
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What Lies Beneath: Discovering Treasure
What Lies Beneath: Discovering TreasureDeeper and deeper into the water the diver went. Down past a goldfish, some aquatic vegetation, straight down to the sandy bottom. The diver knew treasure was near, as he plunged his hands into the sand. And he was right! There they were, dozens of them, ...
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