The Grand Roundup: Medicare for All's trillion-dollar trade-offs, STAT’s Commure probe, the ICHRA covered-lives boom, new rounds for Aligned Marketplace and Innovaccer, and more

Kevin and Martin open on employer health: Bloomberg is asking staff to contribute to health insurance premiums after years of covering 100%, and a new survey shows small employers fleeing the big-three PBMs for centers of excellence and advanced primary care. Then they discuss Aligned Marketplace's $20 million raise and an HRA Council survey showing ICHRA lives roughly doubled year over year.

They also talk about a Yale preprint claiming Medicare for All would save a trillion dollars a year — but nobody's grappling honestly with what that means for access and quality.

There are lots of private market updates: Pearl Health's admin cost, a STAT investigation into Commure's Athelas unit over referral deals that raise kickback questions, Main Street Health's 533% growth, and Cityblock's new Humana partnership in North Carolina.

They close with Hims & Hers earnings, where gross margin slid from 76% to 64% amid a shift to branded GLP-1s, and a managed care quarter where both the shrink-and-focus insurers and the grow-at-all-costs insurers somehow both won.

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Links referenced

• National Alliance of Healthcare Purchaser Coalitions survey: https://www.nationalalliancehealth.org/news/employers-with-claims-data-access-take-more-action-on-healthcare-costs-national-alliance-survey-finds/
• HRA Council survey on ICHRA covered lives: https://hracouncil.org/report/
• Milliman/Society of Actuaries report on DPC cost savings: https://www.soa.org/globalassets/assets/files/resources/research-report/2020/direct-primary-care-eval-model.pdf
• Yale School of Public Health preprint on Medicare for All: https://www.medrxiv.org/content/10.64898/2026.07.22.26358689v1
• STAT investigative reporting on Commure/Athelas: https://www.statnews.com/2026/08/12/inside-commure-athelas-mad-dash-automate-health-care/
• Thursday’s live Q2 public markets recap: https://luma.com/3bw3xhq3

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