Marketplace disenrollment, melanoma vaccine, GLP-1 and breast cancer, COVID-19 pediatric vaccines
Friday Shorts: June 12, 2026
A. Marketplace disenrollment increased dramatically in 2026
Source: Pogue, S et al Emerging State Data Paint a Bleak Picture of 2026 Marketplace Enrollment Commonwealth Fund, June 8, 2026
The Commonwealth Fund reports on early data from 6 states that track first-quarter disenrollment reports shows that many enrollees of marketplace exchange plans disenrolled in the first quarter of 2026. All states reported much higher rates of disenrollment compared to 2025, likely due to the discontinuation of enhanced subsidies. The growing number of uninsured people could lead to financial strain on some providers, and could diminish access for some services to patients regardless of insurance status. Those who are disenrolling are likely relatively healthier than those who remain enrolled, portending steeper future premium increases in the marketplace plans. This could dissuade employers that were otherwise considering moving to Individual Coverage Health Reimbursement Arrangements (ICHRA) plans.
The report highlights a national trend where enrollment in bronze plans, characterized by very high deductibles, increased from approximately 30% to 40%. Consequently, a larger portion of marketplace plan members will be underinsured, which will also increase provider financial strain.
Here’s a link to a past post on how Medicaid cuts can impact employer-sponsored health plans.
B. Over two-thirds cancer-free five years after melanoma vaccine
Research presented at the American Society of Clinical Oncology showed that after treatment with a new tailored mRNA vaccine, 68.8% of those with melanoma that had spread to lymph nodes or other organs were cancer-free five years after treatment. This compares to 49.1% of those who were treated with conventional therapy (pembrolizumab, Keytruda).
The vaccine is a set of “neoantigens” individually tailored based on the genetics of each case of melanoma to train each patient’s immune system to recognize and attack their specific tumor. It is delivered via an mRNA vaccine so that the immune system would not inactivate these manufactured neoantigens. The mRNA vaccine was administered in addition to conventional therapy, and caused no additional adverse effects beyond those seen with conventional therapy.
This vaccine will now go into broader testing, and if approved could further improve outcomes (and increase medical costs) for patients with high risk melanomas. This shows the continued value of mRNA vaccines beyond infectious disease.
C. Improved survival of women with breast cancer treated with GLP-1 medications
Source: Tatum KL, et al. Survival and Recurrence With GLP-1 Receptor Agonists in Breast Cancer. JAMA Network Open. May 11, 2026. Shaded area represents 95% confidence interval; both graphs show differences that are statistically significant.
Researchers reviewed a database of 841,831 women from 2006–2023 and identified between 1,600 and 4,000 (depending on subgroup) with newly diagnosed breast cancer who had been treated with GLP-1 or other medications for obesity or diabetes; these women were then matched to similar women who had not received such treatment. Those with two prescriptions for GLP-1 medications either before or after diagnosis were considered GLP-1 users, and they were matched based on demographics (age, gender, race, ethnicity) and social risk factors. Those treated with GLP-1 medications were 91% less likely to die and 67% less likely to have a recurrence.
This is an observational study and does not prove causality. There could have been unmeasured differences between the groups. For instance, GLP-1 users may have had better metabolic health overall, greater healthcare engagement, or lower grade tumors, all of which independently predict better cancer outcomes.
This is further evidence that GLP-1 medications could be protective against obesity-related cancers.
D. New federal analysis shows no pediatric deaths definitively caused by COVID-19 vaccinations
Source: Lin DY, et al Effects of COVID-19 vaccination and previous SARS-CoV-2 infection on omicron infection and severe outcomes in children under 12 years of age in the USA: an observational cohort study. Lancet Infect Dis. November, 2023
The former head of the Food and Drug Administration’s vaccine division claimed without supporting data in November that COVID-19 vaccinations caused the deaths of 10 children. The federal analysis of 96 reported cases of adverse effects released last month found there were no cases where deaths were ‘certain’ to be linked to vaccination; five were classified as “possible” and two as “probable” but alternative explanations couldn’t be ruled out. Most cases were linked to heart inflammation, which can also be caused by viruses including COVID-19.
Childhood death from COVID-19 has thankfully been rare. A study from North Carolina demonstrated that children under 12 who were vaccinated were far less likely to be hospitalized or die than those who were unvaccinated.