January 21, 2026
Insurer Policy Concessions, Political Theater, & the Limits of Cost Reforms [UNH, CI, CVS, ELV]
While UNH’s announcement this morning that it will rebate its expected 2026 ACA profits has drawn the most attention – and may pressure other Obamacare insurers [ELV, CI, HUM, CNC, OSCR, MOH] to make similar…
January 20, 2026
CORRECTED: PBMs: Latest Spending Draft’s Watered-Down Reforms Are Incremental, Not Transformational [UNH, CVS, CI, CNC, ELV, HUM]
The latest draft of the government spending bill, released early this morning, presents an even more manageable policy outcome for pharmacy benefit managers (PBM) [UNH, CVS, CI, CNC, ELV, HUM] than previously expected; it revives…
January 15, 2026
Trump’s Great Healthcare Plan – We’ve Seen and Heard It Before
President Trump’s long-teased “Great Healthcare Plan”, released this morning, does little to meaningfully move the needle on healthcare redesign or cost containment beyond our prior expectations for legislative action affecting Obamacare insurers, non-ACA managed care…
November 7, 2025
Obesity Drug Pricing Deal: Devil in the Details
As outlined by the Trump administration, we view yesterday’s obesity drug pricing deal with NVO and LLY as a modest near-term positive (potentially better for LLY), with the $245 / mo. price point for Medicare…
October 17, 2025
Trump’s Fertility Push May Cut Costs, But Adoption Barriers May Remain [PGNY, Maven, Carrot, MRK.GY]
The Trump administration’s new guidance on employer-sponsored fertility benefits and deal with Merck KGaA’s (MRK.GY) EMD Serono to sell select fertility drugs at most-favored-nation (MFN) prices, which were announced Thursday, boosts visibility for companies like…
October 15, 2025
PBMs: Policy Headwinds Persist with Some New Developments [CVS, CI, UNH, ELV]
Policy headwinds facing pharmacy benefit managers (PBMs) [CVS, CI, UNH, ELV] remain entrenched despite shifting details since this spring. Recent developments, like California’s PBM law, White House drug pricing efforts, and the FTC litigation, underscore…
August 18, 2025
[CVS, CI, UNH, ELV]: CA’s PBM Reform Bill Appears Next Up in PBM Fight
With California’s legislature coming back Monday from its summer recess for its final few weeks of the regular session, pharmacy benefit manager (PBM) legislation is still on the docket and likely to invite headline risk…
August 7, 2025
Health Insurer / Provider Legislative Agenda: Band-Aid Likely in September CR, More Substantial Package Potentially Later in the Year
With the August recess in full swing for the next few weeks, the various healthcare-related legislative items on Congress’s to-do list (see below) remains lengthy for the rest of the calendar year. We are still…
July 28, 2025
CY26 Medicare Part D: Additional Spending but CMS Starting to Put on the Brakes
Today’s CMS release regarding its CY26 Medicare Part D program gives the impression the agency is focusing on stability in its drug benefit program with the goal to ensure 1) enrollees – especially those in…
June 13, 2025
PBMs: State Legislative Risks Persist Through Session Ends [CI, CVS, UNH, HUM, ELV, Navitus]
With many 2025 state legislative sessions having concluded, pharmacy benefit managers (PBMs) have – for the moment – successfully avoided various bills seeking to aggressively curb industry practices, except for a few new laws in…