July 9, 2025
Reconciliation: Final Healthcare Provisions; Clarifying Tweaks to DPP Language and Overlooked Parts of Work Requirements
While we still agree with consensus about the negative bias towards hospitals and Medicaid insurers from the One Big Beautiful Bill Act (OBBA) signed into law last Friday, we note a few tweaks in the…
June 30, 2025
Healthcare and Reconciliation: Where Things Stand Amid Floor Debate
We expect the Senate to pass the reconciliation bill within the next 24 hours, despite the current reconciliation drama (parliamentarian rulings, CBO projection of deficits post-2034, Senator Thom Tillis’s (R-NC) retirement announcement, House member opposition,…
June 26, 2025
Hospitals, Obamacare, Medicaid: Parliamentarian Decisions Likely to Force Rewriting on Provider Tax, Uncertain about CSR and Enhanced FMAP Policies
The sizable hole left by the Senate parliamentarian decisions on various Medicaid and Obamacare provisions, which were reported this morning by Senate democrats (here and here) injects uncertainty for hospitals, Obamacare insurers, Medicaid managed care,…
June 17, 2025
Healthcare: Thoughts on the Senate Finance Draft’s Healthcare Provisions
The Senate Finance Committee’s (SFC) draft healthcare and tax portion of the reconciliation bill makes some changes, relative to the House-passed measure, but is overall consistent with that version, with the implications being lower Medicaid…
June 3, 2025
Potential Targets for Change Among Healthcare Reconciliation Policies [THC, ARDT, CNC, MOH, ELV]
As we await the Senate’s likely release of its reconciliation measure over the next week or so, we continue to expect the upper chamber to smooth the edges around some of the House-passed reconciliation bill’s…
May 16, 2025
[CNC, MOH, ELV, OSCR, ARDT, THC, ACHC]: What’s Next for Healthcare in House’s Reconciliation Proposal
As we head into this weekend, below are our latest thoughts on the healthcare components of the reconciliation bill and where things stand and what changes may be in store. This afternoon’s sidelining of the…
May 13, 2025
[ELV, CNC, MOH, UNH, CVS] CMS Managed Care Provider Tax Proposal
Yesterday’s CMS proposal confirms our suspicion that the agency would seek to tighten state provider taxes – primarily those on managed care [ELV, UNH, CNC, MOH, CVS, CI, OSCR]– used to secure sizable federal Medicaid…
May 12, 2025
Healthcare & Reconciliation: Worst Case Avoided
The House Energy & Commerce Committee’s (E&C) reconciliation draft (text and summary) seems to largely align with our expectations regarding cuts / risks in Medicaid, Obamacare, and pharmacy benefit managers (PBM). While there were still…
May 6, 2025
Optimism for Longer Term Resolution on Obamacare eAPTCs Remains but CMS Suggests Expiration [OSCR, CNC, MOH, ELV, HCA, THC]
Notwithstanding a recent CMS memo advising insurers to design their Obamacare plan bids assuming expiration of the enhanced premium subsidies at year-end, we remain optimistic that Congress ultimately settles on a middle ground (revision and…
April 29, 2025
[CNC, MOH, ELV, ARDT, UHS, CYH] Rising Risk of Medicaid Expansion Reforms in Reconciliation – Per-Capita Cap in the Lead
A week away from an anticipated House Energy and Commerce committee (E&C) hearing – and whose timing could easily slip – we do not see any release of pressure on Medicaid insurers [CNC, MOH, ELV,…