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,…
April 21, 2025
Medicaid Provider Tax Proposal: Too Little Info to Appropriately Size Threat [UHS, ARDT, MOH, CNC, ACHC, ENSG]
Today’s Office of Management and Budget (OMB) posting that it is reviewing a proposed CMS regulation about appropriate use of Medicaid provider taxes offers too little information to appropriately size the threat to hospitals (UHS,…
April 3, 2025
Senate Budget Resolution & Healthcare Offsets
In response to yesterday’s Senate budget resolution proposal and the GOP’s assumption of the current policy baseline for scoring purposes, we think Congress continues to target Medicaid, Medicare hospital site neutrality, and PBM reforms as…
March 10, 2025
[OSCR, ELV, CNC, HCA, THC]: Targeting Obamacare Program Integrity in Rulemaking and Legislation
With all eyes focused on whether Congress will extend the enhanced ACA subsidies or let them lapse – we remain optimistic of a middle ground (revision and extension) – we caution investors about the headline…
February 23, 2025
Medicaid Reform Watch: Still Early On – What to Watch for [CNC, MOH, ARDT, CYH, ENSG, ADUS]
As the budget resolution process and subsequent reconciliation strategy unfolds, Medicaid reforms that have posed headline enrollment and payment risk to Medicaid insurers [CNC, MOH, ELV], dual eligible insurers [UNH, HUM, ELV, CVS],hospitals [ARDT, CYH,…
February 10, 2025
Sizing Medicaid Work Requirement Risks [CNC, MOH, ELV, THC, ARDT, ENS, ADUS]
As we await the House’s budget reconciliation strategy this week, the Senate FY25 budget resolution proposal released late Friday bolsters our expectations for Medicaid work requirements, which we see as one the most likely Medicaid-related…