March 30, 2026
Hospitals, Insurer, Home Care, HSAs, PBMs: What Is a Realistic Federal Healthcare Savings Target in Reconciliation?
As the prospects have risen for another budget reconciliation bill, so has the risk for another legislative round of healthcare spending cuts, pressuring insurers, hospitals and home care and hospice agencies as a partial pay-fors…
March 10, 2026
Medicaid Expansion Levels – Thoughts on Potential 2027 Enrollment Declines [MOH, CNC, ELV]
With Medicaid insurers [MOH, CNC, ELV] projecting more muted Medicaid enrollment changes for 2026 compared with the sizable attrition during the post-pandemic Medicaid unwinding – and little guidance on what comes next – investors are…
January 26, 2026
Medicare Advantage: CMS’s Negative Surprise of Flat Rates and Risk Adjustment Changes – What Now?
CMS’s negative surprise to Medicare Advantage (MA) insurers [HUM, UNH, ALHC, CVS, ELV, CNC] – which is also likely to spill over into weakness among insurers less or not exposed to this market [MOH, OSCR,…
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…
November 17, 2025
CMS Provider Tax Guidance: More Details, But Not Necessarily Stricter or More Aggressive Interpretation [ARDT, CYH, HCA, THC, UHS, CNC, MOH, ELV]
CMS’s preliminary guidance to states on its interpretation of the One Big Beautiful Bill’s (OBBB) Medicaid provider tax provisions does not appear to tighten the screws on states, and thereby threaten hospitals [ARDT, CYH, HCA,…
September 10, 2025
Status of Medicaid Work Requirements Among States [CNC, MOH, CYH, HCA, THC, UHS, ACHC, MMS]
Headline risk to Medicaid insurers [CNC, MOH], hospitals [CYH, HCA, THC], behavioral providers [UHS, ACHC], and Medicaid contractors [MMS] is likely to ramp up in the coming months as 15 states take affirmative steps toward…
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…