November 24, 2025
ACA HIX Fix: Enactment Odds Improve But Details TBD [OSCR, CNC, ACHC, THC, CYH, UHS, DVA, HQY]
Media reports (here, here, here) indicate that an ACA compromise may be imminent, with President Trump reportedly offering to support extension of the enhanced premium tax subsidies (with limitations) while channeling a portion into health…
November 19, 2025
Finance Committee Hearing: Still Think ACA Subsidy Deal is More Likely Even If Late [OSCR, CNC, CYH, UHS, DVA, FMS, HQY, WBS]
This morning’s Senate Finance Committee hearing on rising healthcare costs did little to break the stalemate on Obamacare, but no one expected a breakthrough today. The hearing primarily served as a venue for both sides…
November 9, 2025
Obamacare HIX Fix: HSAs for All or Compromise on Subsidy Changes? We Still Think the Latter [OSCR, CNC, ELV, MOH, UNH, HQY, WBS, EHTH]
President Trump’s Truth Social posts over the weekend, along with that of other Republicans, suggest an existential threat for Obamacare insurers [OSCR, CNC, ELV, MOH, UNH] and potentially other commercial health insurers [CI, CVS] while…
October 6, 2025
Still Optimistic on Obamacare Subsidy Fix with Reforms, But Less So on Age Rating and Reinsurance [OSCR, CNC, ELV, CYH, THC, HCA, UHS, ACHC]
Nearly a week into the government shutdown, with the parties dug in, we continue to expect Congress to “fix” the enhanced Obamacare subsidy cliff, benefiting exchange insurers, hospitals, and behavioral health providers. The questions remain…
September 25, 2025
Obamacare Fix: Still Optimistic, But Not Clean or Near Term [OSCR, CNC, HCA, THC, UHS, ACHC]
We continue to be optimistic and think the odds have risen above 50% that Congress later this year reaches a compromise to “fix” the expiring enhanced Obamacare subsidies, which would further remove some of the…
August 25, 2025
Court’s Stay of CMS’s Obamacare Rule Provisions Is Clear Positive Sign But Uncertain Policy Outlook Still Suggests Messy Sign-Up [OSCR, CNC, HCA, THC, UHS, HQY]
A federal district court’s ruling Friday to stay part of CMS’s Obamacare program integrity regulation is a positive development for exchange insurers [OSCR, CNC, ELV, MOH], hospitals [HCA, THC, CYH, ARDT, MPW, municipal-backed facilities] and…
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 22, 2025
Obamacare Enhanced Subsidy Debate – Where We Stand [OSCR, CNC, ELV, THC, CYH, UHS]
While exchange insurers (OSCR, CNC, ELV) and hospitals (THC, CYH, ARDT, UHS, HCA) try to figure out their Obamacare businesses for next year with the various regulatory and reconciliation-related changes leading to anticipated enrollment declines…
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,…