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 22, 2025
Obamacare: Program Integrity Rule Meets Overall Expectations, Though Relative Slight Improvement; Risk Remains
Amidst the behind-the-scenes Senate debate of its draft reconciliation bill, CMS made good on its threat to jettison improper and fraudulent Obamacare enrollment, impacting ACA insurers [OSCR, CNC, ELV, MOH] and hospitals / behavioral facilities…
June 8, 2025
[HCA, THC, CYH, hospitals] White House Memo Adds Another Wrinkle to State-Directed Payment Programs in Medicaid
A new complication has arisen for hospitals [HCA, THC, CYH, ARDT, UHS, non-profit / municipally-backed facilities] – and to a lesser extent nursing homes, behavioral providers, and certain physicians – in the debate over payment…
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…
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 16, 2025
Trump Biopharma EO: Laying the Groundwork for Additional Hospital Reconciliation Targets [municipal-backed, HCA, THC, CYH, ARDT, UHS]
President Trump’s executive order (EO) on biopharma yesterday suggests the hospital sector is a larger target than administration officials have let on to date and seems to proffer more substance about additional ways to garner…
March 5, 2025
Diving Deeper on Outlook for Hospital-Targeted Medicaid Reforms [ARDT, CYH, HCA, THC, UHS, municipal-backed hospitals]
We do not see any let-up any time soon on policy-related headwinds confronting hospitals [ARDT, CYH, HCA, THC, UHS, municipal-backed systems] as Congress hunts for palatable reconciliation savings. While many of the circulated Medicaid ideas,…
January 28, 2025
[CNC, MOH, ARDT, UHS, ENSG, ADUS]: Medicaid Funding & Best Bet on OMB Funding Memo
We lean against yesterday’s OMB directive for temporarily pausing federal funding for grants, loans and programs applying largely to Medicaid’s payments to the states for Medicaid insurers (CNC, MOH, ELV, UNH, CVS) or for reimbursements…