Uncategorized


April 21, 2026

Being Coy on BALANCE – How Could CMS and Insurers Get to Yes [UNH, ELV, HUM, CVS, CNC, CI, MOH]

By Beth Steindecker

UnitedHealth’s (UNH) comments on its earnings call this morning, responding to a question about potential participation in CMS’s BALANCE obesity drug model, suggest that further design changes will be required for it – and likely…

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April 21, 2026

INSP: MAC Modifier Feedback Bolsters View

By John Leppard

Amid persistent investor questions on Medicare Administrative Contractor (MAC) billing / coding requirements for Inspire Medical’s (INSP) Inspire V device, we continue to believe that the MACs will ultimately instruct providers to use the -52…

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April 20, 2026

Capitol Policy Weekly: Reconciliation, Warsh, Export Controls, California Social Media in Focus

By Joe Lieber

With the House and Senate both in session this week, Washington’s focus will remain concentrated on the Iran-U.S. conflict, which heated up yesterday after the U.S. seized an Iranian ship. We have though an escalation…

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April 17, 2026

(META, GOOGL, SNAP, TikTok) California’s Bipartisan Push to Ban Under-16s from Social Media Clears First Hurdle

By Joe Lieber

We assign roughly 65% probability that California’s pending legislation, AB 1709, which is a bipartisan ban on kids under 16 years old from creating accounts on social media platforms (META, GOOGL, SNAP, TikTok) that have…

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April 15, 2026

Reconciliation 2.0: Defense and Healthcare in Focus

By Joe Lieber

Congressional Republicans seem poised to move ahead with a “skinny” $65-$75 billion reconciliation bill that, importantly for investors, does not look like it will include: The ~$200 billion in additional defense funds, in part to…

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April 13, 2026

Capitol Policy Weekly: Iran, Powell, Trade, and DHS Funding Top the Agenda as Congress Returns

By Joe Lieber

With the House and Senate back in session this week after a two-week spring break, Washington’s focus will remain concentrated on the following issues:  The U.S.-Iran conflict and likely War Powers Resolution votes in both chambers.   The path for ~$200 billion in additional defense funding, $15-$25 billion in aid for farmers,…

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April 12, 2026

Inpatient Hospitals: Slight Medicare Growth for FY27, But Future Holds Mandatory Bundles and Less Automatic Bonuses for New Tech [HCA, THC, CYH, ENSG, PACS, PNTG]

By Beth Steindecker

FY27 Medicare reimbursement proposals for inpatient hospitals [HCA, THC, CYH, ARDT, UHS, MPT, muni-backed systems] largely met expectations for a smaller increase, versus FY26, with most changes appearing formulaic and math-based rather than policy-led. Despite…

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April 10, 2026

(ASML, TOELY, NVDA) New Semiconductor Export-Control Bill, the MATCH Act, Unlikely to Become Law

By Joe Lieber

In the past week, the House and Senate have introduced bipartisan legislation known as the MATCH Act, or the Multilateral Alignment of Technology Controls on Hardware Act, which poses headline risk for ASML (ASML) and Tokyo Electron (TOELY). The legislative measure is designed to tighten U.S. export controls on semiconductor manufacturing equipment…

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April 9, 2026

Social Media Litigation and META/GOOGL Potential Valuations

By Joe Lieber

The recent social media verdicts in New Mexico and California raise the valuation question for investors about how far P/Es might fall for META (META) and (Alphabet) GOOGL assuming litigation risks continue and potentially intensifies. History’s answer is that the path isn’t linear. In different cases, it took the market time…

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April 9, 2026

Inspire Medical (INSP): More MAC Wrinkles

By John Leppard

While we view today’s update of Medicare Administrative Contractor (MAC) WPS’s billing and coding article for hypoglossal nerve stimulation (HGNS) – omitting requirements that physicians bill using a -52 (reduced work) modifier – as directionally…

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