March 27, 2025
Auto and Reciprocal Tariff Update
We have the following comments about Trump’s auto tariff announcement yesterday, given that some of the guidance was unclear, and in the lead up to the reciprocal tariff announcements expected on April 2. We have…
March 26, 2025
DC Quick Takes: Reciprocal Trade, Reconciliation, Trade and the Debt Limit
As we await President Trump’s decision on auto tariffs, we see a lot going on in DC that we want to address: 1) trade; 2) reconciliation; 3) tax cuts; and 4) the debt limit. Reciprocal…
March 25, 2025
HUM, ALHC, UNH: Optimistic for Mid-Single Digit MA Rate Increase for CY26, Upcoding Remains a Longer-Term Issue
Anticipating CMS’s issuance of its final CY26 Medicare Advantage (MA) rate notice within the next two weeks (on or before Monday, April 7), we remain optimistic about near-term regulatory changes for MA insurers [HUM, ALHC,…
March 24, 2025
Capital Policy Weekly-March 24-28: Trade, Budgets, Taxes and Noms
Congress is back in session for three weeks after a weeklong recess. Focus this week will likely be on: President Trump’s tariff announcement next week on April 2. Negotiations between the House and Senate on…
March 21, 2025
EXAS, GH: Colorectal Cancer Coverage in Hand, Edits to Come?
An update to CMS’s colorectal cancer (CRC) screening National Coverage Determination (NCD) formally establishes coverage for EXAS’ Cologuard Plus ($592) and GH’s Shield ($1,495), with claims processing likely available within 30 days. While we have…
March 20, 2025
Tariffs, Tax Cuts and Deficits
We continue to believe some of President Trump’s tariffs will stay in place longer than the markets seem to expect (see below) and won’t be negotiated away in short order. We also continue to anticipate…
March 20, 2025
EW, ABT: Tricuspid Replacement Coverage Benign
We view CMS’s final coverage decision on transcatheter tricuspid valve replacement (TTVR) as an incremental positive for Edwards Lifesciences’ (EW) Evoque, in that it eliminates proposed limitations to only those with severe tricuspid regurgitation (TR)…
March 14, 2025
Oz Nomination: Moving towards Senate Confirmation, Medicare Advantage Comments Show Mixed View
Today’s Senate Finance Committee confirmation hearing of Dr. Mehmet Oz as Trump’s CMS Administrator provided limited new insights into his approach to Medicare, Medicaid, Obamacare, pharmacy benefit management reforms, health savings account adoption, and healthcare…
March 14, 2025
After Govt. Shutdown Avoided, Will Next Year’s Spending Process Look Similar?
With Senate Minority Leader Chuck Schumer (D-NY) relenting on passage of what DC is calling a “year-long” continuing resolution (CR) through Sept. 30, as we expected, we think the same scenario could play out next…
March 12, 2025
Government Shutdown Now likely?
Moments ago, Senate Majority Leader Chuck Schumer (D-NY) stated that that Republicans don’t have the 60 votes in the Senate to pass the seven-month continuing resolution (CR), which some speculate could lead to a shutdown….