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 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…
June 3, 2025
Potential Targets for Change Among Healthcare Reconciliation Policies [THC, ARDT, CNC, MOH, ELV]
As we await the Senate’s likely release of its reconciliation measure over the next week or so, we continue to expect the upper chamber to smooth the edges around some of the House-passed reconciliation bill’s…
May 16, 2025
[CNC, MOH, ELV, OSCR, ARDT, THC, ACHC]: What’s Next for Healthcare in House’s Reconciliation Proposal
As we head into this weekend, below are our latest thoughts on the healthcare components of the reconciliation bill and where things stand and what changes may be in store. This afternoon’s sidelining of the…
May 13, 2025
[ELV, CNC, MOH, UNH, CVS] CMS Managed Care Provider Tax Proposal
Yesterday’s CMS proposal confirms our suspicion that the agency would seek to tighten state provider taxes – primarily those on managed care [ELV, UNH, CNC, MOH, CVS, CI, OSCR]– used to secure sizable federal Medicaid…
May 6, 2025
Optimism for Longer Term Resolution on Obamacare eAPTCs Remains but CMS Suggests Expiration [OSCR, CNC, MOH, ELV, HCA, THC]
Notwithstanding a recent CMS memo advising insurers to design their Obamacare plan bids assuming expiration of the enhanced premium subsidies at year-end, we remain optimistic that Congress ultimately settles on a middle ground (revision and…
April 3, 2025
Senate Budget Resolution & Healthcare Offsets
In response to yesterday’s Senate budget resolution proposal and the GOP’s assumption of the current policy baseline for scoring purposes, we think Congress continues to target Medicaid, Medicare hospital site neutrality, and PBM reforms as…
March 10, 2025
[OSCR, ELV, CNC, HCA, THC]: Targeting Obamacare Program Integrity in Rulemaking and Legislation
With all eyes focused on whether Congress will extend the enhanced ACA subsidies or let them lapse – we remain optimistic of a middle ground (revision and extension) – we caution investors about the headline…
January 22, 2025
[OSCR, CNC, HCA, THC, WELL] Optimistic on ACA Subsidies, But Watching Other Risks
While investors in insurers and providers seem most concerned about the fate of the expiring enhanced ACA subsidies, which we still expect to be revised but ultimately extended later this year, other – albeit smaller…
November 7, 2024
[OSCR, CNC, MOH, ELV] Enhanced Obamacare Exchange Subsidies – How Might They Stay?
Key Takeaways: We think investors exposed to insurers in the ACA exchange markets (OSCR, CNC, MOH, ELV) are underestimating the odds that the next Congress temporarily extends some of the enhanced Obamacare subsidies to focus…