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 17, 2025
CMS Provider Tax Guidance: More Details, But Not Necessarily Stricter or More Aggressive Interpretation [ARDT, CYH, HCA, THC, UHS, CNC, MOH, ELV]
CMS’s preliminary guidance to states on its interpretation of the One Big Beautiful Bill’s (OBBB) Medicaid provider tax provisions does not appear to tighten the screws on states, and thereby threaten hospitals [ARDT, CYH, HCA,…
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…
November 7, 2025
Obesity Drug Pricing Deal: Devil in the Details
As outlined by the Trump administration, we view yesterday’s obesity drug pricing deal with NVO and LLY as a modest near-term positive (potentially better for LLY), with the $245 / mo. price point for Medicare…
November 5, 2025
Medicare Advantage: Still Expecting Light Regulatory Touch for CY27 [HUM, ALHC, AGL, UNH, CVS, ELV, CNC, PRVA]
Listening to recent earnings calls held by various Medicare Advantage (MA) insurers and value-based care providers [HUM, ALHC, AGL, UNH, CVS, ELV] leaves us with the following thoughts on the MA regulatory policy environment for…
October 14, 2025
[HUM] Stars Rating Litigation Likely Brings Chapter to Close
We think this morning’s court ruling against Humana (HUM) in its Medicare Advantage (MA) Stars litigation is likely the end of the road in its efforts to secure a higher score for its 2026 payment…
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 29, 2025
Medicare Advantage: CMS’ Stable Message Eclipsed by Falling Enrollment Forecast, But A Wait and See Attitude Is Appropriate
While reports over the weekend about CMS’s Friday release of the Medicare Advantage (MA) and Part D Plan (PDP) premium, deductible and other information for the 2026 plan year focused on the 2.6% projected cut…
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…
September 10, 2025
Status of Medicaid Work Requirements Among States [CNC, MOH, CYH, HCA, THC, UHS, ACHC, MMS]
Headline risk to Medicaid insurers [CNC, MOH], hospitals [CYH, HCA, THC], behavioral providers [UHS, ACHC], and Medicaid contractors [MMS] is likely to ramp up in the coming months as 15 states take affirmative steps toward…