Healthcare Payers / Providers

Recent Obamacare developments (ACA proposal, House committee subpoenas, and OSCR’s earnings) reinforce this market’s durability and clear directional shift toward more-streamlined, lower-cost coverage and greater encouragement of enrollees to be more involved in their healthcare,…

Cigna’s (CI) proposed settlement with the FTC over antitrust allegations regarding its PBM pricing, rebating and formulary practices around insulin likely establishes the basic framework that UNH and CVS will have to match to resolve…

The recent public clash between CMS Administrator Mehmet Oz and California Governor Gavin Newsom (D-CA) over Medicare fraud has renewed questions about whether the hospice industry [CHE, BTSG, PNTG, ADUS, AVAH, UNH, private Elara Caring…

CMS’s negative surprise to Medicare Advantage (MA) insurers [HUM, UNH, ALHC, CVS, ELV, CNC] – which is also likely to spill over into weakness among insurers less or not exposed to this market [MOH, OSCR,…

While UNH’s announcement this morning that it will rebate its expected 2026 ACA profits has drawn the most attention – and may pressure other Obamacare insurers [ELV, CI, HUM, CNC, OSCR, MOH] to make similar…

The latest draft of the government spending bill, released early this morning, presents an even more manageable policy outcome for pharmacy benefit managers (PBM) [UNH, CVS, CI, CNC, ELV, HUM] than previously expected; it revives…

We expect the Medicare Payment Advisory Commission’s (MedPAC) FY/CY27 provider payment recommendations to meet the same fate as in prior years: largely ignored by Congress, though selectively cited by CMS to justify future regulatory tightening…

President Trump’s long-teased “Great Healthcare Plan”, released this morning, does little to meaningfully move the needle on healthcare redesign or cost containment beyond our prior expectations for legislative action affecting Obamacare insurers, non-ACA managed care…

Despite reports this afternoon that a bipartisan compromise on enhanced Obamacare premium subsidies will not be ready this week and is now expected to slip to the week of January 26, we continue to expect…

With the start of the new year and holdover of some key issues from 2025, 1Q26 promises various policy catalysts across the health insurer and provider landscapes, informing company growth and revenue prospects for the…