Insights: Healthcare

Medicare Advantage (CY26 Rates)

CMS has released the CY26 Medicare Advantage (MA) Final Rule (also known as the Part II rule, which addresses payment issues). Under the rule, CMS asserts that aggregate plan payments will increase next year by a projected 5.06% or $25b over FY25.

Energy, Financials, Healthcare, Macro, Tech / Media / Telecom

Senate Republicans are this week planning to begin consideration of a joint budget resolution that will eventually get adopted by the House as well. It appears Republicans are preparing to forgo the typical process for agreeing in the context of the budget resolution on the basic parameters of how they’ll achieve spending cuts, and will wait...

Drug Pricing (IPI/MFN)

President Trump has repeatedly complained about the disparity in the price of drugs in the U.S. versus in other countries, and HHS/CMS explored international reference pricing during his first term. Dr. Mehmet Oz, Trump’s nominee to lead CMS, referenced the concept in his recent confirmation hearing. The America First Policy Institute (AFPI), a...

Energy, Financials, Healthcare, Macro, Tech / Media / Telecom

Senate Republicans continue to deliberate over the major issues associated with a single, broad-based budget resolution that allows for large-scale tax cuts and spending reductions, as was passed by the House and endorsed by President Trump (versus the narrower Senate-passed version that just focuses on border and defense spending). House...

Medicare Extenders

An offset to the -2.8% cut to Medicare Physician Fee Schedule (PFS) payments for CY25 was not included in the House-passed continuing resolution (CR), which would fund the government for the remainder of FY25 (through September)). Rep. Murphy (R-NC) – a member of the GOP Doctors Caucus and a leader on this issue – has indicated that House...

Affordable Care Act (ACA) Exchanges

HHS has issued a proposed rule entitled “ACA Individual Health Insurance Market & Exchange Program Integrity,” which includes regulatory changes that would limit access to ACA individual market plans and eligibility for premium subsidies. As constructed, HHS projects the rule would decrease enrollment by 750k to 2.1m (total) between 2026 and 2029...