Insights: Healthcare

Medicare Advance

CMS has released the PY27 Advance Notice for the Medicare Advantage (MA) Program (also known as the Part II proposed rule, which addresses payment issues). Under the proposal, CMS proposes to increase aggregate plan payments next year by a net 0.09% relative to PY26 levels (or +$700m over PY26).

Bipartisan leaders of the House and Senate Appropriations Committees have reached a deal setting FY26 funding for HHS and its sub-agencies, including NIH. This funding is included in the broader FY26 Labor/HHS appropriations bill. The deal largely conforms with the language approved by Senate Appropriations in June of last year. The House is...

Pharmacy Benefit Managers (PBMs)

Leadership of the House and Senate Appropriations Committees have included PBM reform provisions in their bipartisan deal on the FY26 Labor/HHS appropriations bill. The House is planning to vote on this and other appropriations bills on Thursday as part of a combined “minibus.” The Senate will likely pass the bill and send it to the President’s...

Judge Walker of the U.S. District Court for the District of Maine temporarily blocked the Health Resources and Services Administration (HRSA) from implementing its 340B Rebate Pilot Program, which would have allowed drugmakers to provide 340B-discounted drug prices using a rebate mechanism. The Trump administration subsequently requested the...

After a surge in activity last week, movement toward a bipartisan deal extending the expired ACA enhanced subsidies (eAPTCs) has stalled and begun to wane. Senate Majority Leader Thune (R-SD), while still supportive of the notion of a deal, has indicated this needs to be wrapped up by the end of January. However, bipartisan negotiations in the...

Affordable Care Act Subsidies

Legislative activity related to expired ACA enhanced subsidies (eAPTCs) continues to accelerate and is moving in a more bipartisan direction. Yesterday, the House passed – on a bipartisan 230-196 basis – a bill to retroactively extend the subsidies for three years (through 2028). This bill was the result of a rarely-used “discharge...