Insights: Policy

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

Election Update (House/Senate Results, Policy Implications for Lame Duck Session, 2027-28)

As of this evening, Democrats are on track to gain a net seven Senate seats, giving them a strong 54-46 seat majority next year. This is beyond the most aggressive expectations of leading race handicappers such as the Cook Political Report. Democrats have won a net 29 House seats so far, giving them a majority. Over 100 races have yet to be...

Healthcare, Macro

Reconciliation – Debt Limit, Defense, Farmers, Medicaid

There is some contemplation on the part of Republicans of enacting a partisan reconciliation bill in the post-election lame duck session in order to provide supplemental funding for the Iran war and other purposes. Prior to leaving for their summer recess, House Republicans passed a budget resolution, which provides a framework for what would...

Medicare ESRD/Dialysis Reimbursement

CMS issued the CY27 ESRD/dialysis final rule. CMS projects a 2.7% aggregate payment increase versus CY26, up from the proposed 1.1% (although the final base rate of $297.52 is below the proposed $299.55).

Peptides (FDA, Compounding)

HHS announced a draft interim policy under which FDA would exercise enforcement discretion for 503A compounding of six unapproved peptides: BPC-157, KPV, TB-500, MOTS-c, Semax, and Epitalon. The policy establishes conditions for ingredient sourcing, testing, patient-specific prescriptions, and safety reporting while FDA considers adding the...

Medicaid (OBBBA Work Requirements)

Judge Stearns of the Federal District Court of Massachusetts struck down CMS’s additional impairment test for Medicaid’s medical-frailty exemption. The court also barred federal penalties against the plaintiff states for implementation errors or delays for six months from the order, through April 29, 2027. The underlying work requirement and...

Balance Billing (IDREs)

A series of recent CMS and congressional actions points to increasing scrutiny of the independent dispute resolution entities (IDREs) that arbitrate payment disputes under the No Surprises Act (NSA).