Insights: Policy

Medicaid Work Requirements (OBBBA)

Democratic officials in 25 states and the District of Columbia filed suit in the U.S. District Court for the District of Massachusetts challenging CMS’s interim final rule (IFR) implementing OBBBA’s Medicaid work requirement.

USMCA, Mexico/Canada Tariffs

The U.S. informed Canada and Mexico that it does not intend to renew the USMCA trilateral free trade agreement “in its current form.” The USMCA will remain in force (as confirmed by USTR’) and the decision not to immediately renew the pact for another 16 year period means the three sides will enter into annual reviews over the next decade, which...

Affordable Care Act (ACA) Exchanges

On June 12, the U.S. District Court for the District of Maryland ruled in City of Columbus v. Kennedy, vacating eight provisions of the PY26 Marketplace Integrity & Affordability Final Rule. The court had previously stayed six of those provisions and this latest ruling sets aside the challenged provisions on the merits.

Drug Pricing/Trade

Last week, USTR launched a Section 301 tariff investigation into Germany’s drug pricing policies, arguing that the country underpays for pharmaceutical products. Almost half of Senate Republicans pushed for the investigation earlier this month. Germany said the investigation could jeopardize the U.S.-EU trade pact, which caps most tariffs at...

Medicare ESRD/Dialysis Reimbursement

CMS has issued the CY27 End-Stage Renal Disease (ESRD or dialysis) proposed rule. The proposal would increase the ESRD base rate to $299.55 and increase aggregate payments to dialysis facilities by approximately 1.1% compared to CY26.

Federal policy action surrounding data centers has continued to intensify in recent weeks. The Ratepayer Protection Act advanced unanimously out of the House Energy and Commerce (E&C) Committee’s Energy Subcommittee this week. This came on the heels of E&C Ranking Member Pallone (D-NJ) becoming the most influential Congressional Democrat to-date...