Insights: Policy

Medicaid, ACA, PBMs, and HSAs in Reconciliation

Senate Republicans are in intense negotiations over modifications to the Finance Committee (SFC) draft contribution to the reconciliation bill, covering Medicaid, ACA, and other provisions (e.g., HSAs, PBMs). The SFC draft, which is more aggressive than the House bill, continues to draw push back from Republicans in both the House and Senate.

The Senate yesterday passed stablecoin legislation on a 68-30 vote, with the support of 18 Democrats. The House Financial Services Committee (HFSC) has passed both a stablecoin and broader crypto market structure bill in recent weeks. The House Agriculture Committee also passed the market structure bill. HFSC Chair Hill (R-AR) has to-date...

Energy, Healthcare, Macro

Last night, the Senate Finance Committee (SFC) released its draft contribution to the reconciliation bill, covering taxes and Medicaid. Notably, the SFC draft is more aggressive than the House version of the bill in cutting Medicaid, takes a slightly more moderate approach to the House’s cuts to IRA clean energy credits, and extends the SALT cap...

NIH funding has seen some increased visibility as an issue in recent days, with the release of the White House’s formal FY26 budget proposal – which calls for cutting NIH’s funding by ~$18b (~40%) from FY25 levels – and NIH Direct Bhattacharya testifying before the Senate Appropriations Health Subcommittee regarding the President’s budget and...

Tech / Media / Telecom

Rural Broadband (BEAD)

Last Friday, the Commerce Department/NTIA announced a new process for determining how the $42.5b in funding from the BEAD rural broadband program will be distributed. The new rubric for distributing funds eliminates the Biden administration’s emphasis on fiber, as well as various other requirements (e.g., labor, availability of a low-cost plan,...

Pharmacy Benefit Managers

In recent weeks, CVS Health, Cigna’s Express Scripts, and the Pharmaceutical Care Management Association (PCMA) – the trade association representing PBMs – have filed separate federal lawsuits seeking to block implementation of a first-of-its-kind Arkansas law (Act 624) that prohibits PBMs from owning or operating pharmacies in the state.