Insights: Policy

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...

IEEPA Tariffs and the Supreme Court

The Supreme Court (SCOTUS) is scheduled to issue its first opinions of the year this Friday (1/9). This will represent the first opportunity for the Court to issue their opinion in Trump v. V.O.S. Selections, the case concerning the President's imposition of tariffs under IEEPA, though there is no specific indication the IEEPA decision will come...

Elections, Macro

House/Senate Outlook, 2026/2027 Policy Implications

Indicators for the midterm election cycle have been consistently negative for Republicans over the last two months, particularly results in the November NJ and VA elections, the special election in the TN-7 House district, and more modest than expected dynamics for Republicans in the re-districting process. The macro political environment has...

Skin Substitutes

CMS’s Medicare Administrative Contractors (MACs) are withdrawing the Local Coverage Determination (LCD) for “Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers” scheduled to become effective on January 1, 2026.

ACOs (LEAD Model)

The CMS Innovation Center (CMMI) announced the Long-Term Enhanced ACO Design (LEAD) Model, the successor to the soon-to-conclude ACO REACH model.

Drug Pricing/Coverage (GLP-1s)

The CMS Innovation Center (CMMI) announced the Better Approaches to Lifestyle & Nutrition for Comprehensive Health (BALANCE) model, which will test Medicare/Medicaid coverage of GLP-1 drugs for weight loss purposes.