Insights: Policy

Healthcare Extenders/Reforms (ACA eAPTCs, PBMs, HSAs, Extenders, MA, Site Neutral)

The government shutdown continues without a clear off-ramp, and we will soon reach a key inflection point regarding the ACA enhanced subsidies (the start of open enrollment on 11/1, the date by which consumers will start seeing increased prices for their existing or new policies). Republicans remain firm that the expiring eAPTCs should only be...

Russia Sanctions/Tariffs

In the wake of the U.S. and Europe increasing sanctions on Russia, there is a growing expectation in Congress that President Trump will support passage of a bill that would allow the U.S. to impose additional tariffs on countries that buy Russian energy and impose other sanctions. Senate Russia hawks want a vote on that bill within the next month...

Government Shutdown

Multiple upcoming deadlines this week (i.e., pay dates for federal workers and the military, issuance of ACA premium notices, expiration of SNAP (food stamp) spending) imply that we are at a culminating point for the government shutdown. We are seeing a modest increase in external pressure from some Democratic-aligned stakeholders (e.g., AFGE,...

House/Senate 2026 Midterms

Democrats are marginally likely (55% probability) to win the net three+ seats required for a majority in the House. The primary arguments for Democrats winning a House majority are the strong historical trend against the President’s party in midterm elections; President Trump’s low approval rating, particularly on his handling of the economy; and...

Healthcare, Macro

Government Shutdown, ACA, HSAs

There have been virtually no indications in the last couple of days that either side is feeling pressure to shift positions on the government shutdown and there are no major inflection points this week that would create an incentive for it to end. However, there are a number next week that create a notable incentive to re-open the government,...

Tech / Media / Telecom

AI/Semiconductors

While the Commerce Department recently tightened some pre-existing restrictions on chip sales to China, Trump’s more general policy has been to allow for sales of advanced chips (e.g., sales of Nvidia H20 to China and Gulf nations, comments suggesting openness to selling China the more advanced Blackwell chip.) This has generated concern among...