Insights: Clients

Healthcare Extenders/Reforms (MA, Site Neutral, PBMs, Extenders)

Outside of the ACA eAPTCs, lawmakers are also intensifying their work around other unresolved healthcare issues – including, for example, Medicare/Medicaid extenders, pharmacy benefit manager (PBM) reforms, Medicare Advantage (MA) upcoding reforms, and Medicare fee-for-service (FFS) site neutral payment reforms.

Affordable Care Act (Enhanced Subsidies)

With Congress returning from August recess, lawmaker focus on the end-of-year expiration of the ACA enhanced subsidies (eAPTCs) is intensifying.

IEEPA Litigation

In a 7-4 decision, the Court of Appeals for the Federal Circuit upheld a decision from the U.S. Court of International Trade (CIT) blocking President Trump’s imposition of tariffs under the International Emergency Economic Powers Act (IEEPA). The decision (involving two cases, V.O.S. Selections v. U.S. and Oregon v. U.S.). The Federal Circuit...

As we’ve previously noted, there is some interest among Republicans in passing another reconciliation bill or two (i.e., tax/mandatory spending (entitlements) bill that can be passed on a partisan basis). They have two procedural opportunities to do so in the coming year - under the FY26 and FY27 budget resolutions.

FY26 Appropriations

Congress is in the midst of passing appropriations legislation to sustain government funding (i.e., grants/loans/programs, not entitlements) beyond its current expiration at the end of FY25 on 9/30. House Republicans are pursuing a partisan approach to cutting non-defense spending levels (by ~6% on average) and flat for defense, while the Senate...

Federal Reserve Board

Activity surrounding President Trump’s reshaping of the Fed Board significantly accelerated this week with his effort to fire Fed Board Governor Cook, his comments suggesting he will try to quickly replace her, and additional signs emerging that Republicans are moving to quickly confirm Stephen Miran, Trump’s nominee to fill the seat vacated...