Insights: Clients

Russia Tariffs and Sanctions

Earlier this week, Senate Majority Leader Thune said he will not advance Russia sanctions legislation after President Trump committed to use his existing authorities to punish Russia if it does not agree to a peace deal with Ukraine by 9/2. This is a shift in position from last week when both Thune and Speaker Johnson, with the backing of the...

Gambling Tax in OBBBA

Backlash is beginning to emerge – from stakeholder groups, voters, and some bipartisan lawmakers – regarding the constraints on gambling loss deductions included in Republican’s recently enacted reconciliation bill (OBBBA). Stakeholders, such as the American Gaming Association and the National Thoroughbred Racing Association, are ramping up an...

Criticism of Federal Reserve Chair Powell

President Trump and his team have in the last few days materially increased their criticism of Fed Chair Powell, arguing that he has waited too long to lower interest rates and that he has not properly managed renovations of the Fed’s headquarters buildings. Trump has reiterated that he does not intend to fire Powell, but the White House appears...

Pharmacy Benefit Managers (PBMs)

Though PBM reforms ended up being stripped from Republican’s recently enacted reconciliation bill (the One Big Beautiful Bill Act or OBBBA), lawmaker interest in constraining the practices of industry is not fading. In recent days, Senate Finance Chair Crapo (R-ID) indicated that a bipartisan deal to impose new regulations on PBMs would be a top...

Affordable Care Act (ACA) Subsidies

With the One Big Beautiful Bill Act (OBBBA) having been enacted into law, Republican lawmakers are shifting their focus on the remainder of the legislative agenda for 2025. And in recent days, several Republicans – including some in leadership – have signaled discussions are underway as to whether and how to address the impending expiration of...

Medicare Outpatient/ASC Reimbursement

CMS has issued the CY26 Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) proposed rule. Under the rule, CMS proposes to increase OPPS and ASC payments by an aggregate 2.4% for CY26 relative to CY25 ($b and $480m increases, respectively). That rate update is comprised of 3.2% market basket update reduced by a...