Insights | Meridian Research Group | Page 5

The U.S. and China agreed to a one-year trade truce in which the U.S. will reduce fentanyl tariffs by 10% and ease export controls while China will buy U.S. agricultural goods and ease rare earth export controls, among other promised trade-offs. The deal does not address increased sales to China of advanced semiconductor chips, nor the U.S....

Pharmacy Benefit Managers (PBMs, Cigna)

Cigna announced that its PBM, Express Scripts (under the Evernorth division), will shift to a rebate-free model in the commercial/employer-sponsored market. Under this model, discounts on drugs will be passed through upfront to beneficiaries at the pharmacy counter instead of relying on post-purchase rebates. This change will begin with fully...

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,...

Mergers & Acquisitions

Thoma Bravo (Calabrio)/Verint

The companies refiled HSR on 10/22. The HSR waiting period now expires November 21. While we acknowledge meaningful second-request risk, our expectation is that the deal will avoid such an outcome. The global WEM market for contact centers appears fairly consolidated–on a revenue basis, three firms hold as much as 75% of the market (dropping to...