Congress
End of Year Bill – With about one week to go before Congress goes on recess for the remainder of the term there’s still no resolution on an end of year funding bill that would keep the government open. Observers are expecting that if there are health care changes this year they’ll be included however if its still unclear what it’ll be.
PBM Divestment Bill – A bipartisan bill was released this week that would force prescription drug managers to divest from their pharmacies they own. This would include CVS, Cigna, and United to make large changes to their companies. The legislation will not be enacted this year but could be revisited next year.
New Energy and Commerce Chair – Brett Guthrie will take over the powerful E&C Committee in the House. Guthrie is on the record of wanting to amend the Drug Negotiations portions of the IRA but exempting small molecule drugs for more time after coming to market from the drug negotiation portion.
Legal Cases
- DACA – A federal judge issued a preliminary injunction around enforcing the recently finalized Biden Administration regulation that extends premium tax subsidies to DACA (dreamers) recipients. The rule is blocked in Ohio, Idaho, Nebraska, South Carolina, Kansas, Alabama, Virginia, Tennessee, Indiana, Missouri, Montana, North Dakota, South Dakota, Iowa, New Hampshire, Kentucky, Texas, Florida, and Arkansas.
- Navarro et al v. Wells Fargo – A case worth monitoring will be heard on December 17th in which former employees are suing the company over alleged mismanagement of their plans by allowing prescription drug costs to be high. The case could put more pressure on employers to reign in health care costs or choose to avoid offering plans to avoid lawsuits.
CBO
CBO released updated estimates on what effect sunsetting enhanced (ARP/IRA) subsidies will have. CBO expects that the effects of sunsetting will occur over 3 years (2026 to 2028) as some people will temporarily stay enrolled. CBO estimates an initial uninsured increase of 2.2 million in 2026 (ultimately by 2028 around 3.8 million). Finally, CBO estimates that benchmark premiums to increase 4.3% in 2026 (ultimately by 2028 around 7.9% increase).
