On the Hill
Senate and House Republicans continue to discuss what should be included in the reconciliation bill. According to several outlets the House would like to pass a singular reconciliation bill that includes immigration and tax issues in April. From a health policy perspective, the key question is if there will be cuts to health programs to offset tax cuts. There have been two developments this week
- House Speaker John announced that cuts to Social Security and Medicare would not be included in the reconciliation package.
- However several outlets reported that House Republicans were actively considering per capita caps to Medicaid spending. Such a policy would result (and be designed) to reduce Medicaid spending over time. During the 2018 ACA repeal attempt per capita caps were considered. CBO scored some of those proposal as a reducing federal Medicaid spending by $588 to $893 billion over 9 years.
ACA Enrollment
CMS reported that so far ACA Open Enrollment had already hit a record high number. Over 23.6 million consumers have selected a plan so far. West Virginia, Rhode Island, Michigan, and Alabama had some of the largest enrollment increases year over year so far. New York has had one of the largest decreases (although this is due to the policy change as a result of New York’s 1332 waiver).
2025 Trends to Watch
- One question is whether the incoming Administration will impose large tariffs on medical devices or other medical related items. Modern Healthcare reported that the potential for large tariffs on Medical devices could have significant price effects since 75% of medical devices marketed in the US are manufactured outside of the US.
- ICHRA – Centene recently announced a President of ICHRA. There is some consideration within the industry that ICHRA will potentially accelerate in 2025 (and beyond), especially if there are regulatory changes.
